Ethical Dimensions of Geriatric Care: Value Conflicts for the 21st Century

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S.F. Spicker, S.R. Ingman, Ian Lawson
Springer Science & Business Media, Oct 31, 1987 - Medical - 336 pages
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.
 

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Contents

Aging and Dependency in the 21st Century
3
Commentary on Jacob A Brodys Essay
23
Changing Images of Dependency in Prolongevity
29
An Evolutionary Perspective on Senescence
45
Efficiency and Equity
67
National Policies vs Individual Choice
79
Commentary on Baruch Brodys Essay
95
The Rights of Passage
105
The Ethics and Economics of Suicide in Old Age
161
Comments on the Essays of Dubler Battin Kataja and Gavin
191
A Prudential Account
197
CrossNational Perspective on Distributive Justice
223
The Bad the Ugly and the Unfortunate
263
Obstacles to a Prosthetic Society
273
NOTES ON CONTRIBUTORS
291
INDEX
293

Case Studies in Geriatric Care
129
Legal Rights and Responsibilities in Agent Custody
137

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Page 289 - These trends can be summed up as the inverse care law: that the availability of good medical care tends to vary inversely with the need of the population served.

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