Ethico-Legal Considerations in the Care of Older Adults PDF

ETHICO-LEGAL CONSIDERATIONS IN THE CARE OF THE OLDER ADULTS  TABLE OF CONTENTS A. Senior Citizen’s Law RA 7432 RA 9257 RA 9994 B. Violence among elderly C. Ethical Issues  LAWS AFFECTING SENIOR CIT...

ETHICO-LEGAL CONSIDERATIONS IN THE CARE OF THE OLDER ADULTS  TABLE OF CONTENTS A. Senior Citizen’s Law RA 7432 RA 9257 RA 9994 B. Violence among elderly C. Ethical Issues  LAWS AFFECTING SENIOR CITIZENS SENIOR CITIZEN’S LAW 1. RA 7432- An act to maximize the contribution of senior citizens to nation building, grant benefits and special privileges and for other purposes. Approved on April 23, 1992 under the administration of Former Philippine President, Corazon Aquino.  RELEVANT PROVISIONS OF RA 7432 POLIC Y 1.Reaffirm the valued Filipino Tradition AIM S 1.Senior citizens assisted and appreciated 2.Establish programs beneficial to Senior Citizens PRIVILEGE S 20 % discount from all establishments  RELEVANT PROVISIONS OF RA 7432 EMPHASIS ON HEALTHCARE 1.) 20 % discount and purchase of medicines anywhere in the Free Available medicines in all public health programs Available diagnostic and therapeutic procedures Use of operating rooms and special units Accommodations in the charity ward Professional and counseling services  LAWS AFFECTING SENIOR CITIZENS 2. RA 9257 or Expanded Senior Citizens Act of 2003- An act granting additional benefits and privileges to Senior Citizens Amending for the purpose Republic Act No. 7432. PRIVILEGE 1. ) 20 % discount and purchase of medicines anywhere in the Philippines, plus free funeral and burial services. 2. ) Priority lanes  LAWS AFFECTING SENIOR CITIZENS 3. RA 9994 or Expanded Senior Citizens Act of 2010- An act granting additional benefits and privileges to Senior Citizens, further amending Republic Act No. 7432. Approved on February 15, 2010 under the administration of Former Philippine President Gloria Arroyo. A. The grant of 20% discount and exemption from the value added tax (VAT).  SENIOR CITIZEN LAW RA RA 9257 RA 9994 7432 20 % discount from all 20 % discount and 20 % discount and purchase establishments purchase of medicines, and purchase of of medicines, plus funeral medicines and VAT exemption. and burial free  VIOLENCE AMONG ELDERLY Elder violence- A single or repeated act, or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person. It could be physical, psychological, emotional, financial abuse or neglect of elderly people.  VIOLENCE AMONG ELDERLY Physical Abuse: any action that causes physical pain or injury. Psychological/emotional abuse: The infliction of mental anguish. E.g.: ignoring, isolating, shouting. Financial/Material abuse: Illegal or improper exploitation and/or use of funds or resources.  VIOLENCE AMONG ELDERLY Sexual abuse: Non-consensual contact of any kind with an older person. Neglect: The refusal or failure to fulfil a care-taking obligation including/excluding a conscious and intentional attempt to inflict physical or emotional distress on the older person. When including, it involves a deliberate decision by the caregiver to withhold care or resources, potentially causing harm. When excluding, neglect may arise from carelessness, lack of knowledge, or inability to provide adequate care, resulting in harm or distress to the older person despite the absence of malicious intent.  ETHICAL ISSUES Physical restraint - should be used only when the patient is a danger for himself or others and when all other behavior management have been exhausted. Chemical restraint - is by giving psychoactive pharmacological agents. It is prescribed with caution and only when for the clear benefit of the patient.  WITHHOLDING AND WITHDRAWING TREATMENT Withholding treatment means not starting a medical treatment that could prolong life or address a serious health condition. For example, a doctor may decide not to begin a new course of chemotherapy for a terminally ill cancer patient when the likelihood of success is minimal, and the treatment could cause additional suffering. Withdrawing treatment involves stopping an ongoing treatment that is no longer beneficial to the patient. An example is turning off a ventilator for a patient in a persistent vegetative state where there is no reasonable hope for recovery.  MEDICAL DECISION MAKING FOR A POTENTIALLY INCOMPETENT PATIENT involves special ethical and legal considerations, as the patient may not be able to fully understand or communicate their preferences regarding treatment. When a patient is deemed incompetent (e.g., due to cognitive impairments, severe illness, or unconsciousness), the responsibility of decision-making often falls to a surrogate or follows pre-established directives.  INFORMED CONSENT is a fundamental ethical and legal principle in healthcare, requiring that patients be given adequate information about a medical treatment or procedure before agreeing to undergo it. It ensures that patients have the autonomy to make decisions about their health based on a clear understanding of the benefits, risks, and alternatives. the older adults and caregivers have the right to all information available or arranging for court appointment. If proxy is available, discuss and take substituted judgements or best interests.  PATIENT OPPOSITION TO PLACEMENT Placing the patient in a nursing home based on patient will Nurse should remember the rights of patient as well as caregiver. When all approaches failed contact outside source such as Ombudsman or hospital ethics committee  ASSISTED SUICIDE AND EUTHANASIA Assisted suicide refers to the act of providing a person with the means to end their own life, typically in cases of terminal illness or unbearable suffering. This can involve providing medication that the patient self-administers. Ethical Considerations: Supporters argue that it respects patient autonomy and allows individuals to choose a dignified end to their suffering. Opponents raise concerns about potential abuses, the sanctity of life, and the risk of coercion.  ASSISTED SUICIDE AND EUTHANASIA Euthanasia involves a healthcare professional actively administering medication or interventions to intentionally end a patient’s life. It can be voluntary (with the patient's consent), non-voluntary (without explicit consent), or involuntary (against the patient's wishes). Ethical Considerations: Proponents argue that euthanasia can be a compassionate response to unbearable suffering and a means to uphold a person’s dignity. Critics often express concerns about moral implications, potential for abuse, and the role of healthcare professionals in ending life.  DO NOT RESUSCITATE ORDERS Purpose: DNR orders are designed to respect a patient's autonomy and their wishes regarding end-of-life care. They are typically put in place for patients with terminal illnesses, severe health conditions, or those who wish to avoid aggressive interventions that may not align with their goals of care. Discussion and Consent: A DNR order should be discussed between the patient (or their surrogate decision-maker) and their healthcare provider. This conversation should cover the implications of the order, the patient's medical condition, and the potential outcomes of resuscitation efforts. Ethical Considerations: DNR orders can raise ethical questions about patient autonomy, quality of life, and the role of healthcare providers in honoring a patient’s wishes while ensuring appropriate care.