ERIC Number: ED255789
Record Type: RIE
Publication Date: 1984-Nov
Reference Count: 0
An Ethical Framework for Long-Term Care Decision Making.
McCullough, Laurence B.; And Others
Values enter into the consideration of chronic care options at both the macro, or policy level, and at the individual, decision making level. The ethical dimensions of these decisions, however, have been largely overlooked. A model of long-term care (LTC) decision making is proposed which incorporates an empirical foundation into an ethical framework. It begins with the assumption that there are three relevant parties, the elderly person, his or her family, and the professional provider group. The model allows for conflict which arises from the implicit consideration of one party's values by another party in the decision making process. In order to investigate the accuracy and relevance of this model for application in actual cases of LTC decision making, a pilot project was developed in which participants were interviewed during or shortly after their involvement in an LTC decision. Interviews were completed with 15 family decision makers, five of the impaired individuals, and, in five cases, with the primary physician. In order to identify value-based conflicts that arise in LTC decision making, open ended interview schedules specific to each of the three parties were developed. Four moral principles were found to be relevant to the determination of what is in an elderly person's best interests for the satisfaction of needs, the amelioration of risks, and securing benefits of LTC. These four principles: beneficence (maximally satisfying need and producing benefit at the lowest possible risk), respect for autonomy, filial responsibility, and justice, together constitute an ethical framework for LTC decision making for the elderly. This framework expands the context in which students of gerontology and practitioners of geriatrics should understand the process of LTC decision making, and shows it to be a process inescapably marked by moral conflict. (LLL)
Publication Type: Opinion Papers; Speeches/Meeting Papers
Education Level: N/A
Authoring Institution: N/A
Identifiers: Long Term Care
Note: Paper presented at the Annual Scientific Meeting of the Gerontological Society (37th, San Antonio, TX, November 16-20, 1984). Support for this research was provided by the Atlantic Richfield Foundation.