Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-22T13:12:12.814Z Has data issue: false hasContentIssue false
  • English
  • Français

Moral Discourse and Public Policy in Aging: Framing Problems, Seeking Solutions, and “Public Ethics”*

Published online by Cambridge University Press:  29 November 2010

Phillip G. Clark
Phillip G. Clark
Affiliation:
The University of Rhode Island
Get access Rights & Permissions [Opens in a new window]

Résumé

Des approches humanistes sont essentielles pour explorer les principales politiques touchant la gérontologie et la gériatrie. Cet article décrit comment l'approche de « l'éthique publique, » c'est-à-dire l'examen des principales valeurs sous-tendant et orientant le procédé d'élaboration des politiques publiques, peut nous faire davantage comprendre les politiques ayant trait au vieillissement. Pour illustrer cette analyse, des exemples tirés d'une étude comparative entre le Canada et les États-Unis sont fournis. Parmi les éléments analysés, on trouve d'abord les principales valeurs sociales formant la toile de fond de cette étude, particulièrement l'opposition entre l'individualisme et le collectivisme. Ensuite, la définition et la résolution des problèmes reposent à la fois sur les faits et les valeurs. Elles impliquent une discussion sur les facteurs sociaux intervenant dans la « crise » du vieillissement, notamment la polarisation des gens en groupes d'âge et la rationalisation des ressources destinées aux soins de la santé. Finalement, la nature du débat public et du discours moral, en qualité de procédé guidant l'élaboration de politiques publiques, est étudiée, et les répercussions quant à l'importance des valeurs dans l'élaboration de nouvelles politiques à venir sont également considérées. Le procédé d'élaboration des politiques publiques, notamment la manière dont il relève les défis associés à une population vieillissante, en dit long sur la cohésion et l'intégrité sous-jacentes de notre société et sur le degré d'humanisme que l'on trouve au sein des principales politiques et institutions sociales.

Keywords

ValuesPublic PolicyHealth CareComparative Gerontology.Valeurspolitique publiquesoins de santégérontologie comparative.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 12 , Issue 4: The Humanities in Gerontology Numéro spécial: Les sciences humaines en gérontologie , Winter/hiver 1993 , pp. 485 - 508
Copyright
Copyright © Canadian Association on Gerontology 1993

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

Aaron, H.J., & Schwartz, W.B. (1984). The painful prescription: Rationing hospital care. Washington, DC: The Brookings Institution.Google Scholar
Agich, G.J. (1990). Reassessing autonomy in long-term care. Hastings Center Report, 20(6), 12–31.CrossRefGoogle ScholarPubMed
Aronson, J. (1992a). Are we really listening? Beyond the official discourse on needs of old people. Canadian Social Work Review, 9(1), 73–87.Google Scholar
Aronson, J. (1992b, November). Giving consumers a say in policy development: Influencing policy or just being heard? Paper presented in the Health and Society Seminar Series, McMaster University, Hamilton, ON.Google Scholar
Aronson, J. (in press). Public consultation on long term care reform: Old people having a say? Women and Environments.Google Scholar
Auerbach, L., & Gerber, A. (1976). Implications of the changing age structure of the Canadian population (Science Council of Canada Pub. No. SS21–3/2–1976). Ottawa, ON: Minister of Supply and Services.Google Scholar
Avorn, J. (1982, May). Should there be an age-relevant clinical policy? Paper presented at a meeting of the Harvard-Hastings Project on Ethics and the Care of the Elderly, Cambridge, MA.Google Scholar
