Ethical aspects of care of the geriatric orthopaedic patient.

Ethical aspects of care of the geriatric orthopaedic patient include respecting patient self-determination as the primary standard of decision making; using advance directives or appropriate surrogate decision makers when patient decisional capacity is lost; and balancing the benefits and burdens of any intervention and its alternatives in arriving at a treatment decision. With an increase in managed care plans, questions of justice in care of the elderly will be raised. Physicians face fiscal incentives that encourage fewer surgical procedures and lower levels of health care particularly in the elderly, a group that notably has benefited from the functional enhancement permitted by modern orthopaedic techniques. Professional vigilance is required of physicians to ensure that appropriate health care services continue to be available to patients.