What is Ethics in Geriatric Care?

 For the elderly, ethics is about how they want to be treated and allowed to make
their own decisions.
 For family members as caregivers, ethics is about doing what is right even when no
one is looking.
 For professionals providing eldercare, ethics is about adherence to established
canons of ethics promulgated by organizations.

Key Ethical Principles in the Care of Older Adults

1. The right to quality health care.

- means that they have adequate access to quality care.
- they have a right to the same high standards of health care as those in any age
group
2. Respect for the individual person.
- Kant explicates this fundamental principle in ethics as follows :
- “So act that you treat humanity in your own person and in the person of everyone
else, as an end and never merely as a means“
3. Autonomy or Self – determination
- Respecting the principle of autonomy means that older patients will be respected
as decision-makers about their own care.
- All competent older persons have a perspective of their own best interests,
shaped by their values and beliefs developed over a lifetime, that defines each
individual as a unique person.
- If a patient lacks the capacity for such a decision and has an advance directive,
the person who has the durable power of attorney can make the decision.
- Paternalism occurs when the nurse does not respect the patient’s right to
autonomy by acting as if he or she knows what is best for the patient, rather than the
patient (Silva & Ludwick, 1999).
- Paternalism disempowers the patient
- Informed consent involves the patient’s right to autonomy and self-determination
Three Elements of Informed Consent
Informed - sufficient information must be provided
Competent - involves the capacity to weigh out the potential benefits in comparison
to the risks by applying “rational reason”
Voluntary - the patient is not coerced into participation and that consent can be
withdrawn at any time
4. Privacy and Confidentiality
- Involves sharing only patient information on a need-to-know basis.
- There may also be instances when a clinician may be obligated to override the
duty to maintain confidentiality
5. Beneficence
- The principle of beneficence or “doing good “ means that the highest good will
be done for older people in a particular situation.
6. Nonmaleficence
- Do no harm
- Concept originated from the Hippocratic Oath
- Applied to nursing by not causing injury, whether it be a physical, psychological,
emotional, or financial injury to patients (Silva & Ludwick, 1999)
6. Justice
- Right to be treated equally, and in some cases equal access to treatment
and allocation of resources
7. Veracity
- truthfulness
- Principle of veracity also compels that the truth is completely told.
- Quality of the relationship between nurse & patient is based on trust & integrity
8. Fidelity
- It involves
an agreement to keep our promises. Fidelity refers to the concept of keeping a
commitment and is based upon the virtue of caring.
- means to respect our words and duty to elder patients
What is an ethical dilemma?
Situations that produce conflicts:

 Between nurses’ values and external systems affecting their decisions

 Between rights of patients and nurses’ responsibilities to those patients actual
conflicts of interest arising when family members and professional caregivers
assist or represent the elderly

Measures to Help Nurses Make Ethical Decisions

1. Encourage patients to express their desires.

2. Identify significant others who impact and are impacted.
3. Know thyself.
4. Read.
5. Discuss.
6. Consult
7. Share
8. Form an Ethics Committee
9. Evaluate Decisions

Philippine Laws related to Care of the Older Persons

1987 Philippine Constitution, Art. XV, sec. 4
 It is the duty of the family to take care of its older person members while the state
may design programs of social security for them.
RA 7432 “Senior Citizens Act of 1992"
o An act to maximize the contribution of senior citizens to nation-building, grant
benefits & special privileges & for other purposes.