• Ethical Issues With an Aging Population

  According to the CDC, “in the United States, the proportion of the population aged >65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030,” (CDC, 2003, para. 2). Caring for this aging population is going to be one of the greatest challenges facing the health care industry. Not only will the number of individuals requiring care rise, but so will the cost. As poignantly stated by Crippen and Barnato, “unless we change the practice of medicine and reduce future costs, and explicitly address the ethical dilemmas we face, there may come a time when our kids simply cannot afford us” (2011, p. 128).

  In this Discussion, you will examine the ethical issues that the United States and other nations must address when faced with the health care challenges of an aging population.

  To prepare:

  • Consider the ethical aspects of health care and health policy for an aging population.
  • Review the Hayutin, Dietz, and Mitchell report presented in the Learning Resources. The authors pose the question, “What are the economic consequences, now and for future generations of taxpayers if we fail to adapt our policies to the changing reality of an older population?” (p. 21). Consider how you would respond to this question. In addition, reflect on the ethical decisions that arise when dispersing limited funds.
  • Contemplate the impact of failing to adjust policy in accordance with the changing reality of an older population.
  • Reflect on the ethical dilemmas that arise when determining expenditures on end-of-life health care.

   

  Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.

• Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.
• Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
• Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

Aging Ethical Aspect of Health Care

Ethics always plays a significant role in caring for our clients, but with the increasingly aging population, our focus on ethics and nursing must adapt to take this into consideration

As health promotion, education and technology advances, the life expectancy for Americans have also risen.  According to the Stanford Center on Longevity, over the next 30 years the population of Americans over the age of 65, will at least double to 80 million (Hayutin, Dietz & Mitchell, 2010). However, with this aging population, it increases the individual’s risk to chronic diseases like obesity, arthritis, diabetes, dementia and hypertension.  Therefore, as a nation now face new challenges such as increasing healthcare costs, more retired citizens than those currently working within the workforce and greater financial burden on the individual for their retirement (Farrelly, 2010).

Code of Ethics

Looking at the Code of Ethics for Nurses by the America Nurses Association (ANA), nothing changes just because the person is elderly.  Provision one, two and three of the Code of Ethics for Nurses, looks at the nurse promoting good, being an advocate, and fighting for patients’ rights, healthcare and self-worth (Fowler & ANA, 2008).  Everyone is a unique, and we must treat them as such.  However, provision four, five and six, looks at promoting health, making decisions and ensuring the safety of our clients (Fowler & ANA, 2008).  While, provision seven, eight and nine, look at maintaining integrity, working with other health care professionals and promoting a scholarly mind, so advancing knowledge and skills through evidence-based research (Fowler & ANA, 2008).  At no point, does age play a part of the Code of Ethics. Throughout my nursing career, I have met senior citizens who are independent, have better health than people a lot younger than themselves and can make their own decisions about their healthcare.

Ethical Dilemma

With the changing and increasing aging population, nurses need to continue to advocate for our clients’ needs.  Under provision two of the Code of Ethics, the nurse’s primary commitment is to the patient.  However, older people often need more medical care, due to chronic illness and the taking of multiple medications.  Also with the elderly nearing the end of their lifespan, it can be thought that investing time and money may be of little benefit in comparison to the younger generation, who have a longer to live (Bognar, 2015).  Thankfully, the federal government prohibits consideration of this factor or the use of age as a factor in cost-benefit analysis (Bognar, 2015). Under provision eight of the Code of Ethics, “Health is a Universal Right” (pg. 31), so available to everyone indiscriminate of their age (Fowler & ANA, 2010)

Next, should we be increasing the age of retirement?  It would certainly provide more finances for health care due to the decreasing workforce, but perhaps the aging population has already paid enough into our society. Maybe we can reduce government spending, encouraging individuals to rely on their personal assets and savings for retirement care. Maybe our focus should only be on palliative care for the over 65-year-old, so maintaining their present quality of life, rather than any life-extending care. By focusing healthcare policy and research on healthcare needs of the younger generation, this will prolong the lifespan of those who have lives still to live, so a chance to make it to aged 65 (Bognar, 2015). However, will this limit the healthcare of the younger generation as they progress throughout their lifespan and become part of the aging population?  Under provision two of the Code of Ethics, we look at the interests of the individual or community (pg. 21), so looking at the client as a person, not their age (Fowler & ANA, 2008).

