Clinical medical ethics combines the disciplines of philosophy, behavioral science, law, and medicine to resolve moral issues and conflicts of values that arise in medicine. While all physicians face ethical dilemmas, the practice of geriatric medicine is particularly rich and ethically complex for many reasons: (1) Many elderly people face chronic illnesses for which treatment is costly and risky and outcomes are uncertain. (2) Many elderly have conditions which profoundly impair communication and cognition. Therefore, there may be uncertainty about who should make health care decisions and what constitutes informed consent. (3) The elderly account for a larger segment of spending on health care, half of which comes from public programs, leading to questions about the relative value of health care compared with other special goods, the value of marginally effective treatments when survival is not likely to be long, the ethical framework for intergenerational transfers of resources, and ultimately the moral issue of rationing of medical resources.
KeywordsNursing Home Ethical Issue Home Care Ethical Dilemma Advance Directive
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- 1.Beauchamp TL, Childress JF. Principles of Biomedical Ethics. 4th ed. New York: Oxford University Press; 1994.Google Scholar
- 2.American Board of Internal Medicine. Caring for the Dying: Identification and Promotion of Physician Competency. Educational Resource Document. Philadelphia: American Board of Internal Medicine; 1996.Google Scholar
- 5.Kane RA, Caplan AL, eds. Everyday Ethics: Resolving Dilemmas in Nursing Home Life. New York: Springer; 1990.Google Scholar
- 6.Gillick MR. A broader role for advance medical planning. Ann Intern Med. 1995;123:621-624. Google Scholar
- 7.Kane RA, Caplan AL, eds. Ethical Conflicts in the Management of Home Care: The Case Manager's Dilemma. New York: Springer; 1993.Google Scholar