Ehni Hans-Joerg, Kadi Selma, Schermer Maartje, Venkatapuram Sridhar
Bioethics. 2018 May;32(4):261-268. doi: 10.1111/bioe.12445.
Gerontologists have proposed different concepts for ageing well such as 'successful ageing', 'active ageing', and 'healthy ageing'. These conceptions are primarily focused on maintaining health and preventing disease. But they also raise the questions: what is a good life in old age and how can it be achieved? While medical in origin, these concepts and strategies for ageing well also contain ethical advice for individuals and societies on how to act regarding ageing and old age. This connection between gerontology and ethics is overlooked by both schools of thought. We thus develop this research programme for a systematic geroethics in four steps. First, we analyze 'successful ageing' as put forward by Rowe and Kahn as a paradigmatic example of a gerontological conception of ageing well. Then, in a second step, we move from criticisms within gerontology to an ethical perspective; in particular, we want to clarify the problem of the claim of universal validity of conceptions of the good life. In a third constructive step, we explain how the 'capabilities approach' could be applied in this context as a normative foundation for the implicit normative assumptions of gerontological conceptions of ageing well, such as a particular choice of functionings, the ethical relevance of human agency, and the resulting claims of individuals towards society. Finally, using a concept developed by the German philosopher Ursula Wolf, we systematically develop the different aspects of the connection between ageing well and the theory of the good life in their full complexity and show their interconnectedness.
老年医学专家针对健康老龄化提出了不同概念,如“成功老龄化”“积极老龄化”和“健康老龄化”。这些概念主要侧重于保持健康和预防疾病。但它们也引发了一些问题:老年的美好生活是什么样的,又如何实现?虽然这些健康老龄化的概念和策略源于医学领域,但它们也包含了关于个人和社会在应对老龄化和老年问题时应如何行动的伦理建议。老年医学与伦理学之间的这种联系被这两种思想流派所忽视。因此,我们分四个步骤开展这个关于系统老年伦理学的研究项目。首先,我们分析罗和卡恩提出的“成功老龄化”,将其作为老年医学中健康老龄化概念的一个典型例子。然后,在第二步中,我们从老年医学内部的批评转向伦理视角;特别是,我们想阐明美好生活概念普遍有效性主张的问题。在第三步建设性步骤中,我们解释“能力方法”如何能在这种背景下作为健康老龄化老年医学概念隐含规范假设的规范基础应用,比如特定的功能选择、人类能动性的伦理相关性以及个人对社会的相应主张。最后,我们运用德国哲学家乌尔苏拉·沃尔夫提出的一个概念,系统地全面阐述健康老龄化与美好生活理论之间联系的不同方面,并展示它们的相互关联性。