Planning Later Life: Bioethics and Public Health in Ageing Societies PDF
Preview Planning Later Life: Bioethics and Public Health in Ageing Societies
Planning Later Life T his book examines the relevance of modern medicine and healthcare in shaping the lives of elderly persons and the practices and institutions of ageing societ- ies. Combining individual and social dimensions, P lanning Later Life discusses the ethical, social, and political consequences of increasing life expectancies and demographic change in the context of biomedicine and public health. By focusing on the field of biomedicine and healthcare, the authors engage read- ers in a dialogue on the ethical and social implications of recent trends in dementia research and care, advance healthcare planning, or the rise of anti-ageing medicine and prevention. Bringing together the largely separated debates of individualist bio- ethics on the one hand, and public health ethics on the other, the volume deliberately considers the entanglements of envisioning, evaluating, and controlling individual and societal futures. So far, the process of devising and exploring the various posi- tive and negative visions and strategies related to later life has rarely been reflected systematically from a philosophical, sociological, and ethical point of view. A s such, this book will be crucial to those working and studying in the life sci- ences, the humanities, and the social sciences, particularly in the areas of bioeth- ics, social work, gerontology and ageing studies, healthcare and social services, sociology, social policy, and geography and population studies. Mark Schweda is Research Fellow at the Department for Medical Ethics and History of Medicine, University Medical Center Göttingen. Larissa Pfaller is Research Associate at the Institute of Sociology at the Univer- sity of Erlangen-Nuremberg and currently Deputy Professor at the University of Hamburg. Kai Brauer is a sociologist and teaches empirical methods and sociology of age- ing at Carinthia University of Applied Sciences (CUAS). Frank Adloff is Professor of Sociology at the University of Hamburg. Silke Schicktanz is a bioethicist and Professor for Cultural and Ethical Studies of Biomedicine at the Department for Medical Ethics and History of Medicine, University Medical Center Göttingen. Routledge Advances in Health and Social Policy For a full list of titles in this series, please visit https://www.routledge.com/ Routledge-Advances-in-Health-and-Social-Policy/book-series/RAHSP Titles in this series : The Invisible Work of Nurses Hospitals, Organisation and Healthcare Davina Allen Domestic Violence in Diverse Contexts A Re-examination of Gender Sarah Wendt and Lana Zannettino Maternity Services and Policy in an International Context Risk, Citizenship and Welfare Regimes Edited by Patricia Kennedy and Naonori Kodate Innovation in Social Welfare and Human Services Rolf Rønning and Marcus Knutagård Social Development and Social Work Perspectives on Social Protection Edited by Julie Drolet Moralising Poverty The ‘Undeserving’ Poor in the Public Gaze Serena Romano Forthcoming titles : M-Health in Developing Countries Design and Implementation Perspectives on Using Mobiles in Healthcare Arul Chib Alcohol, Power and Public Health A Comparative Study of Alcohol Policy Shane Butler, Betsy Thom, James Nicholls and Karen Elmeland Social Policies and Public Action Lavinia Bifulco Planning Later Life Bioethics and Public Health in Ageing Societies Edited by Mark Schweda, Larissa Pfaller, Kai Brauer, Frank Adloff, and Silke Schicktanz First published 2017 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN and by Routledge 711 Third Avenue, New York, NY 10017 Routledge is an imprint of the Taylor & Francis Group, an informa business © 2017 selection and editorial matter, Mark Schweda, Larissa Pfaller, Kai Brauer, Frank Adloff, and Silke Schicktanz; individual chapters, the contributors The right of Mark Schweda, Larissa Pfaller, Kai Brauer, Frank Adloff and Silke Schicktanz to be identified as the authors of the editorial material, and of the authors for their individual chapters, has been asserted in accordance with sections 77 and 78 of the Copyright, Designs and Patents Act 1988. All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. Trademark notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe. British Library Cataloguing-in-Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data Names: Schweda, Mark, editor. Title: Planning later life / edited by Mark Schweda, Larissa Pfaller, Kai