Avorn, J. (1984). Benefit and cost analysis in geriatric care: Turning age discrimination into health policy. New England Journal of Medicine, 310, 1294–1301.CrossRefGoogle ScholarPubMed
Avorn, J., & Langer, E. (1982). Induced disability in nursing home patients: A controlled trial. Journal of the American Geriatrics Society, 30, 397–400.CrossRefGoogle ScholarPubMed
Bankowski, Z., & Gutteridge, F. (1987, June). Health, ethics, and human values. World Health, pp. 9–11.Google Scholar
Barer, M.L., Evans, R.B., Hertzman, C., & Lomas, J. (1987). Aging and health care utilization: New evidence on old fallacies. Social Science and Medicine, 24, 851–862.CrossRefGoogle ScholarPubMed
Barondess, J.A., Kalb, P., Weil, W.B., Cassel, C., & Ginzberg, E. (1988). Clinical decision-making in catastrophic situations: The relevance of age. Journal of the American Geriatrics Society, 36, 919–937.CrossRefGoogle ScholarPubMed
Bellah, R.N., Madsen, R., Sullivan, W.M., Swidler, A., & Tipton, S.M. (1985). Habits of the heart: Individualism and commitment in American life. Berkeley: University of California Press.Google Scholar
Binney, E.A., & Estes, C.L. (1988). The retreat of the state and its transfer of responsibility: The intergenerational war. International Journal of Health Services, 18, 83–96.CrossRefGoogle ScholarPubMed
Binstock, R.H. (1983). The aged as scapegoat. The Gerontologist, 23, 136–143.CrossRefGoogle ScholarPubMed
Binstock, R.H., & Kahana, J. (1988). [Review of Setting limits: Medical goals in an aging society]. The Gerontologist, 28, 424–426.CrossRefGoogle Scholar
Binstock, R.H., & Post, S.G. (1991). Old age and the rationing of health care. In Binstock, R.H. & Post, S.G. (Eds.), Too old for health care? Controversies in medicine, law, economics, and ethics (pp. 1–12). Baltimore, MD: The Johns Hopkins University Press.Google Scholar
Bouvier, L.F., & DeVita, C.J. (1991). The baby boom-Entering midlife. The Population Bulletin, 46(3), 2–33.Google Scholar
Brock, D.W. (1989). Justice, health care, and the elderly. Philosophy and Public Affairs, 18, 297–312.Google ScholarPubMed
Brym, R.J., & Fox, B.J. (1989). From culture to power: The sociology of English Canada, Toronto: Oxford University Press.Google Scholar
Callahan, D. (1987). Setting limits: Medical goals in an aging society. New York: Simon and Schuster.Google Scholar
Callahan, D. (1989). Rationing health care: Will it be necessary? Can it be done without age or disability discrimination? Issues in Law and Medicine, 5, 353–366.Google Scholar
Callahan, D. (1990a). Can old age be given a public meaning? Second Opinion, 15, 12–23.Google Scholar
Callahan, D. (1990b). Rationing medical progress: The way to affordable health care. New England Journal of Medicine, 322, 1810–1813.CrossRefGoogle ScholarPubMed
Callahan, D. (1990c). What kind of life. New York: Simon and Schuster.Google Scholar
Canadian Medical Association. (1984a). Health: A need for redirection (Report of the Task Force on the Allocation of Health Care Resources). Ottawa, ON: Author.Google Scholar
Canadian Medical Association. (1984b). Investigation of the impact of demographic change on the health care system in Canada (Report of the Task Force on the Allocation of Health Care Resources, prepared by Woods Gordon Management Consultants). Ottawa, ON: Author.Google Scholar
Caplan, A. (1981). Kidneys, ethics, and politics: Policy lessons of the ESRD experience. Journal of Health Politics, Policy, and Law, 6, 488–503.CrossRefGoogle ScholarPubMed
Charles, C., & DeMaio, S. (1992). Lay participation in health care decision making: A conceptual framework (Working Paper No. 92–16). Hamilton, ON: McMaster University Centre for Health Economics and Policy Analysis.Google Scholar
Churchill, L.R. (1987). Rationing health care in America: Perceptions and principles of justice. Notre Dame, IN: University of Notre Dame Press.Google Scholar
