سالمندان: مسائل قانونی و اخلاقی در سیاست مراقبت‌های بهداشتی

Aging is a public health priority that is becoming increasingly important in both developed and less developed nations, with individual health care providers and law-makers each facing difficult ethical and policy dilemmas. The complex issues physicians deal with include informed consent and patient decision-making capacity, use of advance care planning and decision-making by family and medical staff, and withdrawing and withholding life-sustaining interventions. Broader questions include: has aging been over medicalized? Is it ethical for older patients to receive less medical care than younger ones, through unspoken practice or formal rationing? Is there inevitable conflict between the generations over scarce medical resources? How should physician, patient and family confront end-of-life decisions? How have different nations responded to increasing numbers of the elderly? Have social values changed as to family responsibility and individual autonomy? This volume brings together the most significant published essays in the field. Cover Half Title Title Page Copyright Page Table of Contents Acknowledgements Series Preface Introduction PART I HEALTHCARE IN AN AGING SOCIETY The Demographic Context 1 ‘Making Aging a Public Health Priority’, American Journal of Public Health, 84, pp. 1213—14 2 ‘Health Care Implications of an Aging Population’, Hong Kong Journal of Gerontology, 8, pp. 5—11 3 ‘Healthcare Policy in the Later Twentieth Century’, Generations - Journal of the American Society on Aging, 12, pp. 44—47 Medical and Cultural Models 4 ‘Ageing and the Limiting Conditions of the Body’, Sociological Research Online, 3, pp. 1—15 5 ‘The Medicalization of Aging and Disability’, Advances in Medical Sociology, 2, pp. 299—315 Ethical Choices for an Aging Society 6 ‘Four Scenarios for an Aging Society’, Hastings Center Report, 24, pp. 32—35 7 ‘Introduction: The Frame of Nature, Gerontology, and Law’, Southern California Law Review, 56, pp. 261—88 PART II DECISION-MAKING FOR THE OLDER PATIENT 8 ‘Ethical Issues in Geriatrics: A Guide for Clinicians’, Mayo Clinic Proceedings, 79, pp. 554—62 Consent and Full Disclosure 9 ‘Some Limits of Informed Consent’, Journal of Medical Ethics, 29, pp. 4—7 10 ‘Consent to Medical Treatment: The Complex Interplay of Patients, Families, and Physicians’, Journal of Medicine and Philosophy, 29, pp. 139—48 Competence 11 ‘Mental Incapacity: Some Proposals for Legislative Reform’, Journal of Medical Ethics, 24, pp. 322—27 12 ‘Pacing Extremely Old Patients: Who Decides - The Doctor, the Patient, or the Relatives?’, Heart, 90, pp. 134—35 Deciding for the Incompetent 13 ‘Japan’s New Safety Net: Reform of Statutory Guardianships and the Creation of Voluntary Guardianships’, National Association of Elder Law Attorneys Quarterly, 13, pp. 5—8 14 ‘Key Issues in the Ethics of Dementia Care’, Neurologic Clinics, 18, pp. 1011—22 15 ‘Quality of Life and Non-Treatment Decisions for Incompetent Patients: A Critique of the Orthodox Approach’, Law, Medicine & Health Care, 17, pp. 234—44 Decision-making at the End of Life 16 ‘A Combined Ethics and Psychiatric Consultation’, General Hospital Psychiatry, 23, pp. 73—76 17 ‘Ethical Issues at the End of Life’, Stanford Law & Policy Review, 9, pp. 267—88 18 ‘Futility Judgments and Therapeutic Conversation’, Journal of the American Geriatrics Society, 42, pp. 902—903 19 ‘Ethical Issues in End-of-Life Geriatric Care: The Approach of Three Monotheistic Religions — Judaism, Catholicism, and Islam’, Journal of the American Geriatrics Society, 51, pp. 1149—54 20 ‘End-of-Life Decision Making: Practical and Ethical Issues for Health Professionals’, Australasian Journal of Ageing, 19, pp. 57—62 21 ‘Stewardship of the Aged: Meeting the Ethical Challenge of Ageism’, Cambridge Quarterly of Healthcare Ethics, 8, pp. 148—59 Advance Directives 22 ‘Adherence to Advance Directives in Critical Care Decision Making: Vignette Study’, British Medical Journal, 327, pp. 1011—14 23 ‘Breaking down the Barriers to a Good Death’, The Lancet, 360, p. 1846 Palliative Care 24 ‘Palliative Care Nursing: Ensuring Competent Care at the End of Life’, Geriatric Nursing, 22, pp. 288—93 Deliberate Death 25 ‘Euthanasia: Killing and Letting Die’, in Martin L. Levine and Shimon Bergman (eds), Law and Aging: International Variations, Jerusalem: JDC-Brookdale, pp. 95—117 26 ‘Legalizing