Ethical standards in allocation of healthcare resources among the elderly population and end of life care
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Ethical standards in allocation of healthcare resources among the elderly population and end of life care
The number of elderly people (65 years) is expected to double to 80 million over the next 30 years. The share of the elderly population will increase 13% – 20% in 2030. This implies that soon, there will be a higher ratio of elderly people as compared children. The population aging is a huge force with political, economic and social implications to the society (Hayutin, Dietz, & Mitchell, 2010). For instance, the rapid increase of cost of healthcare in the past years has created ethical discussion on allocation of resources. The main ethical issue on allocation of resources among the elderly is not entirely based on the quantity of treatment provided, but rather establishing protocols that seek optimum care based on the patient needs (Milstead, 2016).The organization decision making model of healthcare resources among the elderly population and end of life care should be determined by the following ethical standards namely; a) need, b) right, c) merit and d) priority (Craig, 2010, p. 29).
The ethical standard of right highlights the fact that every person is entitled to equal access and consideration of care. As described by Thomas Jefferson in the Declaration of Independence (1776), equality in health care is inherent and inalienable. Therefore, every individual should be given equal opportunity so that they can access quality and safe care without regard to an individual’s capacity or ability to pay. The ethical standard of merit indicates providing care to people based on their needs and fitness. This involves assessing individual cognitive function, degree of illness progression, legal status among others. This ethical framework guides use of the limited resource to yield the most successful outcome (Craig, 2010, p. 29).
The ethical framework of need is based on evaluation of patient’s health status. In this context, an elderly patient who needs cosmetic surgery to repair scaring caused by burn have greater need as compared to another patient’s needs for the same healthcare procedure for rhinoplasty. In this context, the most sever painful conditions should receive preferential treatment during resource allocation (Pavlish et al., 2011). The ethical framework of priority is important especially when ranking patient’s group. In current settings, there lacks effective framework on priority of care, which makes the healthcare providers to use their own discretion to determine who receives care; in most cases, the wealthy receive care before the poor deserving patients. In an ethical resource allocation framework, the priority is always the needy patient, so the monetary gains of an organization must not outweigh the patient’s outcome (Craig, 2010, p.29).
Ethical implications of resource allocations
The shift towards high population rate of the older population has enormous economic, social and political implication to the society. This is because as people live longer, there will be many people above 65 years as compared to children. It is estimated that by 2032, 1 in 5 Americans will be above 65 years. This indicates that there will be fewer potential workers per every retiree, and the financial as well as social cost of the aging population will increase. This indicates that the fiscal burden on tax payers will skyrocket (Hayutin, Dietz, & Mitchell, 2010).
The shift towards population will also challenge resource allocation. Suburbs and traditional nuclear families will increasingly become single and will comprise mainly of the older couples. Diversity will increase among the older people where 60% of the older population will be from minorities. The cost of healthcare is likely to be propelled by increase in technological advancement. Therefore, it is likely that the current healthcare spending might crowd-out spending for other healthcare needs across the country. If no interventions are put in place, the current deficits will leave a high interest for principal payments for future generations (Hayutin, Dietz, & Mitchell, 2010).
Evidently, these unprecedented demographic development calls for an urgent and strategic action. This calls for a deeper understanding so as to effectively deal with the new realities of life. This discussion demonstrates that is appropriate measures are put in place; the high cost of care could be reduced and could free up some resources to reduce public deficits in the future (Crippen & Barnato, 2011, p. 126).
References
Craig, H. D. (2010). Caring enough to provide healthcare: An organizational framework for the ethical delivery of healthcare among aging patients. International Journal for Human Caring, 14(4), 27–30.
Crippen, D., & Barnato, A. E. (2011). The ethical implications of health spending: Death and other expensive conditions. Journal of Law, Medicine & Ethics, 39(2), 121–129. doi:10.1111/j.1748-720X.2011.00582.x\
Hayutin, A. M., Dietz, M., & Mitchell, L. (2010). New realities of an older America. Retrieved from http://longevity3.stanford.edu/wp-content/uploads/2013/01/New-Realities-of-an-Older-America.pdf
Milstead, J. A. (2016). Health policy and politics: A nurse’s guide (5th ed.). Burlington, MA: Jones and Bartlett Publishers.
Pavlish, C., Brown-Saltzman, K., Hersh, M., Shirk, M., & Rounkle, A. (2011). Nursing priorities, actions, and regrets for ethical situations in clinical practice. Journal of Nursing Scholarship, 43(4), 385–395. doi:10.1111/j.1547-5069.2011.01422.x
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