Operative Surgical Oncology in the Elderly: Epidemiology, Opportunity, Outcome, and Ethical Issues

2020 ◽  
pp. 249-257
Author(s):  
Xiang Da Dong ◽  
Samuel Barasch
Keyword(s):  
Ethical Issues ◽  
Surgical Oncology ◽  
The Elderly

scholarly journals The “Elderly” in Medicine: Ethical Issues Surrounding This Outdated and Discriminatory Term

2019 ◽  
Vol 56 ◽  
pp. 004695801985697
Author(s):  
Javad Hekmat-panah
Keyword(s):  
Ethical Issues ◽  
Relevant Literature ◽  
Healthcare Providers ◽  
The Elderly ◽  
Health Care Rationing ◽  
Specific Information ◽  
Science And Art ◽  
Increased Risk ◽  
Surgical Treatments ◽  
The Cost

The objective of this study was to investigate and describe how the use of the term “elderly” contributes to bias and problems within the medical system. A systematic review of the relevant literature and history was conducted. The term “elderly” does not define age accurately and carries bias and prejudice that lead to harm through discriminatory practices, institutional prejudices, and “ageist” policies in society and medicine. Doctors and healthcare providers seldom intentionally try to harm any patient, but might do so through unconscious anti-elderly bias. Studies indicate that medical students already demonstrate anti-elderly bias; researchers may lump patients aged 65 and over together, confounding specific information needed for individualized treatments; and out of unwarranted concern, medical and surgical treatments may be denied, despite minimal increased risk of mortality. When the cost of healthcare rises, it is the elderly against whom rationing is suggested. The term “elderly” has no place in medicine. Anti-elderly health care rationing is as unethical as rationing targeted against any group. It is reverse paternalism to make rules that limit others’ medical care, happiness, and life span without their consent. Medicine is the science and art of individual communication, evaluation and treatment. Once we deny care to any one group, we open the door to denial to others.

Anaesthesia for the Elderly Patient (Oxford Anaesthsia Library)

2017 ◽  
Author(s):  
Chris Dodds ◽  
Chandra M. Kumar ◽  
Frédérique Servin
Keyword(s):  
Elderly Patient ◽  
Elderly Patients ◽  
Independent Living ◽  
Ethical Issues ◽  
Preoperative Assessment ◽  
The Elderly ◽  
Day Surgery ◽  
Gynaecological Surgery ◽  
Current State

This book provides a timely and authoritative synopsis of the current state of anaesthesia and the elderly patient at a time when the challenge of caring for the growing numbers of elderly patients is probably the greatest faced by healthcare across the globe. The book reviews important developments in the understanding of clinical practice serving the elderly. It describes the need for anaesthesia to deliver ‘best care’ to the elderly, with the aim to maintain their independent living. It then details the key features of ageing and the effect these have on physiology and pharmacology. Specific aspects of practice, including preoperative assessment; day surgery; emergency surgery; anaesthesia for orthopaedic, urological, and gynaecological surgery, as well as major abdominal surgery; neurosurgery; and critical care. Emphasis is placed on managing postoperative care and cognitive dysfunction (POCD), with additional discussion of ethical issues and the law pertaining to the elderly patient. A new chapter reviews the challenges of treating elderly patients in non-theatre environments.

The treatment of bipolar disorder in the elderly

2017 ◽  
Author(s):  
Gilberto Sousa Alves ◽  
Felipe Kenji Sudo ◽  
Johannes Pantel
Keyword(s):  
Bipolar Disorder ◽  
Gold Standard ◽  
Atypical Antipsychotics ◽  
Extended Release ◽  
Ethical Issues ◽  
The Elderly ◽  
Evidence Based ◽  
Pharmacological Interventions ◽  
First Line ◽  
Evidence Based Guidelines

Bipolar disorder (BD) is an extremely disabling condition characterized by mood switches, and cognitive and functional impairment. The current chapter discusses the updated review on pharmacological and non-pharmacological interventions targeting BD in the elderly. The risk of concurrent medical diseases (eg, metabolic syndrome) and relatively lower tolerability than young BD make the patient safety a major concern in most cases. Evidence-based guidelines, although useful for promoting rational and effective therapy, are generally lacking in elderly BD. Current recommendations for acute mania include atypical antipsychotics, careful use of lithium, and election of valproate as the gold-standard therapy. In acute BD depression, first-line agents in monotherapy may include lithium, lamotrigine, quetiapine, and quetiapine extended release (XR). Electroconvulsive therapy may be an option for severe/refractory cases. Family members or caregivers should be encouraged to support the patient, since potential ethical issues involving patrimony or profession may arise during the treatment.

Forensic Issues and Caregivers of the Elderly

2017 ◽  
Author(s):  
Gary Epstein-Lubow ◽  
Elizabeth Tobin-Tyler
Keyword(s):  
Mental Health ◽  
Family Caregivers ◽  
Mental Health Treatment ◽  
Ethical Issues ◽  
The Elderly ◽  
Patient Centered Care ◽  
Health Condition ◽  
Patient Centered ◽  
Centered Care ◽  
Laws And Policies

Providing patient-centered care for an elderly individual with a mental health condition requires clinicians and family caregivers to work together. This chapter provides a description of a mental health treatment model, the triadic model of caregiving, in which service delivery for a patient includes clinicians communicating with family members or caregivers. Description of the mental health workforce to support patient-centered care is provided along with laws and policies that support family caregivers in their aid of patients. The associated legal responsibilities and ethical issues related to working with patients who have impaired decision-making capacity due to a mental health or substance use condition are explained, including capacity, competence, informed consent, advance care planning, guardianship, fiduciary responsibilities, and ethical concerns.

