Introduction
Access to life extension therapies has remained to be a serious issue of discussion as far as old age is concerned. The main argument has been on whether it is appropriate to set maximum lifespan to establish the age at which individuals must die or whether there should be considerations that make it immoral to live after a particular age. Is it fair to be denied treatment that can help increase lifespan, or is it fairer to come up and use such treatment modalities? This paper highlights the embedded ethical issues in both the imminent threat, as well as cultural differences that are involved in aging.
Overpopulation
Overpopulation has often been cited as the reason behind underdevelopment, particularly in the developing world. The misery associated with overpopulation brings about a lot of confusion, including suspicion of life extension rather than addressing issues such as improving fertility rates. It is not appropriate to look at the issue of overpopulation along with the reasoning that older people must be left to die. In other words, a physician must not ignore a sick and old patient just because doing so would help in reducing mouths to be fed (Haigh & Bagaric, 2002).
There has been a wide misconception, especially among life extension opponents, that it is practical to create a room by reducing populations of individuals thought to have had enough life. The main question raised in this context is: Why should it be the old being sacrificed for others? It is both an aspect of naivety, as well as unquestioned ageism rather than apologize for any individual to hold the thought that older people are expected to die without further argument. That the old should not struggle at all to extend their lives is an expectation that only goes to highlight the lack of human sense of life for individuals belonging to a different social group.
It is important to point out that by extending life the underlying reason does not imply prolonging frailty or disabled old age. Instead, it only targets to delay devastating aging effects. The result of such a move is to reduce or eliminate the number of individuals in society who only survive by depending on others, thus ending up straining the systems established (Haigh & Bagaric, 2002).
Right to Life
While the right to life is a universally popular concept, there is little to it that integrates life-prolonging interventions. In most instances, the right to life only discusses aspects such as abortion, embryo experimentation, as well as euthanasia, and stem cell research on embryos. In other words, the biggest misconception that seems to have been accepted in society is the fact that the embryo is the standard to the right to life.
It is still possible to uphold the right to life through life extension instead of simply focusing on the embryo. In all instances, achieving the intended optimistic right to life would still end up devouring resources. However, it is not a must that huge resources have to be utilized to achieve the right to life (Haigh & Bagaric, 2002). There is a need for positive rights to be guaranteed beyond non-interference instead of considering them to be absolute rights.
Forbidding life extension can be considered as a breach of a downbeat right to life, even if individuals got to a level of accepting that they had no rights to be guaranteed with the life-extension means. Thus, from both the negative and positive perspectives, the right to life appears to be in support of permitting rather than providing life-extension treatment access (Haigh & Bagaric, 2002). Accepting or agreeing to the right to life does not discriminate because of age in any way. This is for as long as reasons that are justifiable morally are not advanced to distinguish between the old and the young. It should be noted that the idea of thinking or believing that a particular group of persons is more entitled to live than another group because of age should not be tolerated in a just society.
Opponents of immortality therapies have often advanced the argument, thus allowing already existing people to live for long, thereby infringing on the rights of upcoming generations or the right to have children. While it is worth moral consideration when it comes to the right to have children, it is impractical to call for all the existing people to die as a way of creating room for the upcoming offspring. Instead, it should be an obvious thing not to trump the interest of prolonging one’s existence simply because of parenting interests (Haigh & Bagaric, 2002).
Cultural Biasness in Provision of Health Care System: Frail Older Adults
While it is a common fact that frail older adults often require a collection of health care attention and services to address their needs, the same is not offered uniformly (Young, 2003). Health problems among the old, whether chronic or acute, should be attended with equal measure in both inpatient and outpatient settings. In particular, long-term care should seek to address the functional needs of the aged in society, such as financing several community-based services (Young, 2003).
