Aging

1. Aging

2. It’s tough getting old in America. • Lack of physical exercise:By age 75… 1/3 of men and ½ of women engage in no physical activity • Arthritis: Afflicts 43 million Americans • Bad diet:: less than 1/3 of age 65+ Americans eat 5-A-Day fruits and vegetables • Diabetes: 20% of age 65 and over have diabetes • Cardiovascular disease: Leading cause of death (Major linkage to tobacco use, lack of exercise, and poor nutrition) • Cancer: Second leading cause of death. (Colorectal cancer is 2nd leading cause of cancer deaths) (breast cancer...76% of cases in women over 50) • Obesity: • Poor oral health: • Injuries: 250,000 hip fractures/year in 65+. One of every three 65+ people has a fall-related injury every year. Motor vehicle related injury has a big jump after age 75. • Suicide: Rate of suicide is higher for elderly white men than any other group (including adolescents)

3. Should Life Sustaining Medical Care be Rationed Based on Age By 2040, people over 65 will account for 21% of the population and consume 45% of all health care expenditures. • 1/3 of the annual Medicare costs are for the 5-6% of beneficiaries who die that year. (Is this a problem …or is it just an expense to be expected?) • 40 million Americans have no medical insurance and are at risk of being denied basic healthcare services. At the same time the government pays most of the healthcare costs of the elderly. The amount of $$ aid to the elderly is greater than to any other group and the elderly (as a group) have the highest disposable income. Fair? • British vs. American system • British system strives for basic medical care for all versus expensive technology for the few who might benefit. Results = nearly identical health status and life expectancy at 60% of the cost  Yes? • Should medical care for the elderly who have lived their natural life expectancy consist only of pain relief rather than expensive services that serve only to forestall death ? • Is it both economically valid and morally acceptable to limit health care for the elderly? • “Aging and death in old age are inevitable….But premature death, and bad schools, and blighted urban areas of great poverty are not inevitable” • Current situation is a result of U.S being an “…affluent, hyper-individualistic, technology driven society” No? • Medical decisions should not be based on whether or not an individual is “deserving” of care. Society doesn’t have the right or capability of making that decision. • “Slippery-slope” argument. Limiting high-tech care may lead to other limitations in care • Couldn’t other health care expenditures being questioned as well. • (Public monies and health insurance monies for infertility treatments in an already overcrowded nation/world)

4. Physician-assisted suicide • The Oregon story: Under Oregon’s Death with Dignity Act, terminally-ill adult Oregonians are allowed to obtain and use prescriptions from their physicians for self-administered, lethal doses of medications.

5. Heart Transplant : ethics case Questions • What should the committee do? • How would you vote if you were on the committee? • In some cases, transplant operations are not successful, and a second operation is needed. Should someone be allowed two transplant procedures? Three? Why or why not? • In some hospitals, alcoholics are not allowed to receive liver transplants. In other hospitals, they are. Those who see alcoholism as a genetically determined condition argue that these people cannot help their addiction. Others feel that these people are responsible and should just stop. Should hospitals deny transplant livers to alcoholics? • What other factors should go into choosing who should get an organ when two people are eligible? List three

6. Is Dr. Melissa Walker Too Old To Have A Baby? : ethics case Questions • At what maternal age, in your opinion, is it NOT okay to give birth to a baby? At what paternal age is it NOT okay to become a new father? • What are the concerns of the couple at this point in their lives? • Should medical doctors deny certain people the right to use reproductive technology? When should they?