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PubMed · 15065621

Ethical issues in geriatrics: a guide for clinicians.

Paul S Mueller·C Christopher Hook·Kevin C Fleming
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Abstract

Because of demographic trends, it is reasonable to expect that clinicians will care for an increasing number of elderly persons with challenging medical and psychosocial problems. These problems and issues, in turn, may lead to daunting ethical dilemmas. Therefore, clinicians should be familiar with ethical dilemmas commonly encountered when caring for elderly patients. We review some of these dilemmas, including ensuring informed consent and confidentiality, determining decision-making capacity, promoting advance care planning and the use of advance directives, surrogate decision making, withdrawing and withholding interventions, using cardiopulmonary resuscitation and do-not-resuscitate orders, responding to requests for interventions, allocating health care resources, and recommending nursing home care. Ethical dilemmas may arise because of poor patient-clinician communication; therefore, we provide practical tips for effective communication. Nevertheless, even in the best circumstances, ethical dilemmas occur. We describe a case-based approach to ethical dilemmas used by the Mayo Clinic Ethics Consultation Service, which begins with a review of the medical indications, patient preferences, quality of life, and contextual features of a given case. This approach enables clinicians to identify and analyze the relevant facts of a case, define the ethical problem, and suggest a solution.

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Advance DirectivesAgedAged, 80 and overCommunicationConfidentialityConflict, PsychologicalCooperative BehaviorDecision MakingGeriatricsHumansInformed ConsentMedical FutilityMental CompetencyPatient AdvocacyPatient Education as TopicPatient SelectionPhysician-Patient RelationsPrinciple-Based EthicsQuality of LifeResuscitation OrdersWithholding TreatmentHealth Care and Public HealthProfessional Patient RelationshipJournal ArticleReview

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BibTeXRIS

Paul S Mueller, C Christopher Hook, Kevin C Fleming. 2004. Ethical issues in geriatrics: a guide for clinicians.. https://doi.org/10.4065/79.4.554

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