Aging, dementia and care: setting limits on the allocation of health care resources to the aged

This article explores the ethical dimensions behind care of the elderly and considers whether younger people should be given priority over the aged in the provision of health care resources. It is argued that age is a relevant consideration in decisions concerning the allocation of health care. The notions of a 'natural life span' and a 'tolerable death' are discussed and on this basis I conclude that while the interests and claims of the elderly must be protected, the use of unlimited resources in the pursuit of life extending measures cannot be justified. When traditional ethical principles are applied to care of the aged they have to be viewed in a modified fashion. The nature of dementia is such that integrity in caregiving has to take account of the patient's premorbid self. I argue that the morally appropriate response to demented patients excludes acute-care, life-extending medicine, but neither does it advocate active euthanasia. The aim is to find a middle ground between treating the demented too aggressively and failing to give them sufficient treatment.