Ethics and Aging in America: Case Study Analysis

| December 15, 2020

The swelling number of elderly people seeking long term palliative care in recent years calls for better comprehension and awareness of quality healthcare services for the population that is sick and advanced in age. The influx of aged patients seeking urgent palliative care in the health facilities is concrete proof that the near future will call for a more reliable medical care system and competent health care providers to take on the responsibility to put in place quality healthcare supported by a secure system that is both efficient and cost-driven. It is true to the adage that the character of a people can be determined by how they treat their elderly, the healthcare system put in place for the elderly therefore acts as a clear reflection of our values as a nation. It is important to note that there are numerous ethical issues in the health care system that affect everyone inconsiderate of age, however, this dissertation intends to shed light only on the ethical issues pertaining to the elderly population as in the case of Ms. L from the case study.


Any future decisions to be made concerning palliative care for the aged population needs to be solely based on an ethical foundation because the issue of efficient healthcare system for the aged will stick with us into the next few decades of the 21st century. The decisions to be made regarding palliative healthcare for the elderly must be made with full comprehension of the political and social climate and an understanding of the history surrounding healthcare for the aged in the nation.

Functional limitations are classified by clinicians into two broad categories for analysis of the intensity of care required by the patient (Garrett, 1989). The first category based on day to day functions and activities, is abbreviated as ADL, which stands for “activities of daily living” such as bathing, eating, toileting, movement and work. A patient classified as ADL-dependent is hindered from daily activity by various cognitive impairments and require special aid to go about their daily activities. Ms. L suffered from an advanced cancer of the vulvar that strained her movements and other daily functions. As in the case of Ms. L, a number of factors, such as her cancer prognosis, her struggle with drug and substance use including narcotics like cocaine and heroin, among other factors have to be considered before a decision was made on the intensity of care she needed at the advanced age of 87. 

Despite Ms. L being HIV positive, she had lived with the virus up to an advanced age of 87 and this can be attributed to the fact that there were significant improvements in dealing with disabling conditions and health complications that affect the elderly patients and this guarantees a longer period of care for people with these disabling conditions.

Ms. L was a senior citizen of African-American descent, and the demographic factors and ethnic compositions definitely had an effect on her need for long-term care (Garrett, 1989). It is projected that the ethnic composition in the United States by the year 2030 will comprise 5% Asiatic origin, 11% Hispanic, 10% African-American and 72% white. These statistics suggest the need for a boost in government finances and subsidies and improved healthcare services for all. It is also an established fact that the racial minorities, Ms. L included, had a high dependency rate on the public subsidies to finance their long-term health care needs. This trend was attributed to the prevailing patterns of distribution of economic resources among the ethnic and racial groups in the United States.

The cost of healthcare is surely an ethical factor to be put into consideration. The gross expenditure required for palliative care and long-term health care are significantly high and are most definitely on the rise. Of the 106.5% billion expenditure on healthcare, 73% was attributed to the various nursing homes, home care and community based care accounted for 27% of the aggregate amount. The individual out of pocket payments contributed to 35% of the overall amount. Benefits from private health insurance companies paid for 5.5% of the total expenditure. The government, both federal and state paid for 57.4% of the total bills.

Long term healthcare for aged patients with underlying conditions such as HIV in the case of Ms. L has continued to be a problem and there is no hope for improvements in the future without concrete plans to change the trends. Barriers to sustainable long term healthcare are put in place by the political class that govern the funding, especially for the ethnic minorities. The past decade has recorded a rise in ethical issues including economic, social and cultural issues acting as barriers.


Pressing shortage in access to affordable long term medical care and adequate professionals in the healthcare sector continues to be a dominant problem in the 21st century. The ethical issues and challenges surrounding healthcare such as access and cost have resulted in undue and unwarranted deaths and the government has an urgent obligation to look into the ethical issues and put in place some concrete plans to solve them.  


Garrett, T. M., Baillie, H. W., Garrett, R. M., & McGeehan, J. F. (1989). Health care ethics: Principles and problems. Englewood Cliffs NJ: Prentice Hall.

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