The complexity of modern medical care produces dilemmas and conflicts in which an ability to understand and explicitly address issues of moral choice and value differences is essential to the practicing physician. Ethical dilemmas are not rare or esoteric events. It is impractical and unnecessary to take every ethical problem to court, and every health care institution does not have a consultant ethicist or an ethics committee. Day-to-day decisions must be made as they arise. Therefore, in addition to technical competence in medicine, the geriatrician also must attain a certain level of ethical competence.
KeywordsNursing Home Ethical Dilemma Advance Directive Ethical Problem Persistent Vegetative State
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- 1.Beauchamp TL, Childers JF. Principles of Biomedical Ethics. 2nd ed. New York, NY: Oxford University Press Inc; 1985.Google Scholar
- 2.The Hastings Center. Guidelines on the Termination of Life-Sustaining Treatment and the Care of the Dying. New York, NY: The Hastings Center; 1987.Google Scholar
- 3.Schloendorff u Society of New York Hospitals,211 NY 125, 105 NE 92 (1914).Google Scholar
- 4.Katz J. The Silent World of Physician and Patient. New York, NY: Free Press; 1985.Google Scholar
- 5.Strull W, Lo B, Charles G. Do patients want to participate in medical decision making? DAMA 1984; 252: 2990 2995.Google Scholar
- 7.Siegler M. Confidentiality in medicine: a decrepit concept. N Engl J Med 1982; 247: 2695.Google Scholar
- 9.Evans R. Health care technology and the inevitability of resource allocation and rationing decisions. JAMA 1983; 249: 2047, 2208.Google Scholar
- 12.Miles SH, Cassel CK, Siegler MS, et al. Institutional Policies About the Use of Life-Sustaining Treatments. Institutional Protocols for Decisions about Life-Sustaining Treatments, Special Report. OTA-BA-389, Washington, DC: Government Printing Office, July 1988.Google Scholar
- 14.President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research Making Health Care Decisions. Washington, DC: LC 82–600637; 1984.Google Scholar
- 17.Society for the Right to Die: Handbook of Living Will Laws. New York, NY: Society for the Right to Die; 1987.Google Scholar
- 19.President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research Defining Death. Washington, DC: 1981, publisher LC 81–600150.Google Scholar
- 23.Lynn J, ed. By No Extraordinary Means. Bloomington, Ind: Indiana University Press; 1986.Google Scholar
- 27.Zweibel N, Cassel CK, eds. Clinical and Policy Issues in the Care of the Nursing Home Patient: Clinics in Geriatric Medicine. Philadelphia, Pa: WB Saunders Co; 1988.Google Scholar