Frail older adults face the risk of utilizing home health and nursing homes. A caregiver’s frailty enhances the chances of the care recipient receiving these services. As Young (2003) reports, the issue of cultural differences and ethics mainly comes in as far as the provision of long-term care is involved. In the US, service use is usually biased towards culture. While the old from Caucasian community enjoy the quality and first-hand long-term care, other ethnic communities that make up the American society, including the African Americans, Hispanics, as well as Asian Americans receive either poor or total lack of long-term care (Young, 203). This implies that minority communities consumer very few health services for the elderly due to discrimination meted on them based on their culture and family values. These biases are deeply entrenched in society. These prejudices end up impeding access (Dilworth-Anderson, Pierre & Hilliard, 2012).
The number of services that a weak elderly individual should receive is determined by various factors. These include the exact needs that are a basis for support, as well as the day-to-day activities that make life. Additionally, it also factors in health problems, sensory limitations, mobility, general psychological changes, cognitive decline, and instrumental activities involved in daily living. These conditions cut across the entire society without necessarily affecting a particular community because of their skin color or other incidental factors. Thus, it becomes a huge ethical issue when the provision of these important services is based on the cultural background of an individual instead of the basic human necessity (Young, 2003).
Long-term care services form several overlapping options. These increasingly subject individuals and their relatives to choices in the system. Besides, long-term needs also change with time, a situation that causes patterns of both persistent as well as episodic use of services. It also causes interaction of both informal and formal support systems (Dilworth-Anderson, Pierre & Hilliard, 2012).
Stigmatization
Old age is a condition erroneously associated with many negative aspects, reasons, and thinking by society. The criticism leveled on efforts aimed at curbing aging has only succeeded in stigmatizing the elderly instead of strongly supporting their course. People are looking at old age with negative thinking and feeling that end up hurting the elderly (Bradley et al. 2010). The continued efforts to mitigate, abolish, eradicate, cure, and even defeat aging have strongly forged a paradigm within which the old are feeling as though they are unfortunate failures (Bradley et al. 2010). The stigmatization creates loneliness, making it a big problem and a critical ethical issue. It is wrong to imagine that this negative thinking and stigmatization will be aggravated through a narrative that educates on ‘successful aging’ to cast off those who fail to evade it.
Those lamenting the fact that there is impending stigmatization and alienation of the aged seem to always overlook the fact that there exists no ‘golden age’ in the history of this world (Bradley et al. 2010). There was no period in the past where it can be argued that the old were treated fairly in recognition of them being patients or subjects to research work. Instead, the fact lies in there is a paucity of research as far as age-related conditions are concerned. On some occasions, the aged are denied the most basic of interventions simply because it is assumed that they are on the verge of dying anyway.
Bradley et al. (2010) note that it is even challenging for specialists and other scientists with the inspiration to cure aging to find the necessary breakthrough because the old in the society will be the first ones to repulse them. The old in society have somehow accepted the fact that their condition is not ‘normal’, thus they are not willing to come forward and receive any kind of feasible treatment. Sympathy, tact, and respect have to be practiced to effectively and ethically address this situation (Bradley et al. 2010).
Stigmatization and stereotyping of the old based on their age are further likely to be perpetuated even more by nurses and other healthcare givers (Richeson & Shelton, 2005). Healthcare workers, in general, develop some of the worst stereotypes and negative attitudes regarding older adults because of the continuous interactions they have with them. This goes against any ethical thinking because the healthcare givers are supposed to be at the forefront in helping society to guide the elderly. The old suffer a lot of untold suffering as a result of this negative attitude. Such suffering includes depression without the caregivers noticing or being misdiagnosed as dementia (Richeson & Shelton, 2005). Older adults suffering from chronic and acute conditions often get mistreated, thus they are overlooked when it comes to being provided with preventive measures, including routine screenings. This happens because of the inclination amongst the nurses and physicians that it is normal for the elderly to face such tribulations. In other words, the aged, even if they are lucky enough to be admitted in homes and other healthcare facilities, could still be suffering in silence because somebody assumes suffering in old age is a normal course.
The negative beliefs harbored by many medical caregivers toward the elderly are worrisome. Self-fulfilling prophecies by the physicians and nurses end up becoming the standards of expectation instead of considering the laid out standards. The elderly are not guaranteed quality life even when they are put under the watch of professional health caregivers (Richeson & Shelton, 2005).
