scholarly journals The “Elderly” in Medicine: Ethical Issues Surrounding This Outdated and Discriminatory Term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

scholarly journals Ethical issues in assistive ambient living technologies for ageing well

2020 ◽  
Vol 79 (47-48) ◽  
pp. 36077-36089
Author(s):  
Francesco Panico ◽  
Gennaro Cordasco ◽  
Carl Vogel ◽  
Luigi Trojano ◽  
Anna Esposito
Keyword(s):  
Ethical Issues ◽  
Healthcare Providers ◽  
Personal Space ◽  
The Elderly ◽  
Ageing Population ◽  
Healthcare Facilities ◽  
Raising Awareness ◽  
New Research ◽  
Physical Changes

AbstractAssistive Ambient Living (AAL) in ageing refers to any device used to support ageing related psychological and physical changes aimed at improving seniors’ quality of life and reducing caregivers’ burdens. The diffusion of these devices opens the ethical issues related to their use in the human personal space. This is particularly relevant when AAL technologies are devoted to the ageing population that exhibits special bio-psycho-social aspects and needs. In spite of this, relatively little research has focused on ethical issues that emerge from AAL technologies. The present article addresses ethical issues emerging when AAL technologies are implemented for assisting the elderly population and is aimed at raising awareness of these aspects among healthcare providers. The overall conclusion encourages a person-oriented approach when designing healthcare facilities. This process must be fulfilled in compliance with the general principles of ethics and individual nature of the person devoted to. This perspective will develop new research paradigms, paving the way for fulfilling essential ethical principles in the development of future generations of personalized AAL devices to support ageing people living independently at their home.

scholarly journals Gerakan Masyarakat Sehat Berbasis Masjid Sebagai Upaya Pengelolaan Mandiri Penyakit Kronik Degenaratif Di Desa Menganti Kecamatan Kesugihan Kabupaten Cilacap Tahun 2020

2020 ◽  
Vol 2 (2) ◽  
pp. 113-119
Author(s):  
Arief Hendrawan ◽  
Widyoningsih
Keyword(s):  
Community Participation ◽  
Community Service ◽  
The Elderly ◽  
Degenerative Diseases ◽  
Religious Media ◽  
Education And Health ◽  
Increased Risk ◽  
And Function ◽  
The Cost ◽  
Role And Function

Increased lifestyle causes an increased risk of degenerative diseases. The costs incurred for the treatment of degenerative diseases are quite high. In order to reduce the cost burden, community participation is required in the community movement for healthy living. One of the efforts to increase community participation is through optimizing the role of the mosque as a medium for religious da'wah to become a social religious media. Community service was carried out from May 2020 to September 2020. The location of the service was at Nurul Huda Mosque, Tembok Hamlet, Kesugihan District, Cilacap Regency. The target of the activity is 18 people in the mosque congregation. The community service method is health education and health screening / examination of mosque congregations. The results obtained from the service program were in the form of an increase in the congregation's understanding of the role and function of the mosque as a social religious facility, an increase in the congregation's understanding of the preparation for the elderly to face old age, the congregation's understanding of degenerative diseases and an increase in understanding of the independent management of degenerative diseases

Ethical Issues Relevant to the Assessment of Suicide Risk in Nonclinical Research Settings

Crisis ◽  
2012 ◽  
Vol 33 (1) ◽  
pp. 54-59 ◽  
Author(s):  
Carolyn M. Wilson ◽  
Bruce K. Christensen
Keyword(s):  
Undergraduate Students ◽  
Suicide Risk ◽  
Ethical Issues ◽  
Current Paper ◽  
Self Report ◽  
Ethical Guidelines ◽  
Schizotypal Personality ◽  
Increased Risk ◽  
Genetic Features ◽  
Conducting Research

