Ethical Issues With an Aging Population

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  • Ethical Issues With an Aging Population

    According to the CDC, “in the United States, the proportion of the population aged >65 years is projected to increase from 12.4% in 2000 to 19.6% in 2030,” (CDC, 2003, para. 2). Caring for this aging population is going to be one of the greatest challenges facing the health care industry. Not only will the number of individuals requiring care rise, but so will the cost. As poignantly stated by Crippen and Barnato, “unless we change the practice of medicine and reduce future costs, and explicitly address the ethical dilemmas we face, there may come a time when our kids simply cannot afford us” (2011, p. 128).

    In this Discussion, you will examine the ethical issues that the United States and other nations must address when faced with the health care challenges of an aging population.

    To prepare:

    • Consider the ethical aspects of health care and health policy for an aging population.
    • Review the Hayutin, Dietz, and Mitchell report presented in the Learning Resources. The authors pose the question, “What are the economic consequences, now and for future generations of taxpayers if we fail to adapt our policies to the changing reality of an older population?” (p. 21). Consider how you would respond to this question. In addition, reflect on the ethical decisions that arise when dispersing limited funds.
    • Contemplate the impact of failing to adjust policy in accordance with the changing reality of an older population.
    • Reflect on the ethical dilemmas that arise when determining expenditures on end-of-life health care.

     

    Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.

  • Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
  • Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
  • Validate an idea with your own experience and additional research.
  • Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

 

 

 

Aging Ethical Aspect of Health Care

Ethics always plays a significant role in caring for our clients, but with the increasingly aging population, our focus on ethics and nursing must adapt to take this into consideration

As health promotion, education and technology advances, the life expectancy for Americans have also risen.  According to the Stanford Center on Longevity, over the next 30 years the population of Americans over the age of 65, will at least double to 80 million (Hayutin, Dietz & Mitchell, 2010). However, with this aging population, it increases the individual’s risk to chronic diseases like obesity, arthritis, diabetes, dementia and hypertension.  Therefore, as a nation now face new challenges such as increasing healthcare costs, more retired citizens than those currently working within the workforce and greater financial burden on the individual for their retirement (Farrelly, 2010).

Code of Ethics

Looking at the Code of Ethics for Nurses by the America Nurses Association (ANA), nothing changes just because the person is elderly.  Provision one, two and three of the Code of Ethics for Nurses, looks at the nurse promoting good, being an advocate, and fighting for patients’ rights, healthcare and self-worth (Fowler & ANA, 2008).  Everyone is a unique, and we must treat them as such.  However, provision four, five and six, looks at promoting health, making decisions and ensuring the safety of our clients (Fowler & ANA, 2008).  While, provision seven, eight and nine, look at maintaining integrity, working with other health care professionals and promoting a scholarly mind, so advancing knowledge and skills through evidence-based research (Fowler & ANA, 2008).  At no point, does age play a part of the Code of Ethics. Throughout my nursing career, I have met senior citizens who are independent, have better health than people a lot younger than themselves and can make their own decisions about their healthcare.

Ethical Dilemma

With the changing and increasing aging population, nurses need to continue to advocate for our clients’ needs.  Under provision two of the Code of Ethics, the nurse’s primary commitment is to the patient.  However, older people often need more medical care, due to chronic illness and the taking of multiple medications.  Also with the elderly nearing the end of their lifespan, it can be thought that investing time and money may be of little benefit in comparison to the younger generation, who have a longer to live (Bognar, 2015).  Thankfully, the federal government prohibits consideration of this factor or the use of age as a factor in cost-benefit analysis (Bognar, 2015). Under provision eight of the Code of Ethics, “Health is a Universal Right” (pg. 31), so available to everyone indiscriminate of their age (Fowler & ANA, 2010)