Churchill, L.R. (1988). Should we ration health care by age? Journal of the American Geriatrics Society, 36, 644–647.CrossRefGoogle ScholarPubMed
Churchill, L.R. (1989). Private virtues, public detriment: Allocating scarce medical resources to the elderly [Review of Setting limits: Medical goals in an aging society]. Ethics, 100, 169–176.CrossRefGoogle ScholarPubMed
Clark, P.G. (1985). The social allocation of health care resources: Ethical dilemmas in age-group competition. The Gerontologist, 25, 119–125.CrossRefGoogle ScholarPubMed
Clark, P.G. (1987). Individual autonomy, cooperative empowerment, and planning for long-term care decision making. Journal of Aging Studies, 1, 65–76.CrossRefGoogle ScholarPubMed
Clark, P.G. (1988). Autonomy, personal empowerment, and quality of life in long-term care. Journal of Applied Gerontology, 7, 279–297.CrossRefGoogle Scholar
Clark, P.G. (1989). The philosophical foundation of empowerment: Implications for geriatric health care programs and practice. Journal of Aging and Health, 1, 267–285.CrossRefGoogle Scholar
Clark, P.G. (1991a). Ethical dimensions of quality of life in aging: Autonomy vs. collectivism in the United States and Canada. The Gerontologist, 31, 631–639.CrossRefGoogle Scholar
Clark, P.G. (1991b). Geriatric health care policy in the United States and Canada: A comparison of facts and values in defining the problems. Journal of Aging Studies, 5, 265–281.CrossRefGoogle Scholar
Clark, P.G. (1993). Public policy in the United States and Canada: Individualism, familial obligation, and collective responsibility in the care of the elderly. In Hendricks, J. & Rosenthal, C.J. (Eds.), The remainder of their days: Domestic policy and older families in the United States and Canada. New York: Garland Publishing.Google Scholar
Cole, T. (1989). Generational equity in America: A cultural historian's perspective. Social Science and Medicine, 29, 377–383.CrossRefGoogle Scholar
Collopy, B. (1985). Medicare: Ethical issues in public policy for the elderly. Social Thought, 11(2), 5–14.CrossRefGoogle Scholar
Collopy, B., Boyle, P., & Jennings, B. (1991). New directions in nursing home ethics. Hastings Center Report, 21(2, Suppl.), 1–15.CrossRefGoogle ScholarPubMed
Collopy, B., Dubler, N., & ZucKerman, C. (1990). The ethics of home care: Autonomy and accommodation. Hastings Center Report, 20(2, Suppl.), 1–16.CrossRefGoogle ScholarPubMed
Conway, J. (1988). An “adapted organic tradition”. Daedalus: Proceedings of the American Academy of Arts and Sciences, 117(4), 381–396.Google Scholar
Cook, F.L., Marshall, V.W., Marshall, J.G., & Kaufman, J.E. (1991, May). Intergenerational equity and the politics of income security for the old. In Marmor, T. (Chair), A North American Look at Economic Security for the Elderly. Symposium conducted at Yale University, New Haven, CT.Google Scholar
Craig, L.A. (1991). Health of nations: An international perspective on U.S. health care reform. Washington, DC: The Wyatt Company.Google Scholar
Daniels, N. (1986). Why saying no to patients in the United States is so hard: Cost containment, justice, and provider autonomy. New England Journal of Medicine, 314, 1380–1383.CrossRefGoogle ScholarPubMed
Daniels, N. (1988). Am I my parents' keeper? An essay on justice between the young and the old. New York: Oxford University Press.Google Scholar
Danis, M., & Churchill, L.R. (1991). Autonomy and the common weal. Hastings Center Report, 21(1), 25–31.CrossRefGoogle ScholarPubMed
Denton, F.T., Li, S.N., & Spencer, B.G. (1987). How will population aging affect the future costs of maintaining health-care standards? In Marshall, V.W. (Ed.), Aging in Canada: Social perspectives (2nd ed.) (pp. 553–568). Markham, ON: Fitzhenry & Whiteside.Google Scholar
