GESTIÓN EN SALUD PÚBLICA: BioEdge: Is ‘elderly’ an offensive and discriminatory term?

domingo, 3 de marzo de 2019

BioEdge: Is ‘elderly’ an offensive and discriminatory term?

BioEdge: Is ‘elderly’ an offensive and discriminatory term?

Bioedge

Is ‘elderly’ an offensive and discriminatory term?

by Michael Cook | 2 Mar 2019 | 1 comment

A University of Chicago neurologist says that the word “elderly” is as anachronistic and offensive as the words “imbecile” or “idiot” and should be not be used by doctors. Dr Javad Hekmat-panah argues in a BMJ opinion piece that “elderly” is nearly meaningless in an era when over-65s have a wide range of health conditions.

“[It] offers no useful information about any of this. In medicine it can evoke false ideas about the person being described as elderly in the listener’s mind, introduce unfair social biases and generalisations, and generate ill conceived policies.”

He says that doctors sometimes treat all patients over a certain age the same, regardless of their underlying state of health. And it is only the elderly who are targets for healthcare rationing schemes. “Aging is not a disease, it is a progressive biological change and there may be vast differences in the health of people who are aged 65 and over. One older patient may not be able to tolerate a medical treatment because of accumulated comorbidities, but another of the same age without comorbidities may easily do so.”

He concludes by declaring that discrimination against the “elderly” violates fundamental principles of medicine and is a human rights issue:

My suggestion that we avoid the term elderly in medicine goes beyond the word itself to encompass all that it connotes: stereotypes, unwarranted impressions, and bias. This is essentially a human rights issue. Medicine is the science and art of individualised communication, evaluation, recommendation, and treatment. Each patient has the right to be treated as an individual, according to medical standards based on their specific age, general condition, and comorbidities. To label everyone above a certain age as elderly and to treat them identically defies this principle, which should be at the heart of medicine.

Michael Cook is editor of BioEdge.

Colombia is a country that flies under the radar as far as euthanasia goes. But it has one of the most progressive legal frameworks for euthanasia anywhere. (See article below.) Children over the age of 6 can request the right to die (with the approval of their parents). It may also be one of the jurisdictions where it is least used. Euthanasia has been permitted since 2015, but only 40 people have taken advantage of it -- according to official records. Unofficially, there may be many more. As in other countries, activist doctors who are impatient with red tape take the law into their own hands.

And bizarrely, Colombian voters have had no say in this momentous legal change. “We have not had a big national debate about this, and I’m not very happy about it," says a former Colombian health minister. “We need a public debate: We are not Belgium or Holland – this is at odds with people’s beliefs and mode of thought.” It would be good for a team of bioethcists to study the situation in Colombia with the same rigour as they have in Belgium, the Netherlands, or Canada.