End of Life Essay

According to IOM (2008), the next propagation of older adults will be the likes of no other before it. It will be the most educated and diverse group of older adults in the nations history. They will dress out themselves apart from their predecessors by having fewer children, higher divorce rates, and a lower likelihood of living in poverty. But the key distinguishing feature of the next generation of older Americans will be their vast numbers. According to the most recent census numbers, there atomic number 18 now 78 million Americans who were born among 1946 and 1964.By 2030 the youngest members of the baby boom generation will be at least 65, and the number of older adults 65 years and older in the unite States is expected to be more than 70 million, or almost double the nearly 37 million older adults alive in 2005. The number of the oldest old, those who argon 80 and over, is also expected to nearly double, from 11 million to 20 million (Institute of Medicine of the field of study Academies IOM, 2008, p. 29). The United States wellness heraldic bearing system faces wide challenges as the baby boomer generation nears retirement age.Current reimbursement policies, workforce practices, and resource allocations all need to be re-evaluated, and redesigned in order to prep be the wellness bearing system for meeting the needs of the inevitably growing population of older adults. Areas such as education, training, recruitment, and retention of the health lot workforce helping older adults will require remodeling. To accomplish this will require the dedication and allocation of greater financial resources, even at a time when budgets are already be severely stretched.The nation is responsible for ensuring that older adults will be cared for by a health care workforce prepared to allow high- whole step care. If current Medicare and Medicaid policies and workforce trends continue, the nation will fail to meet this responsibility. Throwing more money int o a system that is non designed to deliver high-quality, cost-effective care or to facilitate the development of an appropriate workforce would be a largely wasted effort (IOM, 2008, p. 1-12). Ethical Standards for Resource AllocationEthics let a paramount role in solving the complex dilemmas surrounding the aging population and health care. There are several ethical standards I believe should be used in determining resource allocation for the aging population and end of life care. Yet realistically, most are ridiculous with the already limited resources available for health care. Unfortunately surd decisions need to be made in the allocation of resources. Three primary ethical standards that could realistically improve health care for the aging, which I believe should determine resource allocations are 1.Autonomy suggest that individuals live a right to determine what is in their own best busy, though that interest may be limited if exercising that right limits the rights of others. 2. Beneficence means that clinicians should act completely in the interest of their patients. Compassion taking positive action to help others desire to do good core principle of our patient advocacy. 3. Justice implies fairness and that all groups have an equal right to clinical services regardless of race, gender, age, income, or any other characteristic (Teutsch & Rechel, 2012, p.1). It is inevitable that difficult decisions have to be made regarding how health care resources will be allocated for the aging and dying. In my opinion scarce health care resources should be offered as fair as possible (justice), to do the most good for the patient in every situation (beneficence), with respect of the individual human right to have control of what happens to their own body (autonomy). time-honored and end of life patients have a right to care that is dignified and honest.The three ethical standards noted above should be the driving force arsehole determining health care reso urce allocations, allowing for quality care delivery, tailored to individual health needs at any stage of aging by means of the end of life, ensuring protection and satisfaction to such a vulnerable patient population. As stated by Maddox (1998), perhaps the impact of the array of problems, issues, and the myriad difficult decisions that policymakers and managers make may be softened by imaginative and rational strategies to finance, organize, and deliver health care when resources are scarce.Decisions related to scarce resource allocations must(prenominal) be made in consideration of the ethical principles of autonomy, beneficence, and especially justice. Ethical issues related to scarce resource allocation are likely to become more and more complex in the future. Thus, it is imperative that health care leaders diligently and ethically continue to explore these issues (Maddox, 1998, p. 41). Somehow, while using the three standards noted, we need to domesticize our health care s ystem to benefit the aging and dying, and adhere to the codes of conduct the best way possible with the limited resources available.If there is a will, there is a way Ethical Challenges The critically challenging ethical issue of aged establish health care rationing is faced when preparing for an adequate health care system that will meet the care needs of the aging and dying. According to AAM (1988), the rationale for a program of health care rationing base on age rests on the assumption that society should allocate its resources efficiently, and that age-based rationing represents