Aging And Ethics: Philosophical Problems in Gerontology PDF
Preview Aging And Ethics: Philosophical Problems in Gerontology
Aging and Ethics Contemporary Issues in Biomedicine, Ethics, and Society Aging and Ethics, edited by Nancy S. Jecker, 1991 New Harvest: Transplanting Body Parts and Reaping the Benefits, edited by C. Don Keyes, in collaboration with coeditor Walter E. Wiest, 1991 Beyond Baby M, edited by Dianne M. Bartels, Reinhard Priester, Dorothy E. Vawter, and Arthur L. Caplan, 1990 Reproductive Laws for the 1990s, edited by Sherrill Cohen and Nadine Taub, 1989 The Nature of Clinical Ethics, edited by Barry Hoff- master, Benjamin Freedman, and Gwen Fraser, 1988 What Is a Person?, edited by Michael F. Goodman, 1988 Advocacy in Health Care, edited by Joan H. Marks, 1986 Which Babies Shall Live?, edited by Thomas H. Murray and Arthur L. Caplan, 1985 Feeling Good and Doing Better, edited by Thomas H. Murray, Willard Gaylin, and Ruth Macklin, 1984 Ethics and Animals, edited by Harlan B. Miller and William H. Williams, 1983 Profits and Professions, edited by Wade L. Robison, Michael S. Pritchard, and Joseph Ellin, 1983 Visions of Women, edited by LindaA. Bell,1983 Medical Genetics Casebook, by Colleen Clements, 1982 Who Decides?, edited by Nora K. Bell, 1982 The Custom-Made Child?, edited by Helen B. Holmes, Betty B. Hoskins, and Michael Gross, 1980 Medical Responsibility, edited by Wade L. Robison and Michael S. Pritchard, 1979 Contemporary Issues in Biomedical Ethics, edited by John W. Davis, Barry Hoffmaster, and Sarah Shorten, 1979 Aging and Ethics Philosophical Problems in Gerontology Edited by Nancy S. Jecker University of Washington School of Medicine, Seattle, Washington .. Springer Science+Business Media, LLC DEDICATION For my mother, Mae Anna Driscoll Silbergeld November 23, 1923-November 22, 1990 Ubrary of Congre .. Cataloging in Publication Data Main entlV under title: Aging and Ethica: philosophical problems in gerontology I edited by Nancy S. Jecker. p. cm. - (Contemporary issues in biomedicine, ethics, and society) Includes index. ISBN 978-0-89603-255-2 ISBN 978-1-4612-0423-7 (eBook) DOI 10.1007/978-1-4612-0423-7 ,. Gerontology-Moral and ethical aspects. 2. Aging-Moral and ethical aspects. 3. Death-Moral and ethical aspects. 1. Jecker, Nancy Ann Silbergeld. II. Series. HQ1061.A4555 1991 305.26-dc20 91-10792 CIP © 1991,1992 SpringerScience+Business Media New York Originally published by Humana Press Ine. in 1992 Softcover reprint of the hardcover 1s t edition 1992 AII rights reserved. No partof this book may be reproduced, stored in a retrieval system, ortransmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise without written permission from the Publisher. 10 9 8 7 6 5 4 3 2 Preface The Aging Self and the Aging Society Ethical issues involving the elderly have recently come to the fore. This should come as no surprise: Since the turn of the century, there has been an eightfold in crease in the number of Americans over the age of sixty five, and almost a tripling of their proportion to the general population. Those over the age of eighty-five- the fastest growing group in the country-are twenty one more times as numerous as in 1900. Demographers expect this trend to accelerate into the twenty-first century. The aging of society casts into vivid relief a num ber of deep and troubling questions. On the one hand, as individuals, we grapple with the immediate experience of aging and mortality and seek to find in it philosophical or ethical significance. We also wonder what responsi bilities we bear toward aging family members and what expectations of others our plans for old age can reasona bly include. On the other hand, as a community, we must decide: What special role, ifa ny, do older persons occupy in our society? What constitutes a just distribution of medical resources between generations? And, How can institutions that serve the old foster imperiled values, such as autonomy, self-respect, and dignity? Only recently have we begun to explore these themes, yet already a rich and fruitful literature has grown up around them. The essays in this volume address a wide range of concerns, incorporate a multiplicity of disciplines, and afford a broad perspective for viewing the many timely and important issues members of an v vi Preface aging society face. Somewhat procrusteanly, the issues dealt with here can be viewed at four levels. The first level is that of the individual experience of personal ag ing, anticipation ofd eath, and understandingoffinitude. Sally Gadow depicts these aspects vividly, describing the experience ofl iving in an aging body and the reaction an aging body prompts from others. The essays by Baier and Moody explore the meaning ofa ging by calling attention to the whole-life perspective later years afford and the opportunity for self-knowledge and discovery this per spective creates. Thomas Cole's paper also treats the individual experience of aging, by elucidating its his torical expression in the metaphor of life as a journey. The incompleteness of this motif for raising larger questions about the social significance