Ethical issues in geriatrics
Healthcare professionals working in geriatrics interact with a lot of elderly persons with medical and psychosocial problems. They are, therefore, expected to make decisions concerning the health and wellbeing of their patients regularly. However, the health conditions of the elderly may result in ethical dilemmas. Therefore, clinicians should understand the common ethical difficulties encountered and the most appropriate approach when faced with one.
Below are some common ethical dilemmas encountered when caring for the elderly.
1. Patient Confidentiality: This principle requires that the clinicians not to disclose any personal information of their patients to other people. However, the clinician should feel free to ask the patient any personal information illness that is relevant to their health. The clinician cannot share such information with others unless in a situation where the information can be used to protect the patient and the community at large.
2. Informed consent: It is the responsibility of the clinicians to inform the patient about their illnesses and present to them the treatment options as well as their risks and side effects. However, clinicians dealing with an elderly patient with an impaired capacity to make decisions are given authority to make health care decisions that they deem appropriate.
3. Determining decision-making capacity: Older patients often suffer from various illnesses such as dementia that may impair their decision-making capacity. A clinician should be able to identify whether their patient is in the condition of making the right decisions regarding their health. This can be weighed with the patient’s ability to make a choice and understand the nature and consequences of their decision and the ability to reason consistently with previously expressed values.
4. Using a surrogate for decision making: If an elderly patient lacks decision-making capacity, the clinician is obligated to use a reliable surrogate to make decisions on their behalf. If the patient has an AD, then their choices on the surrogate should be respected. However, with the absence of an AD, the clinicians should identify the most appropriate surrogate for the patient. This could be a close relative or guardian.
5. Responding to Resuscitation and do-not-resuscitate orders: Normally, clinicians must perform CPR on their patients unless with a do-not-resuscitate order to which either the patient or the surrogate has consented. Most elderly persons are not aware or do clearly understand what is meant by CPR. Clinicians must explicitly discuss with their clients about CPR and respect their decisions regarding the same.
Ethical issues may arise due to poor clinician-patient communication. However, even with the best efforts, ethical dilemmas are bound to happen when tending to elderly persons. Clinicians should be able to identify and analyze a situation and come up with the most appropriate solution.
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