The ethics of knowing where to stop treatment in a sick and elderly patient

An Emeritus Professor of medical ethics at Imperial College London will deliver a presentation at this year's Euroanaesthesia meeting titled 'Escalating care for the comorbid elderly-where do we stop?". Raanan Gillon, who is President of the UK's Institute of Medical Ethics, will argue that a patient's age should not in itself be considered an ethically relevant criterion for deciding 'where to stop'.

Acknowledging that there is a morally plausible counter-argument – known in the UK as 'the fair innings argument'- according to which scarce life prolonging resources should be preferentially deployed to younger patients, Professor Gillon will argue against it. He says: "If societies do wish to pursue such 'ageist' policies then they should do so only do so after widespread consultation and the enactment of democratically established laws according to which condemned to be denied life-prolonging therapies on grounds of age alone should have a legal right of appeal!"

The moral criteria that are relevant can be summarised, he argues, as the likelihood of achieving a beneficial outcome for the patient, at the cost of a minimised and acceptable risk of harm, in the light of the patient's own views and values where these are ascertainable, and also in the context of fair consideration of competing claims on available resources.

"However, co-morbidity and age may in some circumstances justifiably have a bearing on these criteria," concludes Professor Gillon. "For example co-morbidity may adversely and substantially influence the probability of a beneficial outcome; and some old people may be less inclined than when they were younger to accept the risks and discomforts of major surgery even if it might prolong their lives."

Related Stories

Risk for nonelective thoracic aortic sx up for uninsured

date Apr 16, 2014

(HealthDay)—Uninsured patients have an increased risk of nonelective thoracic aortic operations, and have increased risks of major morbidity or mortality, according to a study published online April 8 in ...

Recommended for you

India's bidi workers suffer for 1,000-a-day habit

date 15 hours ago

Zainab Begum Alvi and her band of young helpers hunch over baskets filled with tobacco flakes and dried leaves, trying to roll a thousand dirt-cheap cigarettes a day at the behest of India's powerful bidi barons.

Key to better sex ed: Focus on gender & power

date Apr 17, 2015

A new analysis by Population Council researcher Nicole Haberland provides powerful evidence that sexuality and HIV education programs addressing gender and power in intimate relationships are far more likely ...

Journal tackles aging policy issues raised by White House

date Apr 17, 2015

In anticipation of the forthcoming 2015 White House Conference on Aging (WHCoA), The Gerontological Society of America (GSA) has produced a special issue of The Gerontologist that outlines a vision for older adults' econom ...

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.