Physician-Aided Death’, Cambridge Quarterly of Healthcare Ethics, 5, pp. 10—23 27 ‘Assessing the Arguments for and against Euthanasia and Assisted Suicide: Part Two’, Cambridge Quarterly of Healthcare Ethics, 7, pp. 388—401 28 ‘Voluntary Active Euthanasia’, Journal of the American Geriatrics Society, 39, p. 826 29 ‘Voluntary Active Euthanasia and Physician-Assisted Suicide in Dutch Nursing Homes: Are the Requirements for Prudent Practice Properly Met?’, Journal of the American Geriatrics Society, 42, pp. 624—29 30 ‘New Information on “Death with Dignity’”, Hastings Center Report, 31, p. 8 PART III ARE THE NEEDS OF THE ELDERLY MET? Clinical Outcomes 31 ‘Age-Related Differences in Care Preferences, Treatment Decisions, and Clinical Outcomes of Seriously Ill Hospitalized Adults: Lessons from SUPPORT’, Journal of the American Geriatrics Society, 48, pp. SI76—82 Health System 32 ‘Caregiving Needs for 2020: Implications for Hong Kong and Other Newly Industrialized Countries’, Hong Kong Journal of Gerontology, 8, pp. 3—8 33 ‘Ethics and Health Care Reform: Outlook for Older Americans’, Activities, Adaptation, and Aging, 18, pp. 97—105 34 ‘The Health and Social System for the Aged in Japan’, Aging Clinical and Experimental Research, 14, pp. 265—70 Long-term Care 35 ‘International Long-Term Care Reform: A Demographic, Economic, and Policy Overview’, Journal of Cross-Cultural Gerontology, 8, pp. 447—61 36 ‘Caring for the Frail Elderly: An International Review’, Health Affairs, 19, pp. 141—49 37 ‘Long-Term Care Policy for Older Americans: Building a Continuum of Care’, Journal of Health & Social Policy, 16, pp. 7—18 PART IV DISTRIBUTIVE JUSTICE Issues of Ethnicity 38 ‘Cross-Cultural Geriatric Ethics: Negotiating Our Differences’, Generations - Journal of the American Society on Aging, 22, pp. 32—39 39 ‘Race and the Intensive Care Unit: Disparities and Preferences for End-of-Life Care’, Critical Care Medicine, 31, pp. S373—78 Family Responsibility 40 ‘Care of the Elderly - Whose Responsibility?’, Hong Kong Journal of Gerontology, 8, pp. 12—18 41 ‘Care and Inheritance: Japanese and English Perspectives on the “Generational Contract’'’, Ageing and Society, 22, pp. 61—77 Setting Limits 42 ‘Setting Limits: A Response’, The Gerontologist, 34, pp. 393—98 43 ‘Medical Implications of Setting Limits: Using Age as a Criterion’, Saint Louis University Law Journal, 33, pp. 603—10 Age Discrimination 44 ‘The Ethical Challenge of Providing Healthcare for the Elderly’, Cambridge Quarterly of Healthcare Ethics, 4, pp. 148—62 45 ‘(How) Is Aging a Health Policy Problem?’, Yale Journal of Health Policy, Law, and Ethics, 4, pp. 47—68 46 ‘Ageism in the NHS and the Human Rights Act 1998: An Ethical and Legal Enquiry’, European Journal of Health Law, 9, pp. 5—18 Age-based Rationing 47 ‘Rationing Fairly: Programmatic Considerations’, Bioethics, 7, pp. 224—33 48 ‘Priority Setting: A Sensible Approach to Medicaid Policy?’, Inquiry, 28, pp. 300—305 49 ‘Age-Based Rationing in the Allocation of Health Care’, Journal of Aging and Health, 12, pp. 511—37 50 ‘Medicare: An Appropriate Age-Related Program?’, Generations - Journal of the American Society on Aging, 19, pp. 50—53 51 “‘Should the Grandparents Die?”: Allocation of Medical Resources with an Aging Population’, Law, Medicine & Health Care, 14, pp. 158—63 52 Ethical Issues in Geriatric Medicine: A Unique Problematic?’, Health Care Analysis, 10, pp. 379—90 Index "Aging is a public health priority that is becoming increasingly important in both developed and less developed nations, with individual health care providers and law-makers each facing difficult ethical and policy dilemmas. The complex issues physicians deal with include informed consent and patient decision-making capacity, use of advance care planning and decision-making by family and medical staff, and withdrawing and withholding life-sustaining interventions. Broader questions include: has aging been over medicalized? Is it ethical for older patients to receive less medical care than younger ones, through unspoken practice or formal rationing? Is there inevitable conflict between the generations over scarce medical resources? How should physician, patient and family confront end-of-life decisions? How have different nations responded to increasing numbers of the elderly? Have social values changed as to family responsibility and individual autonomy? ."--Publisher's website