Abstract
Aim
Against the backdrop of controversial bioethical and public health debates on the role of age in decisions on healthcare allocation, we examine the perspectives of European lay persons on ethical implications of age and aging for medicine and health care.
Subject and methods
The study uses a qualitative approach based on the content analysis of 29 focus group discussions (235 participants) held in 4 European countries (Austria, Germany, the Netherlands, and Sweden) between 2005 and 2012.
Results
While lay persons unanimously reject chronological age as a criterion for resource allocation, they acknowledge that age can be an important factor in ethical decision-making processes in many different ways. In the discussions, they articulate biographical concepts and viewpoints (such as age roles, ideas of the course and prime of life, responsibilities between generations), framing questions of resource allocation with regard to a teleological perspective of a good life.
Conclusion
Participants introduce a biographical outlook on medical decision making while at the same time articulating different conceptions of aging and the life course. Public health ethics needs to find ways to incorporate this plurality of temporal perspectives on the good life.
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Notes
“Cross-Cultural Ethics of Health and Responsibility: Expert and lay perspectives regarding bioethical dilemmas in Germany and Israel”, funded by the German-Israeli-Foundation (GIF), grant no.: 1023-317.4/2008; “Challenges of Biomedicine - Socio-Cultural Contexts, European Governance, and Bioethics”, funded by the European Commission, project no.: SAS6-CT-2003-510238; “Decision-making processes in the context of living kidney donation - medical ethics and medical anthropological aspects”.
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Acknowledgements
We would like to thank the participants of our focus groups for their time and for sharing their views. We also would like to thank Nitzan Rimon-Zarfaty (Negev) and Lukas Kaelin (Vienna) for helpful comments on an earlier version of this paper. Finally, we would like to thank Silke Schicktanz (Göttingen) who was the principal investigator in all three projects.
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The authors declare that they have no conflict of interest.
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Schweda, M., Wöhlke, S. & Inthorn, J. “Not the years in themselves count”: the role of age for European citizens’ moral attitudes towards resource allocation in modern biomedicine. J Public Health 23, 117–126 (2015). https://doi.org/10.1007/s10389-015-0664-9
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DOI: https://doi.org/10.1007/s10389-015-0664-9