Ethical Issues in Geriatrics: A Guide for Clinicians

Paul Mueller, C. Christopher Hook, Kevin C. Fleming

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Because of demographic trends, it is reasonable to expect that clinicians will care for an increasing number of elderly persons with challenging medical and psychosocial problems. These problems and issues, in turn, may lead to daunting ethical dilemmas. Therefore, clinicians should be familiar with ethical dilemmas commonly encountered when caring for elderly patients. We review some of these dilemmas, including ensuring informed consent and confidendality, determining decision-making capacity, promoting advance care planning and the use of advance directives, surrogate decision making, withdrawing and withholding interventions, using cardiopulmonary resuscitation and do-not-resuscitate orders, responding to requests for interventions, allocating health care resources, and recommending nursing home care. Ethical dilemmas may arise because of poor patient-clinician communication; therefore, we provide practical tips for effective communication. Nevertheless, even in the best circumstances, ethical dilemmas occur. We describe a case-based approach to ethical dilemmas used by the Mayo Clinic Ethics Consultation Service, which begins with a review of the medical indications, patient preferences, quality of life, and contextual features of a given case. This approach enables clinicians to identify and analyze the relevant facts of a case, define the ethical problem, and suggest a solution.

Original languageEnglish (US)
Pages (from-to)554-562
Number of pages9
JournalMayo Clinic Proceedings
Volume79
Issue number4
DOIs
StatePublished - Jan 1 2004

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Ethics
Geriatrics
Decision Making
Ethics Consultation
Advance Care Planning
Communication
Resuscitation Orders
Advance Directives
Patient Preference
Health Resources
Cardiopulmonary Resuscitation
Home Care Services
Nursing Care
Nursing Homes
Informed Consent
Quality of Life
Demography
Delivery of Health Care

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ethical Issues in Geriatrics : A Guide for Clinicians. / Mueller, Paul; Hook, C. Christopher; Fleming, Kevin C.

In: Mayo Clinic Proceedings, Vol. 79, No. 4, 01.01.2004, p. 554-562.

Research output: Contribution to journalArticle

Mueller, Paul ; Hook, C. Christopher ; Fleming, Kevin C. / Ethical Issues in Geriatrics : A Guide for Clinicians. In: Mayo Clinic Proceedings. 2004 ; Vol. 79, No. 4. pp. 554-562.
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