Denton, F.T., & Spencer, B.G. (1988). Population aging and the economy: Some issues in resource allocation. In Thornton, J.E. & Winkler, E.R. (Eds.), Ethics and aging: The right to live, the right to die (pp. 98–123). Vancouver, BC: University of British Columbia Press.Google Scholar
Easterlin, R.A. (1991). The economic impact of prospective population changes in advanced industrial countries: An historical perspective. Journal of Gerontology: Social Sciences, 46, S299–309.CrossRefGoogle ScholarPubMed
Estes, C.L., & Binney, E.A. (1991). The biomedicalization of aging: Dangers and dilemmas. In Minkler, M. & Estes, C.L. (Eds.), Critical perspectives on aging: The political and moral economy of growing old (pp. 117–134). Amityville, NY: Baywood.Google Scholar
Estes, C.L., & Gerard, L.E., Zones, J.S., & Swan, J.H. (1984). Political economy, health, and aging. Boston: Little Brown.Google Scholar
Evans, R.G. (1985). Illusions of necessity: Evading responsibility for choice in health care. Journal of Health Politics, Policy, and Law, 10, 439–467.CrossRefGoogle ScholarPubMed
Evans, R.G. (1988). “We'll take care of it for you”: Health care in the Canadian community. Daedalus: Proceedings of the American Academy of Arts and Sciences, 117(4), 155–189.Google Scholar
Evans, R.G., Lomas, J., Barer, M., Labelle, R.J., Fooks, C., Stoddart, G.L., Anderson, G.M., Feeny, D., Gafni, A., Torrance, G.W, & Tholl, W.G. (1989). Controlling health expenditures: The Canadian reality. New England Journal of Medicine, 320, 571–577.CrossRefGoogle ScholarPubMed
Fellegi, I.P. (1988, October). Can we afford an aging society? Canadian Economic Observer, 4 1–4.34.Google Scholar
Francis, J.G., & Francis, L.P. (1987). Rationing of health care in Britain: An ethical critique of public policy-making. In Smeeding, T.M. (Ed.), Should medical care be rationed by age? (pp. 119–134). Totowa, NJ: Rowman and Littlefield.Google Scholar
Fries, J.F. (1983). The compression of morbidity. Milbank Memorial Fund Quarterly, 61, 397–419.CrossRefGoogle ScholarPubMed
Gadow, S. (1983). Frailty and strength: The dialectic in aging. The Gerontologist, 23, 144–147.CrossRefGoogle ScholarPubMed
Getzen, T.E. (1992). Population aging and the growth of health expenditures. Journal of Gerontology: Social Sciences, 47, S98–104.CrossRefGoogle ScholarPubMed
Halper, T. (1978). Paternalism and the elderly. In Spicker, S.F., Woodward, K.M., & Van Tassel, D.D. (Eds.), Aging and the elderly: Humanistic perspectives in gerontology (pp. 321–339). Atlantic Highlands, NJ: Humanities Press, Inc.Google Scholar
Hartz, L. (1955). The liberal tradition in America. Toronto: Longmans.Google Scholar
Health and Welfare Canada (1982). Better pensions for Canadians (Cat. No. CP 45–28/1982E). Ottawa, ON: Minister of Supply and Services.Google Scholar
Heclo, H. (1988). Generational politics. In Palmer, J.L., Smeeding, T., & Torrey, B.B. (Eds.), The vulnerable (pp. 381–111). Washington, DC: The Urban Institute Press.Google Scholar
High, D.M. (1988). All in the family: Extended autonomy and expectations in surrogate health care decisionmaking. The Gerontologist, 28(3, Suppl.), 46–51.CrossRefGoogle Scholar
High, D.M. (1990). Who will make health care decisions for me when I can't? Journal of Aging and Health, 2, 291–309.CrossRefGoogle ScholarPubMed
High, D.M. (1991). A new myth about families of older people? The Gerontologist, 31, 611–618.CrossRefGoogle ScholarPubMed
Hofland, B.F. (1988). Autonomy in long term care: Background issues and a programmatic response. The Gerontologist, 28(3, Suppl.), 3–9.CrossRefGoogle Scholar
Horowitz, G. (1966). Conservatism, Liberalism, and Socialism in Canada: An interpretation. Canadian Journal of Economic and Political Science, 32, 143–171.CrossRefGoogle Scholar