Background: Our laboratory recently confronted this issue while conducting research with undergraduate students at the University of Waterloo (UW). Although our main objective was to examine cognitive and genetic features of individuals with schizotypal personality disorder (SPD), the study protocol also entailed the completion of various self-report measures to identify participants deemed at increased risk for suicide. Aims and Methods: This paper seeks to review and discuss the relevant ethical guidelines and legislation that bear upon a psychologist’s obligation to further assess and intervene when research participants reveal that they are at increased risk for suicide. Results and Conclusions: In the current paper we argue that psychologists are ethically impelled to assess and appropriately intervene in cases of suicide risk, even when such risk is revealed within a research context. We also discuss how any such obligation may potentially be modulated by the research participant’s expectations of the role of a psychologist, within such a context. Although the focus of the current paper is on the ethical obligations of psychologists, specifically those practicing within Canada, the relevance of this paper extends to all regulated health professionals conducting research in nonclinical settings.

Stroke Prevention in Non-Valvular Atrial Fibrillation

1997 ◽  
Vol 17 (03) ◽  
pp. 166-169
Author(s):  
Judith O’Brien ◽  
Wendy Klittich ◽  
J. Jaime Caro
Keyword(s):  
Atrial Fibrillation ◽  
Clinical Trials ◽  
Care Home ◽  
Relevant Literature ◽  
Clinical Trial Data ◽  
Outcome Data ◽  
Sensitivity Analyses ◽  
Bleeding Events ◽  
Discharge Data ◽  
The Cost

SummaryDespite evidence from 6 major clinical trials that warfarin effectively prevents strokes in atrial fibrillation, clinicians and health care managers may remain reluctant to support anticoagulant prophylaxis because of its perceived costs. Yet, doing nothing also has a price. To assess this, we carried out a pharmacoe-conomic analysis of warfarin use in atrial fibrillation. The course of the disease, including the occurrence of cerebral and systemic emboli, intracranial and other major bleeding events, was modeled and a meta-analysis of the clinical trials and other relevant literature was carried out to estimate the required probabilities with and without warfarin use. The cost of managing each event, including acute and subsequent care, home care equipment and MD costs, was derived by estimating the cost per resource unit, the proportion consuming each resource and the volume of use. Unit costs and volumes of use were determined from established US government databases, all charges were adjusted using cost-to-charge ratios, and a 3% discount rate was applied to costs incurred beyond the first year. The proportions of patients consuming each resource were estimated by fitting a joint distribution to the clinical trial data, stroke outcome data from a recent Swedish study and aggregate ICD-9 specific, Massachusetts discharge data. If nothing is done, 3.2% more patients will suffer serious emboli annually and the expected annual cost of managing a patient will increase by DM 2,544 (1996 German Marks), from DM 4,366 to DM 6,910. Extensive multiway sensitivity analyses revealed that the higher price of doing nothing persists except for very extreme combinations of inputs unsupported by literature or clinical standards. The price of doing nothing is thus so high, both in health and economic terms, that cost-consciousness as well as clinical considerations mandate warfarin prophylaxis in atrial fibrillation.

The Unusual Cruelty of Nursing Homes Behind Bars

2020 ◽  
Vol 32 (5) ◽  
pp. 264-271
Author(s):  
Rachel E. López
Keyword(s):  
Nursing Homes ◽  
Human Dignity ◽  
Prison Population ◽  
Financial Burden ◽  
The Elderly ◽  
The United States ◽  
Term Care ◽  
Trained Staff ◽  
State Prisons ◽  
The Cost

The elderly prison population continues to rise along with higher rates of dementia behind bars. To maintain the detention of this elderly population, federal and state prisons are creating long-term care units, which in turn carry a heavy financial burden. Prisons are thus gearing up to become nursing homes, but without the proper trained staff and adequate financial support. The costs both to taxpayers and to human dignity are only now becoming clear. This article squarely addresses the second dimension of this carceral practice, that is the cost to human dignity. Namely, it sets out why indefinitely incarcerating someone with dementia or other neurocognitive disorders violates the Eighth Amendment of the United States Constitution’s prohibition on cruel and unusual punishment. This conclusion derives from the confluence of two lines of U.S. Supreme Court precedent. First, in Madison v. Alabama, the Court recently held that executing someone (in Madison’s case someone with dementia) who cannot rationally understand their sentence amounts to cruel and unusual punishment. Second, in line with Miller v. Alabama, which puts life without parole (LWOP) sentences in the same class as death sentences due to their irrevocability, this holding should be extended to LWOP sentences. Put another way, this article explains why being condemned to life is equivalent to death for someone whose neurodegenerative disease is so severe that they cannot rationally understand their punishment.

