When is the worst time to lose one’s life?
This is an uncomfortable question for many, but one to which – if we are to evaluate deaths in the field of global health – we need a plausible answer. Unlike surveys of what constitutes a good or poor quality of life and how to evaluate this, there are, to my knowledge, no reliable surveys of people’s reflections on when the worst time is to lose one’s life. However, the standard evaluative practice today is as follows: Prenatal deaths are ignored, while deaths immediately after birth are evaluated as the worst possible deaths. There are reasons to question this practice.
Many of us have a strong intuition that death most often entails something negative, but why this is the case is not a given.
There are at least two key factors: One is the size of the future one loses, and the other is the degree to which the individual is relevantly connected with this future. Undoubtedly, fetuses lose a great future by dying after 28 weeks of gestation (i.e. stillbirths), but they are not necessarily connected to this future in any relevant sense. The same goes for neonates. In my PhD, I argue that especially young children have much of both factors. I could imagine that death is worst somewhere in childhood, but not necessarily right after birth. There is more to be said on the matter, and I hope that more people dare to partake in this discussion in the future, especially considering how deaths are already evaluated in the field of global health today.