Next, should we be increasing the age of retirement?  It would certainly provide more finances for health care due to the decreasing workforce, but perhaps the aging population has already paid enough into our society. Maybe we can reduce government spending, encouraging individuals to rely on their personal assets and savings for retirement care. Maybe our focus should only be on palliative care for the over 65-year-old, so maintaining their present quality of life, rather than any life-extending care. By focusing healthcare policy and research on healthcare needs of the younger generation, this will prolong the lifespan of those who have lives still to live, so a chance to make it to aged 65 (Bognar, 2015). However, will this limit the healthcare of the younger generation as they progress throughout their lifespan and become part of the aging population?  Under provision two of the Code of Ethics, we look at the interests of the individual or community (pg. 21), so looking at the client as a person, not their age (Fowler & ANA, 2008).

Also with policy and research, consent plays an important part. Informed consent may not be a problem initially, but as time progresses, it may be a concern due to the possible changing mental status of the client during and throughout the research and policy process (Ries, 2010). Older people can be more of a challenge or a vulnerable group to study. Maybe they do not have the resources to participate in the studies or with both chronic illnesses and multiple medications, it is potentially too complicated to address just one disease by itself (Ries, 2010). However, looking at provision seven of the Code of Ethics, it promotes advances in nursing practice and scholarly research, but it does not stipulate an age limit (Fowler & ANA, 2008). Nurses, therefore, need to work closely with their patients, gaining knowledge, advocating for their individual clients’ specific rights; by doing so, the nurse can carry out their clients’ personal beliefs and wishes without question (Zomorodi & Foley, 2009).

Conclusion

Health care policies favor the younger population, however, in our changing environment and aging population, we need to consider the fuller picture of healthcare.  Protecting people’s health at any age is important, and everyone deserves an equal share of opportunities throughout the span of life (Bognar, 2015).  However, it is our responsibility as nurses to ensure our clients have all the information about their health so that they can make their own informed decisions. We should not be rationing health care on age, disability or any other factors. Only an individual can decide the cost of their own life, and in cannot be assumed that an older person still does not have their own life goals to accomplish still (Gruenewald, 2012).

References

Bognar, G. (2015). Fair Innings. Bioethics. Retrieved from http://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=1&sid=a218ce66-aed5-4f27-b9dd-3d24ce53acf3%40sessionmgr103&hid=126

Farrelly, C. (2010). Equality and the duty to retard human ageing. Bioethics. Retrieved from http://eds.a.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?sid=e4700d76-f00a-4aea-a15e-a7f4a910f765%40sessionmgr4007&vid=2&hid=4210

Fowler, M. D., & American Nurses Association. (2008). Guide to the code of ethics for nurses: Interpretation and application. Retrieved from http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html

Gruenewald, D. A. (2012). Can Health Care Rationing Ever Be Rational? Journal of Law, Medicine & Ethics. Retrieved from http://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?sid=780c3109-5597-4727-b4cd-3b29aa55cadc%40sessionmgr104&vid=13&hid=104 

Hayutin, A. M., Dietz, M. & Mitchell, L. (2010). New Realities of an Older America. Stanford Center of Longevity. Retrieved from http://longevity3.stanford.edu/wp-content/uploads/2013/01/New-Realities-of-an-Older-America.pdf

Ries, N. (2010). Ethics, Health Research, and Canada’s Aging Population. Canadian Journal on Aging. Retrieved fromhttp://eds.b.ebscohost.com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=8&sid=a218ce66-aed5-4f27-b9dd-3d24ce53acf3%40sessionmgr103&hid=126

Zomorodi, M., & Foley, B. (2009). The nature of advocacy vs. paternalism in nursing: Clarifying the ‘thin line.’ Journal of Advanced Nursing, 65(8), 1746–1752. Retrieved from http://web.a.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?sid=ab4fe41a-1124-4cf9-9ccb-46c029d0e241%40sessionmgr4007&vid=1&hid=4201

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Describe the event or events you believe had the greatest bearing on enabling this group to access higher education in the United States. Analyze the nature of the event involved and address the following:

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Until fairly recently, the vast majority of U.S. college and university students were white men. At key points in the last 150 years, enrollment changed to include more women and people of color. However, even with greater overall participation in higher education, women and African-Americans had limited opportunities until the 1950s and 1960s. Members of other racial and ethnic groups also have experienced quotas or other limits on their full participation in higher education. In many cases, being married, being a parent, or having a particular political affiliation was cause for discrimination.