Assessment of the Therapeutic Effect of Physiotherapy on Minimizing Imbalances of Geriatric Patients

2020 ◽  
Vol 62 (2) ◽  
pp. 86-91
Author(s):  
Justyna Pawlak ◽  
Małgorzata Dudkiewicz ◽  
Łukasz Kikowski
Keyword(s):  
Quality Of Life ◽  
Therapeutic Effect ◽  
Body Mass ◽  
Geriatric Patients ◽  
The Elderly ◽  
Risk Of Falling ◽  
Increased Risk ◽  
Climbing Stairs ◽  
Tinetti Test

Introduction: The progressing aging process and comorbidities worsen the efficiency of the balance system in the elderly, which leads to a weakening of stability and, as a consequence, to falls and injuries. The first ones lead to: worsening of functioning, reduced mobility, an increased risk of disease and mortality, therefore systematic physical activity and shaping the balance using physiotherapy, which can prevent dangerous falls is very important. Aim: Assessment of the therapeutic effect of physiotherapy on minimizing imbalances in geriatric patients. M aterial and Methods: The study group consisted of 46 people, including 32 women (69.6%) and 14 men (30.4%); average age of respondents – 72.5 years. They were patients of the Department of Rehabilitation of Poddębice Health Center, Ltd. The researchers used a self-made questionnaire, body mass to height index (BMI) and the Tinetti Test. Results: Patients with an elevated BMI (89.1%), as well as those taking more than 4 medication (78.3%), have had more falls over the past year (respectively 91.4% and 81.4%). After the use of comprehensive therapy, none of the patients achieved a worse result than before the physiotherapy while 91.3% of the respondents had an increase in the number of points scored in the Tinetti Test. The percentage of patients at high risk of falling reduced from 67.4% to 37%. There was also a decrease in the fear of walking (in 58.7%), falling (in 57.7%) and climbing stairs (in 47.9%). According to 78.3% of respondents, physiotherapy positively affected their independence and quality of life. Conclusions: The use of comprehensive physiotherapy reduces the fear of walking, climbing stairs and falling, which can be a good predictor of prevention. Both polypragmasia and an elevated body mass index (BMI) increase the risk of falling. Comprehensive physiotherapy of geriatric patients helps to improve balance and gait stereotype. Physiotherapy for the elderly helps improve the quality of life, independence, minimize imbalances, and thus reduce the risk of falls. Balance exercises play an important role in preventing falls.

Cardiovascular Disease in Spondyloarthritides

2020 ◽  
Vol 18 (5) ◽  
pp. 473-487 ◽  
Author(s):  
Charalampos Papagoras ◽  
Paraskevi V. Voulgari ◽  
Alexandros A. Drosos
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Healthcare Providers ◽  
Cardiovascular Death ◽  
Point Of View ◽  
Treat To Target ◽  
Inflammatory Joint Diseases ◽  
Scientific Organizations ◽  
Increased Risk ◽  
Risk Patients

The spondyloarthritides are a group of chronic systemic inflammatory joint diseases, the main types being ankylosing spondylitis (AS) and psoriatic arthritis (PsA). Evidence accumulating during the last decades suggests that patients with AS or PsA carry an increased risk for cardiovascular disease and cardiovascular death. This risk appears to be mediated by systemic inflammation over and above classical cardiovascular risk factors. The excess cardiovascular risk in those patients has been formally acknowledged by scientific organizations, which have called physicians’ attention to the matter. The application by Rheumatologists of new effective anti-rheumatic treatments and treat-to-target strategies seems to benefit patients from a cardiovascular point of view, as well. However, more data are needed in order to verify whether anti-rheumatic treatments do have an effect on cardiovascular risk and whether there are differences among them in this regard. Most importantly, a higher level of awareness of the cardiovascular risk is needed among patients and healthcare providers, better tools to recognize at-risk patients and, ultimately, commitment to address in parallel both the musculoskeletal and the cardiovascular aspect of the disease.

