Making longevity in an aging society: linking Medicare policy and the new ethical field.

Perspectives in Biology and Medicine
Sharon R Kaufman

Abstract

Life-extending interventions for older persons are changing medical knowledge and societal expectations about longevity. Today's consciousness about growing older is partly shaped by a new form of ethics, constituted by and enabled through the routines and institutions that comprise ordinary clinical care. Unlike bioethics, whose emphasis is on clinical decision-making in individual situations, this new form of ethics is exceptionally diffuse and can be characterized as an ethical field. It is located in and shaped by health-care policies, standard technologies, and clinical evidence, and it emerges in what patients and families come to need and want. Three developments illustrate this ethical field at work: the changing nature of disease, especially the ascent of risk awareness and risk-based strategies for life extension; the role of technology in reshaping the ends of medicine; and the role of Medicare policy in creating need and ethical necessity. Medicare's expanding criteria for payment coverage of liver transplantation and implantable cardiac devices illustrate the pervasive logic of this new form of ethics. The powerful connection between the technological imperative and its ethical necessity is rarely mentioned in Medi...Continue Reading

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Citations

May 21, 2013·Journal of General Internal Medicine·Bjorg ThorsteinsdottirJon C Tilburt
Nov 6, 2013·Cardiology Clinics·Keith M Swetz, J Keith Mansel
Apr 26, 2014·Anthropology & Medicine·Julie Høgsgaard Andersen, Susan Reynolds Whyte
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Jun 5, 2021·Journal of Aging Studies·Michael D Barnett, Jessica H Helphrey

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