of aging suggests the need to transcend personal aging and consider aging in a social context. Moving then from a phenomenological and per sonallevel to an interpersonal and public second level, Hagestad describes the change in family structure an aging society implies. English and Callahan attempt to say what exactly grown children owe their elderly par ents, as distinguished from what it would be kind or salutary for them to provide. Fry considers concrete problems of medical decision making with elderly patients. She illustrates the significance of the elderly patient adult offspring and elderly patient-nurse relationships for safeguarding autonomous choices. Finally, Barker and Jecker touch on the ways that patient-family rela tionships can enable (or disable) responsible medical de cision making. The third level is oriented less toward the intimate and interpersonal aspects of aging and more toward social consciousness of and collective responsibility for it. One Preface vii issue that arises at this level is whether it is ever ethi cally appropriate to disenfranchise the elderly from pub licly financed life-extending medical care. Callahan and Daniels suggest that it is, and delineate the conditions where limiting health care for older persons is consistent with standards of justice. Waymack rejects their argu ments and attempts to show that using age as a criterion of exclusion from medical care is not ultimately defen sible. J ecker likewise casts doubt on the proposal to exclude the elderly from life-extending medical care. She challenges the concept of a "natural life span" upon which this proposal rests. A related issue is how to define gen eral health care goals for older Americans. Menzel shows that figuring the costs of meeting health care goals is enormously complex. Boyajian points out that a large gap exists between initially stated goals and their achievement in political and administrative processes. A fourth and final level brings us full circle to the general philosophical level with which our inquiry began. Jonsen considers the salience of age and argues that the elderly occupy a privileged position by virtue of their collective past contributions. Schneiderman and Jecker ask, What is a fitting stance toward human finitude and aging? A final essay, by Nagel, suggests that coming to terms with our "cosmic unimportance" requires learning to feel at home with certain ironies in human existence. Nancy S. Jecker Acknowledgments The Role of Intimate Others in Medical Decision Making, by Nancy S. Jecker originally appeared in The Gerontologist, vol 30, 1990, eGerontological Society of America Umiting Health Care for the Old, by Daniel Callahan originally appeared in Setting Umits, Simon & Schuster, Inc., 1f>1987 by Daniel Callahan Families as earegivers: The Umits of Motality, by Daniel Callahan originally appearad in The Archives of Physical Medicine and Rehabilitation, vol 69, 1988 The Meaning of Ufe and the Meaning of Old Age, by Harry R. Moody originaly appeared in What Does It Mean to Grow Old?, Durham, NC, Duke University Press 1986, Thomas R. Cole and Sally Gadow, ads The Absurd, by Thomas Nagel originally appeared in the Joumal of Philosophy, LXIII:20 (1971) The Aging Society as a Context for FamUy Ufe, by Gunhild O. Hagestad was reprinted by permission of Daedalus, Joumal of the American Academy of Arts and Sciences, "The Aging Society," Winter 1986, Vol. 115, No.1, Cambridge, MA What Do GroMl Children 0w8 'Their Parents?, by Jane English originaDy appearad in Philosophical and Lsga/ Reflections on Parenthood, New York: OxfoJd University Press, 1979, Onora O'Neill and Wi.iam Rudcick, ads. Contents v Preface Contributors Xl The Aging Individual 3 The Meaning of Life Kurt Baier 51 The Meaning of Life in Old Age Harry R. Moody 93 Oedipus and the Meaning of Aging: Personal Reflections and Historical Perspectives Thomas R. Cole 113 Recovering the Body in Aging Sally Gadow Aging and Filial Responsibility 123 The Aging Society as a Context for Family Life Gunhild O. Hagestad 147 What Do Grown Children Owe Their Parents? Jane English 155 Families as Caregivers: The Limits of Morality Daniel Callahan 171 Health Care and Decision Making Sara T. Fry 187 Rethinking Family Loyalties Evelyn M. Barker 199 The Role of Intimate Others in Medical Decision Making Nancy S. Jecker ix x Contents Distributive Justice in an Aging Society 219 Limiting Health Care for the Old Daniel Callahan 227 A Lifespan Approach to Health Care Norman Daniels 247 Old Age and the Rationing of Scarce Health Care Resources Mark H. Waymack 269 Appeals to Nature in Theories ofA ge-Group Justice Nancy S. Jecker 285 Paying the Real Costs of Lifesaving Paul T. Menzel 307 Intent and Actuality: Sacrificing the Old and Other Health Care Goals Jane A. Boyajian Philosophical Reflections on Aging and Death 341 Resentment and the Rights of the Elderly Albert R. Jonsen 353 Ancient Myth and Modem Medicine: Lessons from Baucis and Philemon Lawrence J. Schneiderman 367 The Meaning of Temporality in Old Age Nancy S. Jecker 375 The Absurd Thomas Nagel 389 Index
The list of books you might like
