Ethical Dimensions of Geriatric Care

1. Front Matter

   Pages i-xxxiii

   PDF

2. Understanding the Biology and Epidemiology of Aging

   1. Front Matter

      Pages 1-1

      PDF

   2. The Best of Times/The Worst of Times: Aging and Dependency in the 21st Century

      • Jacob A. Brody

      Pages 3-21

   3. Commentary on Jacob A. Brody’s Essay

      • Tom Beauchamp

      Pages 23-27

   4. Changing Images of Dependency in Prolongevity

      • Albert Rosenfeld

      Pages 29-44

   5. An Evolutionary Perspective on Senescence

      • Randolph Martin Nesse

      Pages 45-64

3. Philosophical Reflections on Medical Care Provision for the Aged

   1. Front Matter

      Pages 65-65

      PDF

   2. Health Care: Efficiency and Equity

      • Daniel M. Hausman

      Pages 67-78

   3. Wholehearted and Halfhearted Care: National Policies vs. Individual Choice

      • Baruch Brody

      Pages 79-93

   4. Commentary on Baruch Brody’s Essay

      • Thomas Halper

      Pages 95-103

   5. Revival, Resuscitation, and Resurrection: The Rights of Passage

      • Teo Forcht Dagi

      Pages 105-126

4. Self-Determination in Late-Life Dependency

   1. Front Matter

      Pages 127-127

      PDF

   2. Self-Determination in Later Life: Case Studies in Geriatric Care

      • Molly Rees Gavin, Gayle Kataja

      Pages 129-136

   3. The Dependent Elderly: Legal Rights and Responsibilities in Agent Custody

      • Nancy Neveloff Dubler

      Pages 137-159

   4. Choosing the Time to Die: The Ethics and Economics of Suicide in Old Age

      • Margaret P. Battin

      Pages 161-189

   5. Elderly Dependency and Autonomy: Comments on the Essays of Dubler, Battin, Kataja and Gavin

      • Joseph M. Healey

      Pages 191-194

5. Justice in the Provision of Medical Care for the Aged

   1. Front Matter

      Pages 195-195

      PDF

   2. Equal Opportunity, Justice, and Health Care for the Elderly: A Prudential Account

      • Norman Daniels

      Pages 197-221

   3. ESRD and the Elderly: Cross-National Perspective on Distributive Justice

      • Stanley R. Ingman, Derek Gill, James Campbell

      Pages 223-262

   4. The Bad, the Ugly, and the Unfortunate

      • H. Tristram Engelhardt Jr.

      Pages 263-270

There is both a timeliness and a transcendent 'rightness' in the fact that scholars, clinicians, and health professionals are beginning to examine the ethics-based components of decision making in health care of the elderly. Ethics - as the discipline concerned with right or wrong conduct and moral duty - pervades hospital rooms, nursing home corridors, physicians' offices, and the halls of Congress as decisions are made that concern the allocation of health-related services to individuals and groups in need. In particular, care of older persons recently has received dispropor­ tionate attention in discussions of ethics and clinical care. Age alone, of course, should not generate special focus on ill individuals about whom concerns arise based on value conflicts tacitly involved in the delivery of health care. Having said that age is not the principal criterion for attention to ethics-based concerns in health care, it must be acknowl­ edged that old people have a high prevalence of conditions that provoke interest and put them in harm's way if value conflicts are not identified and seriously addressed. Issues that concern autonomy, the allocation of scarce resources, inter-generational competition and conflict, the withholding of treat­ ment in treatable disease, and substitute and proxy decision making for the cognitively impaired all have special relevance for older persons.

• aging
• autonomy
• ethics
• geriatrics
• senescence

`This volume should be read by academicians and clinicians alike who work in health and aging.'
Carroll L. Estes, University of California (May 1987)
`This is an important work that focuses on the challenging ethical decisions involved in the care and treatment of the elderly.'
Philip R. Lee, University of California (June 1987)

• Division of Humanistic Studies in Medicine, School of Medicine, University of Connecticut Health Center, Farmington, USA

  Stuart F. Spicker

• Department of Family and Community Medicine, University of Missouri at Columbia, Columbia, USA

  Stanley R. Ingman

• School of Medicine, University of Connecticut Health Center, Farmington, USA

  Ian R. Lawson

Policies and ethics