Clinical Ethics Issues in Geriatric Psychiatry

Psychiatrists treating older adults must address a rich mixture of medical, psychiatric, and psychosocial issues that may lead to ethical dilemmas involving autonomy, patient welfare, and social justice. Because of the potentially disabling effects of neuropsychiatric conditions disproportionately affecting older adults, their autonomy may become compromised. Psychiatrists thus become involved in assessing decisional and other types of capacity and in treating conditions that may affect capacity. The balance of risks and benefits of medical interventions must be weighed carefully in older adults, especially in the settings of dementia and end-of-life care. Finally, the care of older adults raises difficult questions about the allocation of scarce medical resources.