Ingman, S.R., Gill, D., & Campbell, J. (1987). ESRD and the elderly: Cross-national perspective on distributive justice. In Spicker, S.F., Ingman, S.R., & Law son, I.R. (Eds.), Ethical dimensions of geriatric care (pp. 223–262). Dordrecht/Boston: D. Reidel Publishing Co.CrossRefGoogle Scholar
Jecker, N.S. (1987). Excluding the elderly: A reply to Callahan [Review of Setting limits: Medical goals in an aging society]. Philosophy and Public Policy, 7(4), 12–15.Google Scholar
Jecker, N.S. (1988). Disenfranchising the elderly from life-extending medical care. Public Affairs Quarterly, 2(3), 51–68.Google ScholarPubMed
Jecker, N.S., & Pearlman, R.A. (1989). Ethical constraints on rationing medical care by age. Journal of the American Geriatrics Society, 37, 1067–1075.CrossRefGoogle ScholarPubMed
Jonsen, A.R., & Butler, L.H. (1975). Public ethics and policy making. Hastings Center Report, 5(4), 19–31.CrossRefGoogle ScholarPubMed
Kane, R.A., & Caplan, A.L. (1990). Everyday ethics: Resolving dilemmas in nursing home life. New York: Springer Publishing Company.Google Scholar
Kane, R.L., & Kane, R.A. (1985). A will and a way: What the United States can learn from Canada about caring for the elderly. New York: Columbia University Press.CrossRefGoogle Scholar
Katz, S., Branch, L.G., Branson, M.H., Papsidero, J.A., Beck, J.C., & Greer, D.S. (1983). Active life expectancy. New England Journal of Medicine, 309, 1218–1224.CrossRefGoogle ScholarPubMed
Katz, S., Greer, D.S., Beck, J.C., Branch, L.G., & Spector, W.D. (1985). Active life expectancy: Societal implications. In Institute of Medicine, Committee on an Aging Society (Ed.), America's aging: Health in an older society (pp. 57–72). Washington, DC: National Academy Press.Google Scholar
Kennedy, R.D. (1984). The British National Health Service [Letter to the Editor]. New England Journal of Medicine, 310, 1672.Google Scholar
Kenny, N. (1987). The ethics of restraint. In Economic Council of Canada (Ed.), Aging with limited health resources: Proceedings of a colloquium on health care (No. EC22–139/1987E) (pp. 151–153). Ottawa, ON: Minister of Supply and Services.Google Scholar
Kilner, J.F. (1988). Age as a basis for allocating lifesaving medical resources: An ethical analysis. Journal of Health Politics, Policy, and Law, 13, 405–423.CrossRefGoogle ScholarPubMed
Kingson, E.R. (1988). Generational equity: An unexpected opportunity to broaden the politics of aging. The Gerontologist, 28, 765–772.CrossRefGoogle ScholarPubMed
Kingson, E.R., Hirshorn, B.A., & Cornman, J.M. (1986). Ties that bind: The interdependence of generations. Washington, DC: Seven Locks Press.Google Scholar
Langer, J., & Rodin, J. (1976). The effects of choice and enhanced personal responsibility for the aged: A field experiment in an institutional setting. Journal of Personality and Social Psychology, 34, 191–198.CrossRefGoogle Scholar
Lee, S.S. (1982). Health policy, a social contract: A comparison of the United States and Canada. Journal of Public Health Policy, 3, 293–301.CrossRefGoogle Scholar
Levinsky, N.G. (1990). Age as a criterion for rationing health care. New England Journal of Medicine, 322, 1813–1816.CrossRefGoogle ScholarPubMed
Lipset, S.M. (1963). The first new nation: The United States in historical and comparative perspective. New York: Basic Books.Google Scholar
Lipset, S.M. (1990). Continental divide: The values and institutions of the United States and Canada. New York: Routledge, Chapman, and Hall.Google Scholar
Longman, P. (1985, June). Justice between generations. The Atlantic Monthly, pp. 73–81.Google Scholar
Longman, P. (1987). Born to pay: The new politics of aging in America. Boston: Houghton Mifflin.Google Scholar
