Ethical issues in long-term care for the elderly.

During the past 20 years there has been a wealth of literature on various aspects of ethical decision-making. The ethical dilemmas which confront health professionals become more and more complex as knowledge and technology expand. Professionals have more and more effect on human lives. As research provides professionals with more intervention tools, questions arise about "quality of life" and "who has the right to make life and death decisions." This paper examines the potential for ethical difficulties in long-term care settings for the elderly. Given the necessity for a multidisciplinary approach to geriatric care, a variety of professionals are involved in the delivery of services in multiple settings. For the purpose of this paper, these professionals are referred to as "health professionals" since we are defining health as physical, mental, and social well-being. Case examples will be used to illustrate potential issues when health professionals intervene with elderly persons who are in difficult situations. To provide a context, five codes of ethics (ie, health educators, social workers, physicians, clinical psychologists and nurses) will be examined. Each of these health profesionals is involved in service provision to an elderly client/patient or his family in the area of long-term care. These codes will be examined in light of their historic roots.