End of Life Essay

harmonise to IOM (2008), the adjacent propagation of of age(p) adults provide be like no former(a) before it. It will be the most educated and diverse pigeonholing of sometime(a) adults in the nations history. They will set themselves asunder 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 senior Americans will be their vast numbers. According to the most late census numbers, there be now 78 million Americans who were innate(p) between 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 united States is expected to be more(prenominal) than 70 million, or almost double the to the highest degree 37 million older adults alive in 2005. The number of the oldest old, those who ar 80 and over, is also expected to nearly double, from 11 million to 20 m illion (Institute of Medicine of the interior(a) Academies IOM, 2008, p. 29). The linked States wellness apprehension system of rules faces enormous challenges as the baby baby boomer generation nears retirement age.Current reimbursement policies, workforce practices, and resource apportionments all expect to be re-evaluated, and redesigned in order to prepargon the health billing system for considering the ask of the inevitably growing nation of older adults. Areas practically(prenominal) as education, training, recruitment, and retention of the health c are workforce serving older adults will require remodeling. To accomplish this will require the dedication and storage tryst 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 traded for by a health care workforce ready to provide high- whole tone care. If current Medicare and Medicaid policies and workforc e tr cans continue, the nation will fail to meet this responsibility. Throwing more money into a system that is non designed to peddle 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 have a paramount role in solving the complex dilemmas surrounding the ageing population and health care. at that place are several honourable standards I believe should be utilize in determining resource allocation for the aging population and oddment of tone sentence care. Yet realistically, most are unreasonable with the already exceptional resources available for health care. Unfortunately hard decisions need to be do in the allocation of resources. Three primary ethical standards that could realistically break health care for the aging, which I believe should determine resource allocations are 1.Autonomy suggest that individuals have a ri ght to determine what is in their own best interest, though that interest may be throttle 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 ripe core principle of our patient advocacy. 3. Justice implies rightfulness and that all groups have an equal right to clinical services heedless of race, gender, age, income, or any other characteristic (Teutsch & antiophthalmic factor 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 exactly health care resources should be offered as fair as possible ( rightness), to do the most good for the patient in every situation (beneficence), with respect of the individual gentleman right to have control of what happens to their own body (autonomy). Elderly and end of l ife patients have a right to care that is dignified and honest.The trine ethical standards noted above should be the driving force nooky determining health care resource allocations, allowing for quality care delivery, accommodate to individual health needs at any stage of aging through the end of life, ensuring protection and satisfaction to such a unprotected patient population. As stated by Maddox (1998), perhaps the impact of the armament 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 to scarce resource allocations must be made in context of the ethical principles of autonomy, beneficence, and especially justice. Ethical issues related to scarce resource allocation are likely to become increasingly complex in the future. Thus, it is instant that health care leaders diligently and e thically continue to look for these issues (Maddox, 1998, p. 41). Somehow, while using the three standards noted, we need to reform our health care system to benefit the aging and dying, and adhere to the codes of conduct the best air possible with the limited resources available.If there is a will, there is a panache Ethical Challenges The critically challenging ethical issue of aged establish health care confine is confront 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 limit establish on age rests on the assumption that orderliness should allocate its resources efficiently, and that age-based rationing represents the most efficient method of resource allocation. Within this context, it has been argued that since most of the of age(p) 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 soothe, the greatest portion of health care resources, including expensive medical technologies, are better deployed on younger, more productive segments of the population (American health check Association AMA, 1988, p. 1). One tool real by economist that has been used to measure value of ones life so to speak is known as quality adjusted life years or QALY. It is a widely used measure of health return 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 think to aid decision-makers charged with allocating scarce resources across competing health-care program (Kovner & Knickman, 2011, p. 258). another(prenominal) common term for health care rationing is known as the death panel, or Obama Death Council. This panel is a government self-confidence that would decide who would receive health care and who would not receive health care based on some form of standard use by the government.One difficult ethical question posed is, if we do ration health care, who decides how it is rationed, when and why? The advocates of rationing argue that society benefits from the make up 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 resultant 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 outloo k toward the centre and value of our lives in old age. At the least it might acquire the unnecessarily gloomy prospect that old age should be expect and 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 monetary resource 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 ability to hire overflowing 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 dissolving agent to the problem of agin g, at least no solution that a civilise society could ever tolerate. Rather, our task is to do the best we can with the humanity 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 enticement of betrayal, the illusion of perpetual youth, the despair of frailty, and the loneliness of aging and dying whole (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, Au gust). 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). pickings 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. nursingwo rld. org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol31998/No3Dec1998/ScarceResources. html Teutsch, S. , & Rechel, B. (2012). Ethics of resource allocation and rationing medical care in a time of pecuniary restraint _ US and Europe. Public Health Reviews, 34(1), 10. Retrieved from http//www. publichealthreviews. eu/upload/pdf_files/11/00_Teutsch. pdf