Growing old – a neglected discussion in healthcare ethics? Outlining a healthcare ethic for geriatric patients

Abstract

This study argues that a healthcare ethic for geriatric patients should include more clearly defined and better guidelines than those currently reflected in conventional medical and bio-ethical protocols. The argument is based on the central view that a geriatric patient should be treated as a subject in healthcare and not merely as an object that needs to be cared for. The view is informed by the vulnerability of the person of age: in dealing with this vulnerability, attention should be given to more aspects than the physical health of the patient only. Attention should be paid to the context of a patient (culture, background, language, value system, religion), habitat, access to food and water, safety and security. All of these aspects contribute towards the level of vulnerability of the geriatric patient.

This study is performed by means of a review of relevant literature and reports. The result of this qualitative method is the confirmation that a number of factors contribute to the vulnerability of the geriatric patient and that following from this, these factors should be included in a healthcare ethic. These factors relate to the dignity of the patient, respect for the patient, a sustained and respected existence, the creation of an enabling livelihood and the education of people in relevant institutions and communities to contribute to an acceptable healthcare ethic for geriatric patients.

The study concludes with nine ethical dictums confirming the value and respect for life, attention to vulnerability, and supportive mechanisms to secure an enabling ethical environment for geriatric patients.

Oudword – ʼn verwaarloosde bespreking in gesondheidsorgetiek? Die identifisering van ʼn gesondheidsorgetiek vir geriatriese pasiënte

Hierdie studie argumenteer dat ʼn gesondheidsorgetiek vir geriatriese pasiënte riglyne moet insluit wat duideliker en beter omskryf is as wat tans in die bestaande mediese en bio-etiese protokolle opgeneem is. Die argument is gebaseer op die sentrale perspektief dat die geriatriese pasiënt as ʼn onderwerp in gesondheidsorg hanteer moet word en nie as net ʼn voorwerp waarvoor gesorg moet word nie. Hierdie siening is ingelig deur die broosheid van die bejaarde persoon. Die hantering van broosheid verg meer as net die fisieke gesondheid van die geriatriese pasiënt. Aandag moet gegee word aan die konteks van die pasiënt (kultuur, agtergrond, taal, waardesisteem en godsdiens), woning, toegang tot kos en water, veiligheid en sekuriteit. Al hierdie aspekte dra by tot die broosheid van die geriatriese pasiënt.

Die studie is gebaseer op die ontleding van relevante literatuur en verslae. Die resultaat van hierdie kwalitatiewe metode is die bevestiging van die faktore wat bydra tot die broosheid van die geriatriese pasiënt: etiese riglyne vir hierdie faktore moet ook in ʼn gesondheidsorgetiek vir geriatriese pasiënte ingesluit word. Hierdie faktore verwys na die waardigheid van die pasiënt, respek vir die pasiënt, die volhou van ʼn menswaardige bestaan, volhoubare woning en die onderrig van die personeel van relevante instellings en gemeenskappe om by te dra tot ʼn gesondheidsorg vir geriatriese pasiënte.