Full Description
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.
Contents
Section I : Understanding the Biology and Epidemiology of Aging.- The Best of Times — The Worst of Times: Aging and Dependency in the 21st Century.- Commentary on Jacob A. Brody's Essay.- Changing Images of Dependency in Prolongevity.- An Evolutionary Perspective on Senescence.- Section II: Philosophical Reflections on Medical Care Provision for the Aged.- Health Care: Efficiency and Equity.- Wholehearted and Halfhearted Care: National Policies vs. Individual Choice.- Commentary on Baruch Brody's Essay.- Revival, Resuscitation, and Resurrection: The Rights of Passage.- Section III: Self-Determination in Late-Life Dependency.- Self-Determination in Later Life: Case Studies in Geriatric Care.- The Dependent Elderly: Legal Rights and Responsibilities in Agent Custody.- Choosing the Time to Die: The Ethics and Economics of Suicide in Old Age.- Elderly Dependency and Autonomy: Comments on the Essays of Dubler, Battin, Kataja and Gavin.- Section IV: Justice in the Provision of Medical Care for the Aged.- Equal Opportunity, Justice, and Health Care for the Elderly: A Prudential Account.- ESRD and the Elderly: Cross-National Perspective on Distributive Justice.- The Bad, the Ugly, and the Unfortunate.- Epilogue: The Eighth Stage of Humanity.- Elderly Dependency and Systems Failure: Obstacles to a Prosthetic Society.- Notes on Contributors.
