By Martha B. Holstein PhD, Phyllis B. Mitzen ACSW LCSW

Taking care of elders outdoor of associations is the quickest growing to be region folks healthiness care. construction on their examine learn on the Park Ridge heart, editors Holstein and Mitzen, including a crew of specialists, study the complexities eager about constructing an ethics for community-based long term care. additionally they problem policymakers to make domestic care a extra potential choice for older humans in desire. Chapters deal with the various moral and functional difficulties that come up within the care of older individuals with actual and psychological disabilities--including tips to allocate scarce money, find out how to hold solid caregivers, how one can stability issues of autonomy, possibility and security, and employee rigidity. the quantity is a wonderful source for practitioners, policymakers, and scholars.

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1981). The tyranny of principles. Hastings Center Report, 11, 31-39. CHAPTER 3 Bringing Ethics Home: A New Look at Ethics in the Home and the Community Martha B. Holstein There is every reason to react with alarm to the prospect of a world filled with self-actualizing persons . . freely choosing when to begin and end all their relationships. It is hard to see how, in such a world, children could be raised, the sick or disturbed could be cared for, or people could know each other through their lives and grow old together.

Thus, for many professionals concerns about safety challenges, most fundamentally, the almost single-minded adherence to autonomy usually defined as self-direction, that governs social work practice and contemporary applied ethics. Because of the centrality of safety concerns to long-term care and because it helps reveal the warp and woof of efforts to find meaning in later life, we should look at them in some detail. Powerfully held beliefs about autonomy could not alleviate care workers' concerns about safety, especially if the client lived alone, if family members appeared to be unreliable, or if the client had dementia.

The Belmont Report, published for comment in the Federal Register in 1976 and officially disseminated in 1978, contained a statement of principles to be used for the ethics of human experimentation, but also for bioethical reflection in general. Prior to 1984 there was not much attention or work by ethicists devoted to ethics and aging. What existed had a focus on acute care rather than on longterm care. In 1984, the Retirement Research Foundation (RRF) decided to help fill this gap in attention and knowledge by developing a special initiative in ethics and aging.

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