Ethical issues in the management of elderly patients in gastroenterology and digestive endoscopy

Over the past 30 years, the population of old-aged citizens in most Western countries has been dramatically increasing. These people usually have several comorbidities and often lose their independence, mostly due to neurodegenerating diseases. Benign and malignant gastrointestinal disorders are very common in all age groups, but their incidence increases with age, requiring investigation and therapy. In this setting several ethical issues arise, mostly related to the extent of invasive investigations, adverse drug reactions due to polypharmacy, the risk:benefit ratio of endoscopic therapy, and the quality and validity of informed consent in this frail elderly population.