As the result of several landmark events, many groups became “protected classes” and have been provided with greater opportunities through the force of law. Many states have passed additional laws, and individual colleges and universities have enacted policies prohibiting discrimination in other areas, including sexual orientation, gender identity, and even genetic information.

As defined by the U.S. National Archives and Records Administration (n.d.), protected classes in federal law are:

The groups protected from the [sic] employment discrimination by law. These groups include men and women on the basis of sex; any group which shares a common race, religion, color, or national origin; people over 40; and people with physical or mental [disabilities]. Every U.S. citizen is a member of some protected class, and is entitled to the benefits of EEO [Equal Employment Opportunity] law. However, the EEO laws were passed to correct a history of unfavorable treatment of women and minority group members.

Complete the following for this Question:

  • Choose a federally protected class or another group that has experienced discrimination in higher education to write about for your initial post, and find at least two scholarly articles related to that group’s evolving access to opportunity. Begin your search by accessing the Higher Education in the United States Library Guide (linked in Resources).
  • Based on your reading in this unit and in the articles that you find, identify the most important landmark events that provided opportunities for this group, such as the passage of federal law, a court decision, or a destiny-changing occurrence within a political or social movement.
  • Describe the event or events you believe had the greatest bearing on enabling this group to access higher education in the United States. Analyze the nature of the event involved and address the following:
    • Which of these events would you say primarily resulted from social changes? Why?
    • Which events would you say were primarily economically oriented? Why?
    • Which events would you describe as politically based? Why?
Reference

U.S. National Archives and Records Administration. (n.d.). Equal employment opportunity (EEO) terminology. Retrieved from http://www.archives.gov/eeo/terminology.html#p

Resources

  • ED5570: Higher Education in the United States Library Guide.

Evaluate Goals for Students

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Evaluate Goals for Students

Top of Form

Professional Development of Nursing Professionals

  1 Unsatisfactory 0.00% 2 Less than Satisfactory 75.00% 3 Satisfactory 79.00% 4 Good 89.00% 5 Excellent 100.00%
80.0 %Content  
20.0 % Impact of the IOM Report on Nursing Education Impact of the IOM report on nursing education is not offered. Impact of the IOM report on nursing education is offered but incomplete because relevant information is missing. Impact of the IOM report on nursing education is offered and accurate. Impact of the IOM report on nursing education is accurately explained in detail. Impact of the IOM report on nursing education is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 % Impact of the IOM Report on Practice, Particularly in Primary Care Impact of the IOM report on nursing practice, particularly in primary care, is not offered. Impact of the IOM report on nursing practice is offered but incomplete because relevant information is missing. Impact of the IOM report on nursing practice is offered and accurate. Impact of the IOM report on nursing practice accurately explained in detail Impact of the IOM report on nursing practice is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 % Impact of the IOM Report on Nursing Role as a Leader Impact of the IOM report on nursing role as a leader is not offered. Impact of the IOM report on nursing role is offered but incomplete because relevant information is missing. Impact of the IOM report on nursing role is offered and accurate. Impact of the IOM report on nursing role is accurately explained in detail. Impact of the IOM report on nursing role is accurately explained in detail as well as being insightful or offering thoughtful reflection.
20.0 % Changing Your Practice to Meet the Goals of the IOM Report Explanation to how student would changes his or her practice for the purpose of meeting the goals of the IOM report is not offered. Explanation to how student would changes his or her practice for the purpose of meeting the goals of the IOM report is offered but incomplete because relevant information is missing. Explanation to how student would changes his or her practice for the purpose of meeting the goals of the IOM report is offered in a satisfactory manner. Explanation to how student would changes his or her practice for the purpose of meeting the goals of the IOM report is explained in detail. Explanation to how student would changes his or her practice for the purpose of meeting the goals of the IOM report is explained in detail as well as being insightful or offering thoughtful reflection..
15.0 %Organization and Effectiveness  
5.0 % Thesis Development and Purpose Paper lacks any discernible overall purpose or organizing claim. Thesis and/or main claim are insufficiently developed and/or vague. Purpose is not clear. Thesis and/or main claim are apparent and appropriate to purpose. Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose. Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.
5.0 % Paragraph Development and Transitions Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed. Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident. Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other. A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose. There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.
5.0 % Mechanics of Writing (includes spelling, punctuation, grammar, language use) Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice, sentence structure, and/or word choice are present. Some mechanical errors or typos are present but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.
5.0 %Format  
2.0 % Paper Format (use of appropriate style for the major and assignment) Template is not used appropriately or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Template is used, and formatting is correct, although some minor errors may be present. Template is fully used. There are virtually no errors in formatting style. All format elements are correct.
3.0 % Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting are appropriate to assignment) No reference page is included. No citations are used. Reference page is present. Citations are used inconsistently. Reference page lists sources used in the paper. Sources are appropriately documented, although some errors may be present. Reference page is inclusive of all cited sources. Documentation is appropriate and style is usually correct. In-text citations and a reference page are complete. The documentation of cited sources is free of error.
100 % Total Weightage  

