Book contents
- Frontmatter
- Contents
- List of contributors
- 1 Introduction
- 2 Difficult choices in treating and feeding the debilitated elderly
- 3 The American debate about artificial nutrition and hydration
- 4 Reflections on Horan and Boyle
- 5 The Living Will: the ethical framework of a recent Report
- 6 Some reflections on euthanasia in The Netherlands
- 7 Is there a policy for the elderly needing long-term care?
- 8 Is it possible to provide good quality long-term care without unfair discrimination?
- 9 The prospects for long-term care: current policy and realistic alternatives
- 10 What is required for good quality in long-term care of the elderly?
- 11 Should age make a difference in health care entitlement?
- 12 Economic devices and ethical pitfalls: quality of life, the distribution of resources and the needs of the elderly
- 13 The Aged: non-persons, human dignity and justice
- 14 Economics, justice and the value of life: concluding remarks
- Index
4 - Reflections on Horan and Boyle
Published online by Cambridge University Press: 01 October 2009
- Frontmatter
- Contents
- List of contributors
- 1 Introduction
- 2 Difficult choices in treating and feeding the debilitated elderly
- 3 The American debate about artificial nutrition and hydration
- 4 Reflections on Horan and Boyle
- 5 The Living Will: the ethical framework of a recent Report
- 6 Some reflections on euthanasia in The Netherlands
- 7 Is there a policy for the elderly needing long-term care?
- 8 Is it possible to provide good quality long-term care without unfair discrimination?
- 9 The prospects for long-term care: current policy and realistic alternatives
- 10 What is required for good quality in long-term care of the elderly?
- 11 Should age make a difference in health care entitlement?
- 12 Economic devices and ethical pitfalls: quality of life, the distribution of resources and the needs of the elderly
- 13 The Aged: non-persons, human dignity and justice
- 14 Economics, justice and the value of life: concluding remarks
- Index
Summary
Michael Horan's paper directly reflects his clinical practice in the continuing care setting with patients who, as he says, will have suffered a dramatic loss of independence in moving from home to the geriatric unit. There are very strong reasons, therefore, for seeking to mitigate that loss by encouraging the exercise of self-determination wherever it can be appropriately exercised. Horan shows himself anxious to respect the right to self-determination of the elderly where there is the required capacity to exercise that right and where what the patient desires does not involve injustice to others.
The distinction between what a patient wants and what is required in justice in the treatment of a patient is clearly important in determining the limits of autonomy in concrete situations. When Horan comes to focus in the final part of his paper on three difficult types of decision which from time to time have to be made in the care of the debilitated elderly, it is clear that his practice is in fact governed by considerations of justice.
(1) Psychotropic medication, in dosages which cause drowsiness or induce confusion, may be required in the management of disturbed behaviour in order to avoid foreseeable harm to staff on whom the care of the patients depends.
- Type
- Chapter
- Information
- The Dependent Elderly , pp. 47 - 52Publisher: Cambridge University PressPrint publication year: 1992