Hostname: page-component-cd9895bd7-p9bg8 Total loading time: 0 Render date: 2024-12-22T23:46:19.542Z Has data issue: false hasContentIssue false

The Ethical Challenge of Providing Healthcare for the Elderly

Published online by Cambridge University Press:  29 July 2009

David C. Thomasma
Affiliation:
The Fr. Michael I. English, S. J. Professor of Medical Ethics, and Director of the Medical Humanities Program at Loyola University Chicago Medical Center and the Director of the International Bioethics Institute, Chicago

Extract

Populations around the world are aging at a very fast rate, so much so that care for the elderly will soon rupture even the most carefully planned, enlightened care provisions societies can offer. The demographics in advanced countries demonstrate this dilemma, even without projections based on antiaging medications that may be possible in the near future, and a healthier lifestyle that has preoccupied the yuppies for about 10 years.

Type
Special Section: Elder Ethics
Copyright
Copyright © Cambridge University Press 1995

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Notes

1. Deets, HB. Aging: A worldwide challenge. Modern Maturity 1993 1011.:2Google Scholar

2. Thomasma, DC. Setting floating limits: Functional status care categories as national policy. Business and Professional Ethics Journal 1990;9(3,4): 133–46.CrossRefGoogle ScholarPubMed

3. Hirsley, M, Elsasser, G. Cardinal urges health reform without abortion. Chicago Tribune 1994 05 27;sect 1:4. Bernardin is opposed to “the ethically unacceptable withholding of care based on ‘quality of life’ criteria.”Google Scholar

4. [Anonymous], Medicaid costs zoom with new signups. Chicago Tribune 1993 03 18;sect 1:26.Google Scholar

5. Millenson, M. UAW warning: Fix health care or risk strikes. Chicago Tribune 1993 03 23;sect 1:13.Google Scholar

6. Consumer's Report, 1993 Sept.Google Scholar

7. Allcorn, S. A new direction for health care delivery in the United States. Health Care Strategic Management 1986; 12: 25—8.Google Scholar

8. Mechanic, D. The design of medical care organizations and responsiveness to patients. In: The Growth of Bureaucratic Medicine. New York: Wiley, 1976:99118.Google Scholar

9. Milio, N. The Care of Health in Communities. New York: MacMillan, 1975:166–87.Google Scholar

10. Keats, AW. Should young subsidize elders’ care? Chicago Tribune 1994 May 31;sect 1:6.Google Scholar

11. [Anonymous]. Second opinion: Health economist Uwe E. Reinhardt discusses the right to health care, managed competition, and reform. Pulse: The Health Care Reform Newsletter 1993;1(1):67.Google Scholar

12. [Anonymous]. Aged go hungry as public funds dry up. Chicago Tribune 1993 March 23;sect 1:3.Google Scholar

13. Eckholm, E. Introduction. In: The White House Domestic Policy Council. The President's Health Security Plan. New York: Times Books, 1993:xvi.Google Scholar

14. [Anonymous].Reform will come slowly, look like managed competition. Pulse: The Health Care Reform Newsletter 1993; 1(1):16.Google Scholar

15. Gesensway, D. Managed competition: A better system or a wedge between doctors and patients? ACP Observer 1993;13(1):1, 15.Google Scholar

16. [Anonymous]. Prudential programs experiment with quality and reimbursement. Report on Medical Guidelines & Outcomes Research 1993;4,6:12, 12.Google Scholar

17. ACP Viewpoint. ACP carefully reviewing managed competition. ACP Observer 1993;13(1):15.Google Scholar

18. Buxbaum, R. German physicians’ prescribing practices lead to calls for reform. ACP Observer 1993;13(1):5.Google Scholar

19. Fix, JL. Pfizer offers free medicine to uninsured. USA Today 1993 08 16;B:1.Google Scholar

20. Miles, S. Public policy update – Hillary's health care task force. Newsletter of the Center for Biomedical Ethics (University of Minnesota), 1993;Summer:1.Google Scholar

21. Callahan, D. What Kind of Life? New York: Simon & Schuster, 1990.Google Scholar

22. Neus, E. Delay in care aggravates health woes of uninsured. Chicago Sun-Times 1992 Sept 21:17.Google Scholar

23. Pellegrino, ED, Thomasma, DC. The Virtues in Medical Practice. New York: Oxford University Press, 1993.Google Scholar

