Ethics and Values in Long Term Health Care Thispageintentionallyleftblank Ethics and Values in Long Term Health Care Patricia J. Villani, PhD, MPA Editor Ethics and Values in Long Term Health Care has also been published as Activities, Adaptation & Aging, Volume 18, Numbelll314 1994. © 1994 by The Haworth Press, Inc. All rights reserved. No part of this work may be reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, microfilm and recording, or by any information storage and retrieval system, without permission in writing from the publisher. The development, preparation, and publication of this work has been undertaken with great care. However, the publisher, employees, editors, and agents of The Haworth Press and all imprints of The Haworth Press, Inc., including The Haworth Medical Press and Pharmaceutical Products Press, are not responsible for any errors contained herein or for consequences that may ensue from use of materials or information contained in this work. Opinions expressed by the author(s) are not neces sarily those of The Haworth Press, Inc. First published 1994 by The Haworth Press, Inc., 10 Alice Street, Binghamton, NY 13904-1580 USA This edition published 2016 by Routledge 2 Park Square, Milton Park Abingdon, Oxon OX14 4RN 711 Third Avenue New York, NY 10017 Routledge is an imprint oft he Taylor & Francis Group, an informa business Library of Congress Cataloging-in-Publication Data Ethics and values in long term health care I Patricia J. Villani, editor. p. em. "Has also been published as: Activities, adaptation & aging, volume 18, numbelll 3/4, 1994"-T.p. verso. Includes bibliographical references. ISBN 1-56024-698-7 (alk. paper) 1. Aged-Long-term care-Moral and ethical aspects. 1. Villani, Patricia J. [DNLM: 1. Ethics, Medical. 2. Long-Term Care. 3. Caregivers. 4. Music Therapy. 5. Health Care Reform. W 50 E8413 1994] RC954.3.E87 1994 174 '.2-<1c20 DNLMJDLC for Library of Congress 94-35455 CIP ISBN 13: 978-1-560-24698-5 (hbk) Thispageintentionallyleftblank Ethics and Values in Long Term Health Care CONTENTS Foreword xiii Thomas M. Ennis Introduction 1 Patricia J. Villani PRACTITIONER KNOWLEDGE A Beginner's Guide to Ethical Awareness in Long-Term Care Services 5 Priscilla Kimboko Eva Jewell The Context for Ethical Dilemmas of Long-Term Care 5 Strategies for Resolving Moral Dilemmas in Long-Term Care 7 Developing a Common Language of Ethical Concepts 8 Ethical Rules for Professional-Client Relationships 13 Articulating Moral Arguments and Thoughts 14 Clarifying and Prioritizing Ethical Principles and Values 16 Logistics Within the Ethics Committee 17 Conclusion 19 Ethics and Values in Music Therapy for Persons Who Are Elderly 27 Alicia Ann Clair Qualifications of a Music Therapist 28 Music Therapy Program Involvement 30 Values in Music Therapy 32 Informed Consent 41 Conclusion 44 CAREGIVING Ethical Challenges Facing Family Caregivers of Persons with Alzheimer's Disease 49 Karen A. Roberto Beneficence 50 Autonomy and Paternalism 52 Justice 55 Implications for Practitioners 56 END OF LIFE CHOICES Final Life Choices: Who Decides? 65 Rosalie D. Marinelli Background 66 Introduction 69 Professionals' Dilemma 69 Society's Predicament 72 Patient Responsibilities and Family Obligations 73 Discussion and Conclusion 74 Supporting End of Life Decision Making 77 Linda L. Barrett The Ethical Value of a Utilitarian Approach to Death and Dying 89 Vera R. Jackson Background 89 Societal Polarity 90 Moral vs. Technical Orders 90 The Utilitarian Approach 91 The All Inclusive Model 93 Conclusion 93 HEALTH CARE REFORM Ethics and Health Care Reform: Outlook for Older Americans 97 Marie Raber Michelle Hawkins Should Medical Care Be a Right Without Restrictions by Cost, Age, Citizenship, Prognosis, or Self-Infliction? 107 David C. Blake ABOUT THE EDITOR Patricia J. Villani, PhD, MPA, is President of Gerontology for Education and Research Opportunities, Inc. (GERO, Inc.), a consult ing firm that assists public and private organizations in planning, implementing, and expanding quality eldercare programs. Her 22 years of experience as a program planner and program director in the u.s. Public Health Service, combined with her years as a private con sultant, have given Dr. Villani a broad-based knowledge of health care systems. She has had the opportunity to appraise and analyze ethical dilemmas in many types of health care settings. Dr. Villani is also the Administrator of the Washington Area Geriatric Education Center Consortium in Washington, DC.