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Why is tougher for men (generally) or less acceptable to identify with female characters, and is that similar to coaching?

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(1) A Justice League of Their Own –

Please feel free to touch on 1 or more of the following discussion topics.

1) There appear to be several similarities between Sport Films and the Superhero Genre.  For example, there will be a final conflict/game that generally the hero “wins”.  However, in many cases the woman is a support character, such as a mother or love interest.  However, that changes when a woman is the star, meaning a man is going to have a major role, possibly the main rival or a primary source of conflict (Tom Hanks in ALOTO*). Why and will that change?

2) Males – is there a (female) baseball character that you can identify with in ALOTO as being similar to you or having similar characteristics? Is this something you feel comfortable doing?

Females – generally in sport (or superhero) movies that feature men, are you able to identify with specific characters as being similar to you or having similar characteristics?  Is this something you feel comfortable doing?

All – Why is tougher for men (generally) or less acceptable to identify with female characters, and is that similar to coaching?  Are men as accepting of being coached by women as women are of being coached by men?

3) Do you think society will watch and support a mainstream movie about a transgendered athlete be a box office success?  Why or why not?

4) Feel free to add other items that you found interesting or unique to the film.

*ALOTO = A League of Their Own

(2) Discussion: A Critical Look at the Question of Class

The course text describes the impact of socioeconomic status on parenting style and the socialization of children. Berns defines four levels of “class” and describes characteristics of each. Yet, further reading implies that the concept—and reality—of social class may be more complex than the author’s presentation.

Your role as a student is not only to read for information, but also to read critically as well. Review the “Class Descriptions” and “Effects of Class” sections of the course text (pages 107-109), paying close attention to the values and behaviors ascribed to each class and especially the “lower class” and the “underclass.”

Then, review the “Class Matters: Shadowy Lines That Still Divide” article, which discusses modern views of social class in the United States.

Next, consider the following:

  • What you know about class in America today
  • Your experiences related to class
  • The differences between the presentation of class in America today in the New York Times article and the description of class in the course text
  • Your thoughts about those differences
  • How children may be affected by class and by people’s attitudes and beliefs related to class
  • How the information presented in your text might have a negative affect on teachers’ perceptions of children and their families

By Day 3

Based on the readings and your own experiences, post your thoughts in regard to:

  • Your views on differences between social classes that have the most influence on outcomes for children
  • In your future work with young children and families, how you will avoid allowing stereotypes, assumptions, and labels that can create negative and/or limited perceptions of children and families from influencing you