Allowing the aged autonomy to act or abstain : ethical considerations related to invasive medical procedures in the elderly
| dc.contributor.advisor | Van Niekerk, Anton A. | en_ZA |
| dc.contributor.author | Moolman, Minee | en_ZA |
| dc.contributor.other | Stellenbosch University. Faculty of Arts and Health Sciences. Dept. of Philosophy: Centre for Applied Ethics. | en_ZA |
| dc.date.accessioned | 2020-11-06T11:28:20Z | |
| dc.date.accessioned | 2021-01-31T19:37:51Z | |
| dc.date.available | 2020-11-06T11:28:20Z | |
| dc.date.available | 2021-01-31T19:37:51Z | |
| dc.date.issued | 2020-12 | |
| dc.description | Thesis (MPhil)--Stellenbosch University, 2020. | en_ZA |
| dc.description.abstract | ENGLISH ABSTRACT: Modern medical technology has enabled the use of invasive medical procedures in elderly patients in an attempt to extend life or to improve quality of life. This has created significant complexity in both clinical management and ethical decision making regarding these patients. From antiquity, the focus of medicine has been to relieve suffering and to provide care, as opposed to the modern focus on cure. This shift in the focus of medicine makes ethical considerations regarding the use of invasive medical procedures in the elderly especially important, as technical advances in medicine could create unrealistic expectations of cure (for both patients and caregivers) and if utilised inappropriately, cause failure to suitably care for the elderly. The aim of this thesis is to conceptualise a framework of factors that aids ethical deliberation when invasive medical procedures in elderly patients are considered, representing a standard of due care. The factors incorporated in the framework are identified by evaluating the current ethical landscape regarding invasive medical procedures in the elderly within the context of principlism. Principlism refers to the principlist approach as outlined by Tom Beauchamp and James Childress in Principles of Biomedical Ethics. Despite the current focus on patient autonomy in bioethics and in the medical literature, there is a general lack of awareness by clinicians of the factors that drive an increase in intensity of treatment resulting in invasive medical procedures in the elderly. Narrow views of these factors predominate in the literature and no attempt is made to consolidate all these factors into a conceptual framework for ease of ethical deliberation. It is argued that familiarity with all the factors that influence the use of invasive medical procedures in the elderly, would enable a healthcare practitioner to take these factors into account during ethical deliberations. Reference to a framework that incorporates all these factors would result in more appropriate care of patients, congruent with the principles of respect for autonomy, beneficence and nonmaleficence. Awareness of these factors would also promote the principle of justice by facilitating fair distribution of available resources, as less pressure will be placed on the system if unwanted and unwarranted interventions are avoided. | |
| dc.description.abstract | AFRIKAANSE OPSOMMING: Moderne mediese tegnologie stel bejaarde pasiënte in staat om indringende mediese prosedures te ondergaan in ‘n poging om hulle lewenskwaliteit te verbeter of om hulle lewens te verleng. Beduidende kompleksiteit in die kliniese hantering van sowel as die etiese besluitneming oor hierdie pasiënte vloei hieruit voort. Die fokus van mediese sorg, van antieke tye af, was om siek mense te versorg en om lyding te verlig. Vandag is die klem egter op die genesing van siekte en die herstel van funksie. Hierdie verandering in die fokus van mediese sorg maak etiese oorwegings rakende die gebruik van indringende mediese prosedures in bejaarde pasiënte noodsaaklik. Tegnologiese vooruitgang in mediese sorg kan onrealistiese verwagtinge van genesing skep by beide pasiënte en medici. Onvanpaste gebruik van indringende prosedures kan ook veroorsaak dat daar nie geskikte sorg aan pasiënte verleen word nie. Die fokus van hierdie tesis is om ‘n raamwerk van faktore te konseptualiseer wat etiese besluitneming fasiliteer wanneer indringende mediese prosedures in bejaarde pasiënte oorweeg word. Hierdie raamwerk verteenwoordig ‘n basiese standaard van nodige sorg. Die faktore wat in die raamwerk geïnkorporeer word is geïdentifiseer deur die huidige etiese landskap te evalueer aan die hand van die beginsel-benadering sover dit indringende mediese prosedures in bejaarde pasiënt aanbetref. Die beginsel-benadering is uiteengesit deur Tom Beauchamp en James Childress in hulle boek Principles of Biomedical Ethics. Ten spyte van die huidige klem op pasiënt outonomie in die mediese literatuur sowel as in die bio-etiek, is daar ‘n onkunde by klinici aangaande die faktore wat ‘n toename in die intensiteit van behandeling (met toenemende indringende mediese prosedures in bejaardes) dryf. Eng benaderings rakende hierdie faktore oorheers die literatuur. Geen poging om al die relevante faktore te konsolideer in ‘n konseptuele raamwerk om etiese besluitneming te fasiliteer is tot dusver gemaak nie. Dit word aangevoer dat ‘n grondige kennis van al die faktore wat die gebruik van indringende mediese prosedures in bejaardes beïnvloed, ‘n gesondheidspraktisyn in staat sal stel om hierdie faktore teen mekaar op te weeg tydens etiese beraadslaging. Verwysing na ‘n raamwerk wat al hierdie faktore insluit sal ‘n gesondheidswerker in staat stel om meer toepaslike sorg aan pasiënte te verleen, in lyn met die beginsels van biomediese etiek. Die beginsels van respek vir pasiënt outonomie en pasiënt welsyn asook nie-benadeling van die pasiënt sal eerbiedig word. Die beginsel van geregtigheid sal ook bevorder word as ongewensde en ontoepaslike intervensies vermy kan word wat tot ‘n meer regverdige verdeling van beskikbare hulpbronne sal lei. | |
| dc.description.version | Masters | |
| dc.format.extent | 123 pages | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/10019.1/109163 | |
| dc.language.iso | en_ZA | en_ZA |
| dc.publisher | Stellenbosch : Stellenbosch University | en_ZA |
| dc.rights.holder | Stellenbosch University | en_ZA |
| dc.subject | Elderly people -- Patients -- Rights | en_ZA |
| dc.subject | UCTD | en_ZA |
| dc.subject | Medical ethics | en_ZA |
| dc.subject | Invasive Medical procedures | en_ZA |
| dc.title | Allowing the aged autonomy to act or abstain : ethical considerations related to invasive medical procedures in the elderly | en_ZA |
| dc.type | Thesis | en_ZA |