Does cost containment create conflict in the care of the elderly patient?

Ethical aspects of care of geriatric patients with orthopaedic disorders in clude patient autonomy, beneficence, and nonmalefecince, Advance directives and surrogate decision-makers are required if the patient has lost decisio nal capacity. Investor-owned health plans have captured the major share of the United States medical market, but have been shown to deliver lower qual ity of care than competing methods. A deeply imbedded fear of a government- run health plan with good intentions expressed as bad policy exists. Ageism is one example of how ethical principles map be trampled. The orthopaedic surgeon has a responsibility to maintain and fight for these ethical standa rds.