Perspectives on the Therapeutic Benefits of Arginine Supplementation in Cancer Treatment

2019 ◽  
Vol 19 (7) ◽  
pp. 913-920
Author(s):  
Fabiani L. R. Beal ◽  
Pedro R. Beal ◽  
Juliana R. Beal ◽  
Natan Carvalho-Neves ◽  
Octávio L. Franco ◽  
...  
Keyword(s):  
Amino Acid ◽  
Side Effects ◽  
Cancer Treatment ◽  
Treatment Strategies ◽  
Endothelial Permeability ◽  
The Elderly ◽  
Therapeutic Benefits ◽  
Cell Growth And Differentiation ◽  
The Cost ◽  
Arginine Supplementation

Background: Arginine is considered a semi-essential amino acid in healthy adults and the elderly. This amino acid seems to improve the immune system, stimulate cell growth and differentiation, and increase endothelial permeability, among other effects. For those reasons, it has been theorized that arginine supplementation may be used as an adjuvant to conventional cancer therapy treatments. Objective: This review aims to evaluate the existing knowledge of the scientific community on arginine supplementation in order to improve the efficacy of current cancer treatment. Results: Despite the continued efforts of science to improve treatment strategies, cancer remains one of the greatest causes of death on the planet in adults and elderly people. Chemo and radiotherapy are still the most effective treatments but at the cost of significant side effects. Conclusion: Thus, new therapeutic perspectives have been studied in recent years, to be used in addition to traditional treatments or not, seeking to treat or even cure the various types of cancer with fewer side effects.

scholarly journals Does Social Support Affect the Health of the Elderly in Rural China? A Meta-Analysis Approach

2019 ◽  
Vol 16 (18) ◽  
pp. 3471 ◽  
Author(s):  
Natuya Zhuori ◽  
Yu Cai ◽  
Yan Yan ◽  
Yu Cui ◽  
Minjuan Zhao
Keyword(s):  
Social Support ◽  
Rural Areas ◽  
Rural China ◽  
Statistical Significance ◽  
Empirical Studies ◽  
Relevant Literature ◽  
The Elderly ◽  
Significant Difference ◽  
Meta Regression ◽  
The Impact

As the trend of aging in rural China has intensified, research on the factors affecting the health of the elderly in rural areas has become a hot issue. However, the conclusions of existing studies are inconsistent and even contradictory, making it difficult to form constructive policies with practical value. To explore the reasons for the inconsistent conclusions drawn by relevant research, in this paper we constructed a meta-regression database based on 65 pieces of relevant literature published in the past 25 years. For more valid samples to reduce publication bias, we also set the statistical significance of social support to the health of the elderly in rural areas as a dependent variable. Finally, combined with multi-dimensional social support and its implications for the health of the elderly, meta-regression analysis was carried out on the results of 171 empirical studies. The results show that (1) subjective support rather than objective support can have a significant impact on the health of the elderly in rural areas, and there is no significant difference between other dimensions of social support and objective support; (2) the health status of the elderly in rural areas in samples involving western regions is more sensitive to social support than that in samples not involving the western regions; (3) among the elderly in rural areas, social support for the older male elderly is more likely to improve their health than that for the younger female elderly; and (4) besides this, both data sources and econometric models greatly affect the heterogeneity of the effect of social support on the health of the elderly in rural areas, but neither the published year nor the journal is significant. Finally, relevant policies and follow-up studies on the impact of social support on the health of the elderly in rural areas are discussed.

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