Medicine, Health Care and Philosophy

, Volume 18, Issue 2, pp 229–236 | Cite as

Novel ethical dilemmas arising in geriatric clinical practice

  • Elisa Constanza Calleja-Sordo
  • Adalberto de Hoyos
  • Jorge Méndez-Jiménez
  • Nelly F. Altamirano-Bustamante
  • Sergio Islas-Andrade
  • Alejandro Valderrama
  • Carmen García-Peña
  • Myriam M. Altamirano-Bustamante
Scientific Contribution

Abstract

The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel–patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an ethical dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected (n = 54, 12.8 %). The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients’ life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population.

Keywords

End of life Ethical dilemmas Dignity Qualitative research Elderly 

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  • Elisa Constanza Calleja-Sordo
    • 1
  • Adalberto de Hoyos
    • 1
    • 2
  • Jorge Méndez-Jiménez
    • 1
  • Nelly F. Altamirano-Bustamante
    • 1
    • 3
  • Sergio Islas-Andrade
    • 4
  • Alejandro Valderrama
    • 1
    • 3
  • Carmen García-Peña
    • 5
  • Myriam M. Altamirano-Bustamante
    • 1
    • 4
  1. 1.Grupo transfuncional en ética clínicaCentro Médico Nacional Siglo XXI, IMSSMexicoMexico
  2. 2.Centro de Investigaciones Económicas, Administrativas y SocialesIPNMexicoMexico
  3. 3.Instituto Nacional de PediatríaSecretaría de SaludMexicoMexico
  4. 4.Unidad de Investigación de Enfermedades MetabólicasCentro Médico Nacional Siglo, XXI, IMSSMexicoMexico
  5. 5.Unidad de Investigación epidemiológica en servicios de salud. Área envejecimientoCentro Médico Nacional Siglo XXI, IMSSMexicoMexico

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