Manga, P. (1987). Medicare: Ethics versus economics. Canadian Medical Association Journal, 136, 113–116.Google ScholarPubMed
Marquis, D. (1978). Ethics and the elderly: Some problems. In Spicker, S.F., Woodward, K.M., & Van Tassel, D.D. (Eds.), Aging and the elderly: Humanistic perspectives in gerontology (pp. 341–355). Atlantic Highlands, NJ: Humanities Press, Inc.Google Scholar
McDaniel, S.A. (1987). Demographic aging as a guiding paradigm in Canada's welfare state. Canadian Public Policy — Analyse de Politiques, XIII(3), 330–336.CrossRefGoogle Scholar
McRae, K. (1964). The structure of Canadian history. In Hartz, L. (Ed.), The founding of new societies (pp. 219–274). Toronto: Longmans.Google Scholar
Mercer, S., & Kane, R. (1981). Helplessness and hopelessness among the institutionalized aged: An experiment. In Wechsler, H., Reinherz, H.Z., & Dobbin, D.D. (Eds.), Social wotk research in the human services (pp. 135–151). New York: Human Services Press.Google Scholar
Miller, F.H., & Miller, G.A.H. (1986). The painful prescription: A Procrustean perspective? New England Journal of Medicine, 314, 1383–1386.CrossRefGoogle ScholarPubMed
Minkler, M. (1991). “Generational equity” and the new victim blaming. In Minkler, M. & Estes, C.L. (Eds.), Critical perspectives on aging: The political and moral economy of growing old (pp. 67–80). Amityville, NY: Baywood.Google Scholar
Minkler, M., & Estes, C.L. (1991). Critical perspectives on aging: The political and moral economy of growing old. Amityville, NY: Baywood.Google Scholar
Murphy, B.B., & Wolfson, M.C. (1990, September). When the baby boom grows old: Impacts on Canada's public sector. Paper presented to the United Nations Economic Commission for Europe Seminar on Demographic and Economic Consequences and Implications of Changing Population Age Structure, Ottawa, Canada.Google Scholar
Naylor, CD. (1991). A different view of queues in Ontario. Health Affairs, 10(3), 111–128.CrossRefGoogle ScholarPubMed
Neugarten, B.L., & Havighurst, R.J. (1976). Social policy, social ethics, and the aging society (Report prepared for the National Science Foundation RANN-Research Applications Directorate, No. NSF-RA76–000247). Washington, DC: U.S. Government Printing Office.Google Scholar
Neysmith, S.M. (1987). Social policy implications of an aging society. In Marshall, V.W. (Ed.), Aging in Canada: Social perspectives (2nd ed.) (pp. 586–597). Markham, ON: Fitzhenry & Whiteside.Google Scholar
Parasiuk, W.D. (1987, November). Comments. In Health Care Reform: The Challenge for North America. Conference sponsored by the Americas Society/Canadian Affairs, New York City.Google Scholar
Parsons, V., & Lock, P. (1980). Triage and the patient with renal failure. Journal of Medical Ethics, 6, 173–176.CrossRefGoogle ScholarPubMed
Pellegrino, E.D., & Howell, J.T. (1985). Science, technology and values in an age of aging. Socioeconomics and Planning Science, 19, 225–226.CrossRefGoogle Scholar
Post, S.G. (1989). Technology and the aging society: Ethics and public policy. In Blank, R.H. & Miles, M.K. (Eds.), Biomedical technology and public policy (pp. 201–222). Westport, CT: Greenwood Press.Google Scholar
Potter, R.B. (1969). War and moral discourse. Richmond, VA: John Knox Press.Google Scholar
Preston, S.H. (1984a). Children and the elderly: Divergent paths for America's dependents. Demography, 21, 435–457.CrossRefGoogle ScholarPubMed
Preston, S.H. (1984b). Children and the elderly in the U.S. Scientific American, 251(6), 44–49.CrossRefGoogle ScholarPubMed
Priester, R. (1992). A values framework for health system reform. Health Affairs, 11(1), 84–107.CrossRefGoogle ScholarPubMed
Quadagno, J. (1989). Generational equity and the politics of the welfare state. Politics and Society, 17, 353–376.CrossRefGoogle Scholar
