Dependence and Autonomy in Old Age: An Ethical Framework for Long-term Care

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Cambridge University Press, Aug 7, 2003 - Law - 207 pages
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In this influential book, George Agich abandons comfortable abstractions to reveal the concrete threats to personal autonomy in long-term care, where ethical conflict, dilemma and tragedy are inescapable. His book therefore offers a framework for carers to develop an ethic of long-term care within the complex environment in which many dependent and aged people find themselves. Previously published as Autonomy and Long-term Care, this revised edition, in paperback for the first time, will have wide appeal among bioethicists and health care professionals.
  

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Contents

Introduction
1
Longterm care images
2
Autonomy
6
the problem
8
The liberal theory of autonomy
13
Pluralism toleration and neutrality
14
The state and positive autonomy
21
Some problems with positive autonomy
22
Resultoriented theories
84
Actionoriented theories
85
The concrete view of persons
89
a developmental perspective
93
Narrative approaches
98
Dependence in human development
101
Sickness as dependence
104
Autonomy and identification
108

Liberal principles in longterm care
24
The perils of liberal theory
29
Communitarianism and the contextualist alternative
31
Practical implications of the debate over the foundation of ethics
35
Conflict and conversation
37
The function of rights
39
Limitations of rights
41
Paternalism and the development of persons
43
From paternalism to parentalism
47
Summary
50
Longterm care myth and reality
51
Myths of old age
52
Nursing homes
56
Therapeutic relationships
65
Concepts of illness and disease
69
Models of care
71
The concept of a practice
74
Home care
77
Summary
81
Actual autonomy
83
The paradox of development and problems of identification
112
Implications for longterm care
117
Summary
123
A phenomenological view of actual autonomy
125
General features of the social nature of persons
129
Space
136
Time
143
Communication
152
Affectivity
159
Summary
163
Autonomy and longterm care another look
165
Appeal to autonomy as independence
167
A phenomenologically informed analysis
168
Theories of autonomy
174
Final thoughts
177
References
181
Further reading
198
Index
203
Copyright

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About the author (2003)

George Agich is Chairman of the Department of Bioethics at the Cleveland Clinic Foundation, Professor of Clinical Medicine at Ohio State University and Adjunct Professor of Philosophy at Bowling Green State University. His previous books are Responsibility in Health Care (1982), and The Price of Health (1986), and he is a member of the editorial board of The American Journal of Bioethics and other journals.

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