Just Health Care? 2004
The VI Annual Swedish Symposium on Biomedicine, Ethics and Society was held on May 24-25 in Sandhamn.
An Ethical Crisis of Aging?
Eric Matthews, Emeritus Professor and Honorary Research Professor in Medical Ethics and Philosophy of Psychiatry, Department of Philosophy, and Elizabeth Russell, Emeritus Professor of Social Medicine, Department of Public Health, both University of Aberdeen, Scotland.
Abstract of keynote lecture
There have been many predictions of an impending "crisis" for welfare in general, and the health care system in particular, resulting from projected changes in the age-balance of society. In Aberdeen, we have been involved, with international colleagues, in an investigation into the ethical and policy issues raised by such a crisis, particularly in the context of "solidaristic" health care systems such as the British NHS and the Scandinavian health services.
This has required us to try to get clearer about the rather vague notion of a "crisis of aging". We have found reason to question the assumption that treating an aging population would involve such an increase in overall costs as in itself to create anything dramatic enough to be called a "crisis". There could, however, be an ethical crisis for solidaristic systems based on the concept of a universal right to health care on the basis of need alone. This would be the case if we could continue to provide the full range of medical services to older people only at the cost of unfairness to the younger people who provide most of the funding for the system. This would undermine the sense of social solidarity on which the system rests, and make it morally unsustainable. Our analysis of the main currents of ethical argument, however, suggests that there is no reason why providing medical care for an increased number of older people should create any genuine unfairness to younger people.