the most efficient order of resource allocation. Within this context, it has been argued that since most of the elderly are not in the work force they do not directly benefit society.Although the elderly, it is argued, should be provided with basic necessities and comfort, the greatest portion of health care resources, including expensive medical technologies, are better deployed on younger, more produ ctive segments of the population (American Medical Association AMA, 1988, p. 1). One tool developed by economist that has been used to billhook value of ones life so to speak is known as quality adjusted life years or QALY. It is a widely used government note of health improvement that is used to guide health-care resource allocation decisions.The QALY was originally developed as a measure of health effectiveness for cost-effectiveness analysis, a method intended to aid decision-makers charged with allocating scarce resources across competing health-care program (Kovner & Knickman, 2011, p. 258). Another common term for health care rationing is known as the remainder panel, or Obama Death Council. This panel is a government agency that would decide who would receive health care and who would not receive health care based on some form of standard implemented by the government.One difficult ethical question posed is, if we do ration health care, who decides how it is rationed, when and wherefore? The advocates of rationing argue that society benefits from the increase in economic productivity that results when medical resources are diverted from an elderly, retired population to those younger members of society who are more likely to be working. As stated by Binstock (200), promoting age-based rationing is detrimental to the elderly because it devalues the status of older people and caters to the values of a youth- oriented culture, aculture in which negative stereotyping based on age is prevalent. One possible consequence of denying health care to elderly persons is what it might do to the quality of life for all of us as we approach the too old for health care category. Societal acceptance of the notion that elderly people are unworthy of having their lives saved could markedly shape our general outlook toward the meaning and value of our lives in old age. At the least it might engender the unnecessarily gloomy prospect that old age should be anticipated a nd experienced as a stage in which the quality of life is low.The specter of morbidity and decline could be pervasive and over- whelming (Binstock, 2007, p. 8). Other ethical challenges related to the provisions of aging based health care are 1. Lack of education amongst health care providers in meeting the care needs of the aging and dying as well as providers faced with ethically challenging decisions especially at the end of life. 2. Lack of funds to support the diverse and challenging health needs of the aging, and promotion of comfort when dying, whether it be funds for care, facility placement, or aptitude to hire enough staff to me the high demands of a large population, and education.3. Cost effectiveness vs. quality of care vs. quality of life In the end, there is no solution to the problem of aging, at least no solution that a civilized society could ever tolerate. Rather, our task is to do the best we can with the dry land as it is, improving what we can but especially avoiding as much as possible the greatest evils and miseries of living with old age namely, the temptation of betrayal, the misrepresentation of perpetual youth, the despair of frailty, and the loneliness of aging and dying alone (Georgetown University, 2005, para.62). One way or another it is imperative to our aging society that a health care system is developed under the principals of autonomy, beneficence, and justice that will not deliver care based on rationing and determination of ones worth, but based on the individual and their health needs that will facilitate optimal aging and peaceful dying. References American Medical Association. (1988). Ethical implications of age-based rationing of health care (I-88). Retrieved from http//www.ama-assn. org/resources/doc/ethics/ceja_bi88. pdf Binstock, R. H. (2007, August). Our aging societies ethical, moral, and policy challenges. Journal of Alzheimers Disease, 12, 3-9. Retrieved from http//web. ebscohost. com. ezp. waldenulibrary. org/ehost/pdfviewer/pdfviewer? sid=64fb29eb-cd59-49c6-8750-ad2528de0fba%40sessionmgr110&vid=13&hid=114 Georgetown University. (2005). Taking care ethical caregiving of our aging society. Retrieved from http//bioethics. georgetown.edu/pcbe/reports/taking_care/chapter1. html Institute of Medicine of the National Academies. (2008). Retooling for an aging America building the health care workforce. Retrieved from http//www. fhca. org/members/workforce/retooling. pdf Kovner, PhD, A. R. , & Knickman, PhD, J. R. (2011). Jonas & Kovners Health Care Delivery in the United States (10th ed. , pp. 1-404). New York Springer publishing Company. Maddox, P. J. (1998, December). Administrative ethics and the allocation of scarce resources.The Online Journal of Issues in Nursing, 3(3). Retrieved from http//www. nursingworld. org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol31998/No3Dec1998/ScarceResources. html Teutsch, S. , & Rechel, B. (2012). Ethics of resource allocat ion and rationing medical care in a time of fiscal restraint _ US and Europe. Public Health Reviews, 34(1), 10. Retrieved from http//www. publichealthreviews. eu/upload/pdf_files/11/00_Teutsch. pdf