THE AGING POPULATION - ETHICAL DILEMMAS IN HEALTH-CARE FUNDING

An aging population and the rapid increase in health care expenditures for the elderly raise significant ethical issues about society's obligation to this age group. The competition for limited resources forces us to examine the appropriateness of current health care policies and programs for elderly people. As a framework for discussion the author proposes three criteria for providing health care to the elderly population: to each according to present or past contribution, invoking a "social worthiness" criteria; to each according to his or her need; and to each a decent minimum as a "right". Finally, the author explores the concept of rights to health care as the relationship between rights and justice. These criteria are selected and applied according to our societal values in general. If we are to make ethical standards the core of policy-making and the practice of medicine, we shall need greater involvement of the medical and related professions, government policymakers and the public.