Brauer, Frank Adloff, & Silke Schicktanz. Description: Milton Park, Abingdon, Oxon ; New York, NY : Routledge, 2017. | Includes bibliographical references and index. Identifiers: LCCN 2016058994 | ISBN 9781472481320 (hardback) | ISBN 9781315600772 (ebook) Subjects: LCSH: Bioethics. | Longevity. | Aging—Prevention. | Medical ethics. Classification: LCC QH332 .P57 2017 | DDC 174.2—dc23 LC record available at https://lccn.loc.gov/2016058994 ISBN: 978-1-4724-8132-0 (hbk) ISBN: 978-1-315-60077-2 (ebk) Typeset in Times New Roman by Apex CoVantage, LLC Contents List of figures and tables vii Notes on contributors viii Introduction 1 MARK SCHWEDA, LARISSA PFALLER, AND SILKE SCHICKTANZ PART 1 Conceptions of ageing and old age 9 1 “A season to everything”? Considering life-course perspectives in bioethical and public-health discussions on ageing 11 MARK SCHWEDA 2 Becoming oneself: toward a new philosophy of ageing 31 THOMAS RENTSCH 3 Third age and fourth age in ageing societies – divergent social and ethical discourses 46 FRANÇOIS HÖPFLINGER 4 The nature of the fourth age as a challenge to ageing societies 57 PAUL HIGGS AND CHRIS GILLEARD PART 2 Perspectives and problems of old age in the context of medicine and healthcare 73 5 Old age, potentials, and vulnerability 75 ANDREAS KRUSE vi Contents 6 Competence and cognitive deterioration: are we paying enough attention to ethical issues? 89 PERLA WERNER AND SILKE SCHICKTANZ 7 Opt in or opt out? Rethinking the provision of life-sustaining medical technology to the ‘old old’ 104 HSIU-I YANG 8 Not growing old – gracefully 119 SØREN HOLM 9 How to think about age-group justice: the capabilities approach 131 NANCY S. JECKER PART 3 Individual provisions and public policies in ageing societies 147 10 Final decisions for the final crisis: hopes and hypes regarding the advance directive in Germany 149 KAI BRAUER 11 Preparing existential decisions in later life: advance healthcare planning 164 RALF J. JOX 12 Articulating the case for the Longevity Dividend 181 S. JAY OLSHANSKY 13 Paradoxes of planning later life: anti-ageing practices and the lived body 191 LARISSA PFALLER AND FRANK ADLOFF 14 The visionary shaping of dementia research: imaginations and scenarios in biopolitical narratives and ethical reflections 205 SILKE SCHICKTANZ 15 Solidarity and family care for an ageing population 228 RUUD TER MEULEN 16 Legacies, generations, and ageing futures: the ethics of intergenerativity 240 STEPHEN KATZ AND PETER J. WHITEHOUSE Index 255 Figures and tables Figures 8.1 Life expectancy by age in England and Wales, 1700–2013 121 8.2 Changes in male life expectancy in the UK 122 11.1 Conceptual schema contrasting the advance directive (living will) and the model of advance care planning (ACP), illustrating the ACP characteristics of (1) interactivity (gray triangles for conversations), (2) item plurality (bars with different patterns for various documents), and (3) iterativity (multiple revisions along the time scale) 168 11.2 Conceptual schema depicting the roles and relations of involved parties in ACP – both at the time of preparing and making advance decisions (left cluster) and at the later time of interpreting and applying advance decisions to clinical situations (right cluster) 169 14.1 Examples of campaigns of US ALZ 214 14.2 Examples of motifs from campaigns supported by GER ALZ 215 Tables 3.1 Life expectancy and healthy life expectancy at age 65 in selected European countries, 2013 48 3.2 Health indicators and financial situation of people 55 to 74 years of age in selected European countries, 2014 49 3.3 Post-modern values at higher ages in selected European countries, 2014 50 3.4 Dependence on care and prevalence of dementia by age group 52 Contributors Frank Adloff is Professor of Sociology at the University of Hamburg. His research interests include social theory, political sociology, culture and affec- tivity, conviviality, the gift, and civil society. Kai Brauer is a sociologist and teaches empirical methods and sociology of age- ing at Carinthia University of Applied Sciences (CUAS). He is co-founder of the IARA: Institute of Applied Research on Ageing. He has studied and worked at the Free University of Berlin and at the Universities of Kassel, Erlangen, and Vechta as well as at the WZB Berlin Social Science Center. Chris Gilleard is a Visiting Research Fellow in the Division of Psychiatry at Uni- versity College London. He has co-authored a number of books theorizing the place of ageing and later life in contemporary society, including C ultures of Age- ing: Self, Citizen