Abstract

MARQUES, Rita Gaspar; SIMOES, Pedro Augusto; ROSA, Bárbara Santa  and  SILVESTRE, Margarida. Autonomous elderly: an ethical discussion. Rev Port Med Geral Fam [online]. 2021, vol.37, n.5, pp.482-488.  Epub Oct 31, 2021. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v37i5.13232.

The current increase of the elderly population requires a constant adjustment of health care and in medical acting. The particularities of this population raise several ethical issues that must be discussed in a wide scope, to improve health care and facilitate medical acting towards ethical dilemmas. One of the most frequent ethical issues concerns respect for the autonomy of the elderly since old age is often associated with loss of physical and mental health and, therefore, autonomy. However, age alone does not determine the inability to make decisions, nor vulnerability. Although the context and circumstances surrounding the elderly may influence or even limit their autonomy, the physician cannot assume a paternalistic attitude and decide for the patient. The physician should make a special effort to analyse and understand the patient's decision-making capacity and the context that involves him, namely his vulnerabilities, illness experience, life perspectives, and family influence. Thus, the physician can use this knowledge to promote the decision-making capacity of the elderly, in order to guarantee autonomy, fairness, and justice for these patients. In addition, by promoting autonomy, participation in the community, active aging and quality of life are also enhanced. General practitioners have a privileged and predominant role in this task. Their proximity, the possibility of frequent and prolonged contacts over time, and the knowledge they have about their lives, perspectives, and values, allow these professionals to foster and promote the autonomy of the elderly.

Keywords : Aged; Decision making; Personal autonomy; Ethics; Vulnerable populations; Primary health care.

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