24. Aristotle, , Nicomachean Ethics Vols 1–7, 1129a11135a14.Google Scholar

25. See note 24, Aristotle, . VIII–IX, 1155a11172a15.Google Scholar

26. Aquinas, Thomas, Summa Theologiae, II–II, pp. 5780.Google Scholar

27. Aquinas, St. Thomas. Exp. in Job, c. 11, lect. 1; Parm., XIV, 49;Google Scholar Cf. Bourke, V. Foundations of justice. Proceedings of the American Catholic Philosophical Association 1962;36:1928.CrossRefGoogle Scholar

28. Pellegrino, ED, Thomasma, DC. For the Patient's Good: The Restoration of Beneficence in Health Care. New York: Oxford University Press, 1988.Google Scholar

29. Drane, J. Becoming a Good Doctor: The Place of Virtue and Character in Medical Ethics. Kansas City, MO: Sheed & Ward and the Catholic Health Association, 1988:106.Google Scholar

30. Calabresi, D, Bobbitt, P. Tragic Choices: The Conflicts Society Confronts in the Allocation of Tragically Scarce Resources. New York: W.W. Norton & Co., 1978:150xs.Google Scholar

31. Rawls, J. A Theory of Justice. Cambridge, MA: Belknap Press of Harvard University Press, 1971.Google Scholar

32. Callahan, D. Setting Limits. New York: Simon & Schuster, 1987.Google Scholar

33. Sheldon, JH. British Medical Journal 1950;1:319.CrossRefGoogle Scholar

34. Binstock, RH, Post, SG, Eds. Too Old for Health Care? Controversies in Medicine, Law, Economics and Ethics. Baltimore, MD: Johns Hopkins University Press, 1991.Google Scholar

35. Thomasma, DC. Functional status care categories and national health policy. Journal of the American Geriatric Society 1993;41(4):437–43.CrossRefGoogle ScholarPubMed

36. Thomasma, DC. Quality of life as a moral category of the elderly (Japanese translation). In: International Symposium on Elderly Care: Quality of Life of the Elderly. Tokyo: Sasakawa Foundation, 1993:2331.Google Scholar

37. Beauchamp, T, Childress, J. Principles of Biomedical Ethics. 3d ed.New York: Oxford University Press, 1994.Google Scholar

38. Braithwaite, S, Thomasma, D. Protherapeutic authoritarianism. In: Monagle, J, Thomasma, DC, Eds. Medical Ethics: A Guide for Health Professionals. Rockville, MD: Aspen Publishers, 1988:327–34.Google Scholar

39. Pearlman, R, Inui, T, Carter, W. Variability in physician bioethical decision-making: A case study of euthanasia. Annals of Internal Medicine 1982;97:420.CrossRefGoogle ScholarPubMed

40. Crane, D. The Sanctity of Social Life: Physicians’ Treatment of Critically III Patients. New York: Russell Sage Foundation, 1975.Google Scholar

41. Brown, N, Thompson, D. Nontreatment of fever in extended care facilities. New England Journal of Medicine 1979;300:1246.CrossRefGoogle ScholarPubMed

42. Hilman, H. Editorial: After resuscitation–what? Resuscitation 19;4:73–6.CrossRefGoogle Scholar

43. Nolan, K. In death's shadow: The meanings of withholding resuscitation. Hastings Center Report 1987;17(10):914.CrossRefGoogle ScholarPubMed

44. Toulmin, S. The tyranny of principles. Hastings Center Report 1981;11:31–9.CrossRefGoogle Scholar

45. Veatch, R. Should basic care get priority? Doubts about the Oregon way. Kennedy Institute of Ethics Journal 1991;1(3):187203.CrossRefGoogle ScholarPubMed

46. Caplan, A. If I Were A Rich Man, Could I Buy a Pancreas? Bloomington, IN: Indiana University Press, 1992.Google Scholar

47. Caplan, A, Priester, R. For better or for worse? The moral and policy lessons of Minnesota's HealthRight legislation. Kennedy Institute of Ethics Journal 1992;2(3):201–17.CrossRefGoogle ScholarPubMed

48. [Anonymous]. HHS approves Oregon medicaid plan – with some strings attached. Report on Medical Guidelines & Outcomes Research 1993;4,6:5.Google Scholar

49. See note 48. Anonymous. 1993;4,6:5.Google Scholar

50. See note 48. Anonymous. 1993;4,6:5.Google Scholar

51. Kimball, MC. In the debate over health care reform, physicians are key players — and targets. American College of Physicians Observer 1993;13(2):1.Google Scholar