and the Body (2000), A geing, Corporeality and Embodiment (2013), and Rethinking Old Age: Theorising the Fourth Age (2015) (all with Paul Higgs). Paul Higgs is Professor of the Sociology of Ageing at University College London. He co-authored C ultures of Ageing: Self, Citizen and the Body (2000), A geing, Corporeality and Embodiment (2013), and Rethinking Old Age: Theorising the Fourth Age (2015) (all with Chris Gilleard). He is editor of S ocial Theory and Health and has published in both social gerontology and medical sociology. He is currently engaged in a number of large research projects investigating the social aspects of dementia. He is a Fellow of the Academy of Social Sciences and the Gerontological Society of America. Søren Holm is a Danish medical doctor and philosopher. He is Professor of Bioethics at the University of Manchester School of Law’s Centre for Social Ethics and Policy and holds part-time chairs in Medical Ethics at the Cen- ter for Medical Ethics at Oslo University and the Department of Health Sciences and Technology at Aalborg University. He has presided over the European Society for the Philosophy of Medicine and Health Care and is the vice-president of the International Association of Bioethics. He is a former member of the Danish Council of Ethics and of the Nuffield Council on Bioethics. Contributors ix François Höpflinger is Professor for Sociology (Emeritus) at Zurich University. He was director of the institute “Ageing and Generations” in Sion, Switzerland. His research interests include sociology of ageing and gerontology, demograph- ics, generational ties and societal generational relations, and living and working in later life. He has published on family and care, the baby-boomer generation, dependency and long-term care. He is a member of the steering committee of the Center for Gerontology at the University of Zurich. Nancy S. Jecker is Professor of Bioethics & Humanities at the University of Washington School of Medicine and Adjunct Professor of Philosophy at the School of Law. Her research addresses age-group justice, healthcare allocation, withholding and withdrawing treatment, and ethical theory. She co-authored (with L.J. Schneiderman) W rong Medicine, 2nd edition (2011/Taiwan: 2015), co-edited (with A.R. Jonsen and R.A. Pearlman) B ioethics, 3rd edition (2011), and has published over 100 papers in bioethics and philosophy. Ralf J. Jox is Associate Professor for Geriatric Palliative Care at Lausanne Uni- versity Hospital, Switzerland, and Assistant Professor for Medical Ethics at the University of Munich, Germany. He has published widely on palliative care, end-of-life decision making, advance directives, and surrogate decision mak- ing. He is a member of the task force “Advance Care Planning” of the European Association for Palliative Care as well as a member of the task force “Advance Care Planning” of the Swiss Federal Public Health Office. Stephen Katz is Professor for Sociology at Trent University. He has worked on ageing, pharmaceutical expertise, sexuality, and enhancement and is currently working on the cultural aspects of ageing memory and cognitive impairment. He is author of Disciplining Old Age: The Formation of Gerontological Knowledge (1996) and C ultural Ageing: Life Course, Lifestyle, and Senior Worlds (2005). Andreas Kruse is Professor at and Director of the Institute of Gerontology at Heidelberg University. He is a psychologist, gerontologist, and demographer, a member of the German Ethics Council, and the author of many scientific pub- lications on ageing and old age, perspectives of gerontology, and quality of life in dementia. Among many other honors, he was awarded the Federal Cross of Merit with Ribbon of the Federal Republic of Germany. Ruud ter Meulen is Emeritus Professor in Ethics in Medicine at the University of Bristol. He was Director and Professor in Philosophy at the Institute of Bioethics and the University of Maastricht before moving to Bristol in 2005. He was principal investigator of a range of projects funded within the various Framework Programs of the European Commission, and he presides over the European Association of Centres for Medical Ethics (EACME). S. Jay Olshansky is a Professor in the School of Public Health at the University of Illinois at Chicago, Research Associate at the Center on Ageing at the Uni- versity of Chicago and at the London School of Hygiene and Tropical Medi- cine, and chief scientist at Lapetus Solutions. The focus of his research has
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