Institute of Ethics and History of Medicine, University of Tübingen, Gartenstraße 47, Tübingen, 72074, Germany.
Med Health Care Philos. 2023 Mar;26(1):133-142. doi: 10.1007/s11019-022-10129-5. Epub 2022 Nov 19.
Despite the diversity of ageing, society and academics often describe and label older persons as a vulnerable group. As the term vulnerability is frequently interchangeably used with frailty, dependence, or loss of autonomy, a connection between older age and deficits is promoted. Concerning this, the question arises to what extent it may be helpful to refer to older persons as vulnerable specifically in the context of health care. After analyzing different notions of vulnerability, I argue that it is illegitimate to conclude that older age is related to increased vulnerability. Much more, identifying older adults as a vulnerable group is closely related to ageism and can be associated with paternalistic benevolence and a tendency to overprotection, especially within health care. Additionally, even though older adults are more often in situations of increased vulnerability due to their potentially higher need for health care, I argue further that older adults mainly become a vulnerable group due to ageism. In this way, it can be concluded that the vulnerability of older adults does not originate in certain attributes of the group, but arises from a characteristic of society and, in turn, health personnel, namely ageism. Labeling older adults as vulnerable therefore is only helpful, when it is used to raise awareness of the widespread ageism in society, in this context, especially in the setting of health care, and the negative consequences thereof for older adults.
尽管衰老存在多样性，但社会和学术界经常将老年人描述和标记为弱势群体。由于脆弱性一词经常与虚弱、依赖或自主权丧失互换使用，因此促进了老年人与缺陷之间的联系。关于这一点，出现了一个问题，即在医疗保健背景下，将老年人具体称为弱势群体在多大程度上可能是有帮助的。在分析了脆弱性的不同概念之后，我认为，得出老年人年龄增长与脆弱性增加有关的结论是不合法的。更重要的是，将老年人确定为弱势群体与年龄歧视密切相关，并可能与家长式的仁慈和过度保护的倾向相关联，尤其是在医疗保健领域。此外，尽管由于老年人可能对医疗保健的需求更高，他们更容易处于脆弱性增加的情况下，但我进一步认为，老年人主要是由于年龄歧视而成为弱势群体。通过这种方式，可以得出结论，老年人的脆弱性不是源于该群体的某些属性，而是源于社会的特征，进而源于卫生保健人员的特征，即年龄歧视。因此，只有当将老年人标记为弱势群体被用于提高对社会中普遍存在的年龄歧视的认识时，这种做法才是有帮助的，在这种情况下，尤其是在医疗保健环境中，以及这种歧视对老年人产生的负面影响。
