Handbook on Ethical Issues in Aging

By Tanya Fusco Johnson | Go to book overview

12
Ethical Issues in Family Care

Jennifer Crew Solomon

Families tend to create enduring patterns of reciprocal support between older and younger members. Family social care is provided both by younger family members for older family members and by older people for younger. The focus of social care is providing assistance that increases a person's competence and mastery of the environment, rather than increasing his or her dependence ( Hooyman & Kiyak, 1996). From a life-course perspective, social care begins with nurturing and socializing the young for participation in society. At the other end of the life course, social care provides assistance with tasks of daily living and personal care in cases of extreme disability. The specific type of assistance is determined by the family member's functional ability, living arrangements, and the gender of both caregiver and receiver. A discussion of ethical issues related to family social care must take into account different types of assistance, family structure, gender, age, and racial/ethnic characteristics of caregivers and receivers.

Bound up in these family caregiving contexts are ethical values, issues, and dilemmas. Ethical values (e.g., autonomy, beneficence, justice, fidelity) provide a basis for deciding what a person in a particular situation morally ought to do. A number of ethical issues arise when these values are applied to situations involving the provision of social care by family members. For example, what is the level of cognitive development required for a person to function autonomously? Ethical dilemmas are created by conflicts between ethical values. Should an older person be allowed to continue handling his or her own finances (autonomy) in spite of consistent money mismanagement (nonmaleficence)? In other words, should a person be protected from harm that results from his or her own bad decisions?

This chapter begins with a discussion of the wide range of assistance provided

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