Does cost containment create conflict in the care of the elderly patient?

Ethical aspects of care of geriatric patients with orthopaedic disorders include patient autonomy, beneficence, and nonmaleficence. Advance directives and surrogate decision-makers are required if the patient has lost decisional capacity. Investor-owned health plans have captured the major share of the United States medical market, but have been shown to deliver lower quality of care than competing methods. A deeply imbedded fear of a government-run health plan with good intentions expressed as bad policy exists. Ageism is one example of how ethical principles may be trampled. The orthopaedic surgeon has a responsibility to maintain and fight for these ethical standards.