Ethical Dilemmas In Geriatrics

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Ethical Dilemmas
As population ages, clinicians will care for an increasing number of elderly patients. Just as these patients may present unique and challenging medical dilemmas, so may they also present ethical ones. Ethical dilemmas are present in everyday practice. It provides a brief overview of the situations that may raise ethical concerns. Although, these are not the only ethical concerns that may arise during care of the elderly and are not unique to the population, they represent the most common scenarios that clinicians may encounter in their everyday course of practice. Ethics, according to (Mueller, Hook & Fleming, 2004), is the analysis and identification of the moral problems that arise in the care of patients. Ethical issues on geriatrics: a guide to clinicians (2004) reports that clinicians will care for an increasing number of elderly patients with challenging medical problems.
Ethical principles are judgments that serve as a basic justification for the ethical evaluation of one’s action. They are the viewpoints from which guidance can be obtained along the pathway to a decision. According to the Journal of the American Nurse Association, ethical principles are the general goals that each theory tries to achieve in order to be successful. The widely accepted prima facie ethical principles are; Autonomy, duty to respect one’s right. Beneficence, the desire to do good. Non-maleficence refers to avoidance of harm or hurt. Justice, duty to treat one fairly. (Beauchamp, 2004). While some of the ethical dilemmas includes: ensuring informed consent, determining decision-making capacity, promoting advance care planning, surrogate decision-making, withdrawing and withholdi...

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... clinical trial comparing two treatments is in progress, and a physician has an opinion about which treatment is better. This duty creates a barrier to the enrollment of patients in randomized clinical trials.
Advance Care Planning
Advance care planning allows a patient to identify health care preferences and surrogate decision making in the event the patient cannot make competent health decision. It promotes autonomy of patients who lack, but once possessed, the decision-making capacity. In general, there are two forms of Ads; the living will and the durable power of attorney. Nevertheless, most people, including elderly persons do not have Ads. One study of a random sample of all US deaths (N=13,883) found that only 9.8% of decedents had an AD. Patients with AD, however, were less likely to undergo cardiopulmonary resuscitation and more likely to use hospice care.
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