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Legal and ethical issues in care of older adults 

Legal and ethical issues in care of older adults
Legal and ethical issues in care of older adults
Oxford Textbook of Geriatric Medicine (3 edn)

Reijo Tilvis


Widely accepted ethical principles are taken into account in several international declarations and recommendations, but national legislations of care for old people are characterized by wide diversity. Ethical considerations go further than pure clinical assessments and include all consequences of starting and/or withholding of cure and care. The oldest Hippocratic principles—beneficence (doing good) and non-maleficence (not harming)—are obligations of physicians to act in the best interest of the patients. Autonomy, the existence and feeling of freedom of choice and self-governance, has replaced paternalism, and is cherished in Western culture. Sufficient information and capacity of the patient are preconditions for giving informed consent before any treatment is undertaken. In cases of lacking capacity, the healthcare providers must consult family members or other proxy persons to find out what the patient’s wish might have been. Advanced statements of wishes or advanced directives can help to avoid surrogate decisions.

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