Eldercare Services
Although eldercare service providers are considered as better placed to help the aged in society, their operations and activities create a lot of ethical issues and questions. The issue of conflict of interest comes into play, particularly when the old person’s family members in conjunction with the professional caregivers represent the elderly (Bradley et al. 2010). Several conflicts arise from this scenario, including conflicts touching on the spouses’ wishes against those of the elders and their interests. Clash of interests also occurs pitting the wishes of family members belonging to varying generations against those of the elder. Legally acting guardians, agents, or conservators may also have their interests clash with those of the elder, especially where the parties have different interests. Another kind of conflict exists where the elder’s interests and those of eldercare provider’s business are at loggerheads.
Conflict of interest involving the elderly to be taken care of and the caregiver have the likelihood of souring the relationship that should exist between the two. This situation hampers service delivery. An elder person, for instance, who authorizes that his son manages his estate affairs when the elder becomes incapacitated, may witness a decision being made by the son to distribute the entire estate to the rest of his siblings. Such a conflict remains to be the only potential until such a time when the son makes the move to distribute the estate, ending up impoverishing the father (Bradley et al., 2010).
Caregivers also often fail to keep the confidentiality of the elderly. Instead, they work toward obtaining significant information from their client. Such an act is tantamount to breach of the confidence entrusted to them, particularly where such information is given out and used for the eldercare giver’s benefit. Often, the unethical practice ends up affecting the elder mostly by denying him what is rightfully his.
The old may have their decision-making capacity affected by their health conditions, thus affecting their participation in decision-making processes. Such situations may be exploited by the eldercare providers taking the advantage to benefit themselves at the expense of the elder. Such decisions have a higher likelihood of affecting the elder’s prospect to an extent of even causing death. The eldercare providers, thus, must fully commit themselves to the elder’s needs, including offering protection to their assets and other interests. Where eldercare givers notice that their clients can no longer make sound judgment, the best thing would be to weigh in on all situations before arriving at any kind of decision on behalf of the elder.
In all the above scenarios where the eldercare providers exploit the elder, often there are very limited chances of justice being served. The interaction between the two parties occurs in a secluded environment, thus there are no witnesses to come to the aid of the elders. Their suffering is more painful because, while they know who their oppressors are, they have no means of correcting the situation (Bradley et al, 2010). Family members participating in denying their old relatives a chance to exercise their rights and wishes mainly underscores the fact that these are serious ethical issues that most elderly people go through in silence.
Conclusion
Numerous ethical issues that border on culture and other societal aspects continue to surround the old-age state in general. The elderly are looked at as people who need to forfeit their lives to the young in society because they have had enough. Efforts to prolong life and improve health care quality for the aged are in some quarters looked at as an attempt to create overpopulation. Providing older people with health care is looked at as a strain on resources because older people often suffer from acute and chronic health conditions. The US is culturally biased when it comes to the provision of healthcare services to the aged. Minority communities, including African Americans and indigenous Americans, do not enjoy the same healthcare services for the old compared to their Caucasian counterparts. Physicians and nurses are also guilty of mistreating the old through stigmatization and other stereotypes. These practices have come to be accepted as part of the norm in society. A combination of all these factors creates serious ethical issues that condemn old age as an unwanted condition that should never be tolerated in society.
References
Bradley, L. J. et al. (2010). Ethical imperatives for intervention with elder families. The Family Journal: Counseling and Therapy for Couples and Families, 18(2), 215-221.
Dilworth-Anderson, P., Pierre, G., & Hilliard, T. S. (2012). Social justice, health disparities, and culture in the care of the elderly. Journal of Law, Medicine & Ethics, 40(1), 26-32.
Haigh, R. & Bagaric, M. (2002). Immortality and sentencing law. The Journal of Philosophy, Science & Law, 2, 1-5.
Richeson, J. A., & Shelton, J. N. (2005). A social psychological perspective on the stigmatization of older adults. Journal of Nonverbal Behaviour, 29(1), 75-84.
Young, H. (2003). Challenges and solutions for care of frail older adults.Online Journal of Issues in Nursing, 8(2), 5. Web.