Dg. Jones, AGING, DEMENTIA AND CARE - SETTING LIMITS ON THE ALLOCATION OF HEALTH-CARE RESOURCES TO THE AGED, New Zealand medical journal, 110(1057), 1997, pp. 466-468
This article explores the ethical dimensions behind care of the elderl
y and considers whether younger people should be given priority over t
he aged in the provision of health care resources. It is argued that a
ge is a relevant consideration in decisions concerning the allocation
of health care. The notions of a 'natural life span' and a 'tolerable
death' are discussed and on this basis I conclude that while the inter
ests and claims of the elderly must be protected, the use of unlimited
resources in the pursuit of life extending measures cannot be justifi
ed. When traditional ethical principles are applied to care of the age
d they have to be viewed in a modified fashion. The nature of dementia
is such that integrity in caregiving has to take account of the patie
nt's premorbid self. I argue that the morally appropriate response to
demented patients excludes acute-care, life-extending medicine, but ne
ither does it advocate active euthanasia. The aim is to find a middle
ground between treating the demented too aggressively and failing to g
ive them sufficient treatment.