Also with policy and research, consent plays an important part. Informed consent may not be a problem initially, but as time progresses, it may be a concern due to the possible changing mental status of the client during and throughout the research and policy process (Ries, 2010). Older people can be more of a challenge or a vulnerable group to study. Maybe they do not have the resources to participate in the studies or with both chronic illnesses and multiple medications, it is potentially too complicated to address just one disease by itself (Ries, 2010). However, looking at provision seven of the Code of Ethics, it promotes advances in nursing practice and scholarly research, but it does not stipulate an age limit (Fowler & ANA, 2008). Nurses, therefore, need to work closely with their patients, gaining knowledge, advocating for their individual clients’ specific rights; by doing so, the nurse can carry out their clients’ personal beliefs and wishes without question (Zomorodi & Foley, 2009).

Conclusion

Health care policies favor the younger population, however, in our changing environment and aging population, we need to consider the fuller picture of healthcare.  Protecting people’s health at any age is important, and everyone deserves an equal share of opportunities throughout the span of life (Bognar, 2015).  However, it is our responsibility as nurses to ensure our clients have all the information about their health so that they can make their own informed decisions. We should not be rationing health care on age, disability or any other factors. Only an individual can decide the cost of their own life, and in cannot be assumed that an older person still does not have their own life goals to accomplish still (Gruenewald, 2012).

References

Bognar, G. (2015). Fair Innings. Bioethics. Retrieved from http://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=1&sid=a218ce66-aed5-4f27-b9dd-3d24ce53acf3%40sessionmgr103&hid=126

Farrelly, C. (2010). Equality and the duty to retard human ageing. Bioethics. Retrieved from http://eds.a.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?sid=e4700d76-f00a-4aea-a15e-a7f4a910f765%40sessionmgr4007&vid=2&hid=4210

Fowler, M. D., & American Nurses Association. (2008). Guide to the code of ethics for nurses: Interpretation and application. Retrieved from http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html

Gruenewald, D. A. (2012). Can Health Care Rationing Ever Be Rational? Journal of Law, Medicine & Ethics. Retrieved from http://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?sid=780c3109-5597-4727-b4cd-3b29aa55cadc%40sessionmgr104&vid=13&hid=104 

Hayutin, A. M., Dietz, M. & Mitchell, L. (2010). New Realities of an Older America. Stanford Center of Longevity. Retrieved from http://longevity3.stanford.edu/wp-content/uploads/2013/01/New-Realities-of-an-Older-America.pdf

Ries, N. (2010). Ethics, Health Research, and Canada’s Aging Population. Canadian Journal on Aging. Retrieved fromhttp://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=8&sid=a218ce66-aed5-4f27-b9dd-3d24ce53acf3%40sessionmgr103&hid=126

Zomorodi, M., & Foley, B. (2009). The nature of advocacy vs. paternalism in nursing: Clarifying the ‘thin line.’ Journal of Advanced Nursing, 65(8), 1746–1752. Retrieved from http://web.a.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?sid=ab4fe41a-1124-4cf9-9ccb-46c029d0e241%40sessionmgr4007&vid=1&hid=4201

Reflection

This course was designed to develop skills that will help you be an effective online student and to also help you build a multidisciplinary approach to health. For this Assignment, you reflect on becoming a scholar-practitioner, social change agent, and part of a multidisciplinary field. After reviewing your Learning Resources for this course, consider the issue you addressed in Week 1 and examine how it can be addressed from a multidisciplinary perspective. 

The Assignment (1–2 pages)

• Explain how your understanding of the multidisciplinary nature of the course content has changed or been validated.
• Explain how the issue you discussed in Week 1 of the course can be addressed from a multidisciplinary perspective.
• Expand on your insights utilizing the Learning Resources.

Include proper APA citations and references (see Publication Manual of the American Psychological Association for assistance).