Abstract

BARRETO, João. Ethics in the care of the elderly. Rev Port Med Geral Fam [online]. 2022, vol.38, n.1, pp.114-124.  Epub Feb 28, 2022. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v38i1.13398.

Most older people have multiple medical, nursing, and other care needs, combined with situations of economic and social deprivation, which need to be addressed. Care provision often involves ethical issues, which pose challenges not only for professional carers but also for informal carers and for society.

The author reviews the major principles of biomedical ethics, emphasizing the way in which they apply to elderly patients. It is stressed that these principles not only apply in exceptional and complex cases but also in ordinary situations of everyday life. Sometimes these principles may be in conflict, for example when the imperative to always act in the best interest of the patient clashes with the principle of autonomy. A hierarchy of values is then necessary. Situations of cognitive deficit, dependence, and incapacity often create dilemmas difficult to solve.

Professionals sometimes question the quality of life that can be provided to the elderly, particularly when they suffer from dementia and are close to the end of life. It is not always easy to apply the applicable deontological rules to complex and intricate situations. The author recommends a prudent approach that considers the overall needs of the person, paying attention as much as possible to the expressed or presumed wishes of the patient, the position of close family members, and the opinion of the various team members.

Keywords : Elderly; Ethics; Autonomy; Dementia; Quality of life; Terminal care.

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