scholarly journals Ethical Issues for Otolaryngology and Surgery in the Elderly

1999 ◽  
Vol 78 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Michael D. Seidman ◽  
Donald P. Shapiro ◽  
Najeeb A. Shirwany
Keyword(s):  
Ethical Issues ◽  
The Elderly ◽  
Surgery In The Elderly

scholarly journals Persepsi Perlindungan Hukum dan Aspek Etik terhadap Keinginan Perawat IGD Melakukan CPR pada Out-of-Hospital Cardiac Arrest (OHCA)

2020 ◽  
Vol 6 (2) ◽  
Author(s):  
Wiwin Winarti ◽  
Rosiana Rosiana
Keyword(s):  
Cardiac Arrest ◽  
Survival Rate ◽  
Cardiopulmonary Resuscitation ◽  
Ethical Issues ◽  
Legal Protection ◽  
The Elderly ◽  
Legal Aspects ◽  
Cross Sectional ◽  
Bystander Cpr ◽  
Hospital Cardiac Arrest

ABSTRAKKejadian henti jantung dapat terjadi dimana saja baik di rumah sakit maupun di luar rumah sakit atau Out-of-Hospital Cardiac Arrest (OHCA). Usaha untuk meningkatkan survival rate kejadian henti jantung adalah pemberian Cardiopulmonary resuscitation (CPR)/ resusitasi jantung paru (RJP) yang berkualitas. Faktor yang mempengaruhi seseorang untuk mau menjadi bystander CPR bukan hanya terkait pengetahuan dan teknik melakukan CPR namun juga dipengaruhi oleh faktor sosial, kerelaan melakukan, kesiapan psikologis dan faktor lainnya seperti aspek etik dan hukum. Tujuan penelitian ini untuk mengetahui pengaruh persepsi perlindungan hukum dan aspek etik terhadap keinginan perawat dalam memberikan tindakan CPR pada kejadian Out-of-Hospital Cardiac Arrest. Penelitian menggunakan desain cross-sectional dengan metode kuisioner yang dikembangkan oleh peneliti dan menggunakan total sampling yang melibatkan seluruh perawat IGD RSUD Budhi Asih sebanyak 30 orang. Analisis menggunakan uji Fisher’s Exact dan Cochran-Mantel Haenszel. Hasil penelitian menunjukkan mayoritas responden (56,7%) memiliki persepsi yang negatif terhadap perlindungan hukum terhadap bystander CPR pada OHCA. Meskipun demikian, perawat cenderung memiliki persepsi yang positif ketika menjawab pertanyaan terkait isu etik CPR pada korban anak-anak, wanita maupun lansia. Sebanyak 43,33% (13 perawat) memiliki keinginan positif untuk melakukan CPR pada OHCA sementara 56,67% (17 perawat) lainnya memiliki keinginan negatif sebagai bystander CPR. Hasil uji Cochran-Mantel Haenszel menunjukkan persepsi terhadap perlindungan hukum mempengaruhi keinginan perawat dalam memberikan CPR pada OHCA dan akan diperbesar kemungkinan memberikan CPR apabila perawat tersebut berusia ≥ 30 tahun (p 0,014; OR 14,133; 95% CI 2,081-95,947) dan memiliki masa kerja ≥ 5 tahun (p 0,008; OR 25,667; 95% CI 2,253-292,462). Promosi mengenai aspek legal dan etik, serta landasan hukum perlindungan terhadap bystander CPR menjadi penting untuk dapat meningkatkan keinginan perawat dan jumlah bystander CPR. ABSTRACTCardiac arrest can occur anywhere in the hospital or outside the hospital, which is called Out-of-Hospital Cardiac Arrest (OHCA). An effort to increase the survival rate of cardiac arrest is the provision of quality Cardiopulmonary resuscitation (CPR). Factors that influence a person's willingness to become a bystander CPR are not only related to the knowledge and techniques of conducting CPR but are also influenced by social factors, willingness, psychological readiness, and other factors such as ethical and legal aspects. The purpose of this study is to determine the effect of perceptions of legal protection and ethical issues on the nurses' willingness to provide CPR in the OHCA incident. This study used a cross-sectional design using a questionnaire developed by researchers, conducted at Emergency Department Budhi Asih Regional Hospital in East Jakarta, and used a total sampling method involving 30 ED nurses. Fisher's Exact and Cochran-Mantel Haenszel tests were used to analyze the data. The study findings show that the majority of respondents (56.7%) have a negative perception of the legal protection of bystander CPR in OHCA. However, nurses have a positive perception when answering questions related to the ethical issue of CPR in victims of children, women, and the elderly. 43.33% (13 nurses) have a positive willingness to perform CPR on OHCA, while 56.67% (17 nurses) have a negative willingness as a bystander CPR. The results of the Cochran-Mantel Haenszel test show that perceptions of legal protection may influence nurses' willingness to provide CPPR to OHCA patient, and it will increase the likelihood of giving CPR if the nurse age is ≥ 30 years old (p 0.014; OR 14,133; 95% CI 2,081-95,947) and has been working for ≥ 5 years (p 0.008; OR 25,667; 95% CI 2,253-292,462). Promotion of the legal aspects, ethical issues, and protection to bystander CPR are essential to increase the willingness of nurses and the number of bystander CPR. 

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