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Ethics & aging in Southern California.

Ethics & Aging in Southern California

An Ethics and Aging Project, sponsored by the Ethics Center at Loma Linda University, ran throughout fall 1990 in the greater Los Angeles area. Funded by a $171,300 grant from the National Endowment for the Humanities, the project was designed to enlighten the public and to demonstrate how the humanities can illuminate the question of allocation of health care resources.

The project consisted of four aspects:

A national conference in San Bernardino of twenty specialists in the areas of ethics, medicine, and public policy;

A lecture series spanning three months held at two Southern California locations, with presentations by John C. Bennett, Daniel Callahan, Phillipa Foot, Richard D. Lamm, and Edward Schneider;

Fifteen community forums throughout the area led by humanities scholars discussing the use of age as the guideline for rationing care, coordinated by California Health Decisions. A booklet of excerpts from the writings of Callahan and Joseph Fletcher was a catalyst for discussion.

The planned publication of an anthology based on the papers presented at the conference and in the lecture series.

Three identifiable points of consensus (surely not without exceptions) emerged from the conference, lectures, and community discussions:

(1) Reasonable restrictions on the delivery of health care must be set. Limits on health care availability now exist, but the present ad hoc limits are often irrational, if not immoral. (In a survey of the community forum attendees, 80 percent stated that some form of rationing is needed.)

(2) Treatment effectiveness should be the basis for determining who receives expensive medical care. Categorical approaches such as age-based rationing were rejected in favor of pragmatic case-oriented decisions that weigh societal cost against individual benefit. (Sixty-four percent of survey respondents said the terminally ill should receive restricted health care.)

(3) America desperately needs a comprehensive health care system for reasons of justice and economy. Without such a system, the setting of limits will be inherently inequitable because only the poor would receive the restricted care. Substantial fiscal savings can be realized by systemically addressing the issues of waste, duplication of services, and effectiveness of treatment. Any national health plan must deal with the additional issue of provision for nursing-care patients.

A report on the Ethics and Aging Project as well as project literature is available.--James W. Walters, Ethics & Aging Project Director, Loma Linda University.
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Title Annotation:health care project at Loma Linda University
Author:Walters, James W.
Publication:The Hastings Center Report
Date:Mar 1, 1991
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