|Type of paper:||Report|
|Categories:||Healthcare Ethical dilemma|
The estimate that there will be an increase in the percentage of the aging population by 2030 implies that there will be more people requiring care. In this case, costs of medical care are expected to rise, and hence, the ethics based on challenges have to be addressed. Conventionally, the society should be tasked with enabling the youth to grow older, but it is time that the policies favored helping the old to grow even older. Medical care should be provided with the philosophy that age does not matter. The urgency to solve challenges of the youth should be extended to the aging population. Addressing the ethical issues when faced with healthcare challenges of an aging population is of paramount importance.
The ethical framework for the elderly is based on their vulnerability and the intergenerational solidarity. A major moral issue is the autonomy of the patients. At old age, there is a tendency for a decline in the ability for autonomous decision-making. The functional mental decline necessitates another person to act as a decision maker to the patient. This defines the case of proxy-decision making, and the nominated decision maker must pay attention to the probable needs of the patient. Autonomy goes hand in hand with dignity and the decision made may at times result in disrespect and hence failure to uphold their dignity. A common case for the elderly is filial imprisonment by which the family members limit the freedom of the elderly (Fenech, 2003). In whatever state of sickness, it is essential to ensure that the elderly people do not feel marginalized and thus, the family should be the primary caretakers of a patient. Regarding intergenerational solidarity, justice is an important consideration. It is necessary to provide equity regardless of sex, race, age, or gender.
Justice and moral obligation provide dilemmas when dealing with healthcare of the elderly. Since the senior citizens are at a disadvantage when it comes to their physical and mental capacity, they should be allocated more resources. Governments must work with consideration of various cultures and religions to determine what is best for the aging population. Health care has always been costly, and hence, there is an issue of the economic implications of caring for the elderly (Craig, 2010). Considering that resources are scarce, there has been a debate on prioritization of the needs of the elderly as opposed to other generations. It is, therefore, necessary to blend justice with moral ethics. In my opinion, there is no need for elderly people who are financially stable to depend upon the free services offered by the government. If one is capable of taking responsibility for his/her economic needs, then, by all means, they should do so to allow for the resources to be reassigned to more deserving persons (Crippen & Barnato, 2011). Throughout the existence of mankind, the elderly are usually given utmost respect, and usually, their basic needs are met by society. Failure to adapt to policies to the changing reality of an older population implies that the taxpayers will have to contribute more to the healthcare sector meaning an increase in taxes. This is because as at now, the elderly represent the fastest growing population in the U.S.
Nurses are always the practitioners who spend the most time with patients and hence aid the patients and their families in decision making. The cases involving a conflict of interest should be dealt with extra care to protect the patients and to ensure that there is no breach of the code of conduct. According to Pavlish et al. (2011), not enough evidence-based ethical practices have been developed for elderly patients or those at the end of life. Nurses are often concerned with relieving pain in patients, but at the same time, the regulations require that they get consent from the family before administering any medication. Nurses are also limited regarding what they do because they only take orders from doctors even if they find the decisions improper (Milstead, 2016). For the case of the terminally ill cancer patient whose family refused pain medication for fear that she would die. In cases with such dilemma, my best strategy is to first talk to the family about what is the best for the patient. This requires elaboration to emphasize the need to give pain medication to grant peace for the patient. For a case of filial decision making, autonomy is key, and in this case, the family's wishes have to be met. The best that a nurse can do is to convince them that their decision is not the right one.
In handling the situations where clinical judgment differs from other health providers or family, the best way is to voice the concerns. If the suggestions are not heard, then as the patient's advocate, the nurse should report to the hospital's ethics committee. This action helps in eliminating regret later on for allowing patients to experience unnecessary pain and suffering. According to the ANA code of conduct, neglect is a severe mistake and hence taking no action is not recommended (Pavlish et al., 2011). The elderly patients and those receiving end of life treatment should be accorded dignity, and the nurse should go beyond providing standard care. Conclusively, ethical issues often lead to moral distress if not addressed efficiently and thus, new policies to favor health care for the aging have to be formulated. The best strategy would be to allow professional decisions to have a veto over those by a proxy decision maker in a case where a patient has lost autonomy.
Craig, H. D. (2010). Caring enough to provide healthcare: An organizational framework for the ethical delivery of healthcare among aging patients. International Journal for Human Caring, 14(4), 27-30. Retrieved from the Walden Library databases
Crippen, D., & Barnato, A. E. (2011). The ethical implications of health spending: Death and other expensive conditions. Journal of Law, Medicine & Ethics, 39(2), 121-129. Retrieved from the Walden Library databases
Fenech, F. F. (2003). Ethical issues in ageing. Clinical Medicine, 3(3), 232-234.
Milstead, J. A. (2016). Health policy and politics: A nurse's guide. Jones & Bartlett Learning.
Pavlish, C., Brown-Saltzman, K., Hersh, M., Shirk, M., & Rounkle, A. (2011). Nursing priorities, actions, and regrets for ethical situations in clinical practice. Journal of Nursing Scholarship, 43(4), 385-395. doi:10.1111/j.1547-5069.2011.01422.x
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