Robertson, A. (1991). The politics of Alzheimer's disease: A case study in apocalyptic demography. In Minkler, M. & Estes, C.L. (Eds.), Critical perspectives on aging: The political and moral economy of growing old (pp. 135–150). Amity-ville, NY: Baywood.Google Scholar
Rodeheaver, D., & Logan, R. (1990, November). Individualism in gerontological perspective: Self and society in later life. Paper presented at the 43rd Annual Scientific Meeting of the Gerontological Society of America, Boston, MA.Google Scholar
Rodin, J. (1986). Aging and health: Effects of the sense of control. Science, 233, 1271–1276.CrossRefGoogle ScholarPubMed
Rodin, J., & Langer, E. (1977). Long-term effects of a control-relevant intervention with the institutionalized aged. Journal of Personality and Social Psychology, 35, 897–902.CrossRefGoogle ScholarPubMed
Rombout, M.K. (1975a). Health care institutions and Canada's elderly (Supplement to Long Range Health Planning Staff Paper 75–2). Ottawa, ON: Health and Welfare Canada.Google Scholar
Rombout, M.K. (1975b). Hospitals and the elderly: Present and future trends (Long Range Health Planning Staff Paper 75–2). Ottawa, ON: Health and Welfare Canada.Google Scholar
Roth, P.A., & Harrison, J.K. (1991). Orchestrating social change: An imperative in care of the chronically ill. Journal of Medicine and Philosophy, 16, 343–359.CrossRefGoogle ScholarPubMed
Rowe, J.W., & Kahn, R.L. (1987). Human aging: Usual and successful. Science, 237, 143–149.CrossRefGoogle ScholarPubMed
Schwartz, W.B., & Aaron, H.J. (1984). Rationing hospital care: Lessons from Britain. New England Journal of Medicine, 310, 52–56.CrossRefGoogle ScholarPubMed
Singer, P. (1988). [Review of Setting limits: Medical goals in an aging society]. Bioethics, 2, 151–169.Google Scholar
Soldo, B.J., Pellegrino, E.D., & Howell, J.T. (1985). Epilogue: Confronting the age of aging. Socioeconomics and Planning Science, 19, 289–293.CrossRefGoogle ScholarPubMed
Special Committee on Pension Reform. (1983). Report of the Parliamentary task force on pension reform. Ottawa, ON: Minister of Supply and Services.Google Scholar
Task Force on Retirement Income Policy. (1980). The retirement income system in Canada: Problems and alternative policies for reform (Cat. No. F 2–44/1980–1E). Ottawa, ON: Minister of Supply and Services.Google Scholar
Taylor, M.G. (1978). Health insurance and Canadian public policy: The seven decisions that created the Canadian health insurance system. Montreal: McGill-Queen's University Press.Google Scholar
Tholl, W.G. (1991). Personal communication, August 15.Google Scholar
Thomasma, D.C. (1989). Moving the aged into the house of the dead: A critique of ageist social policy. Journal of the American Geriatrics Society, 37, 169–172.CrossRefGoogle ScholarPubMed
Thompson, E.P. (1971). The moral economy of the English crowd in the 18th century. Past and Present, 50, 76–136.CrossRefGoogle Scholar
Thomson, A. (1991). Federal support for health care: A background paper. Ottawa: The Health Action Lobby.Google Scholar
Tuohy, C. (1986). Conflict and accommodation in the Canadian health care system. In Evans, R.G. & Stoddart, G.L. (Eds.), Medicare at maturity: Achievements, lessons, and challenges (pp. 393–434). Calgary, AB: University of Calgary Press.Google Scholar
Walker, A. (1990). The economic ‘burden’ of ageing and the prospect of intergenerational conflict. Ageing and Society, 10, 377–396.CrossRefGoogle Scholar
Weller, G.R., & Manga, P. (1983). The development of health policy in Canada. In Atkinson, M.M. & Chandler, M.A. (Eds.). The politics of Canadian public policy (pp. 223–246). Toronto: University of Toronto Press.Google Scholar
Wisensale, S.K. (1988). Generational equity and intergenerational policies. The Gerontologist, 28, 773–778.CrossRefGoogle ScholarPubMed