Ethical considerations in chronic musculoskeletal disease
C Ronald MacKenzie1, Inmaculada de Melo-Martin
1Department of Rheumatology and Medicine Hospital for Special Surgery, 535 East 70th Street, New York, NY, 10021, USA, mackenzier@hss.edu.
Insights
Chronic diseases pose significant challenges to patients, families, and healthcare systems. This study examines ethical dilemmas in chronic care, proposing a new framework to address issues of autonomy.
Area of Science:
- Medical Ethics
- Public Health
- Gerontology
Background:
- Chronic diseases are a growing public health concern, particularly with an aging population.
- These conditions significantly impact individuals, families, and healthcare systems.
- Ethical considerations in chronic care lag behind acute care, especially regarding patient autonomy.
Purpose of the Study:
- To address the ethical dilemmas in chronic care settings.
- To examine challenges to individual autonomy in chronic illness.
- To present a framework for exploring ethical problems in chronic care.
Main Methods:
- The study examines a clinical scenario to illustrate ethical challenges.
- It analyzes the complexities of autonomy in chronic care.
- A framework is developed based on the scenario analysis.
Main Results:
- Conventional models of autonomy are often insufficient for chronic care.
- Chronic care ethical dilemmas involve medical, personal, and societal dimensions.
- Multiple participants and long resolution times complicate ethical decision-making.
Conclusions:
- A novel framework is presented for navigating ethical issues in chronic care.
- The framework aims to better address the complexities of patient autonomy.
- This work contributes to the ethical discourse surrounding long-term health conditions.
Abstract:
Chronic diseases compromise the life of the sufferer, encumber their families, and exert intractable burdens on the health-care system. With the aging of the population, such conditions have become the primary determinants of morbidity and mortality and the leading cause of disability in our society. Despite the serious challenges they impose, the ethical discourse engendered by them has lagged behind that of acute care medicine. Of particular relevance are the challenges to individual autonomy, as the dilemmas arising in the chronic care setting have not only medical but personal and societal dimensions, may require the input of multiple participants, and resolve over longer periods of time. As such, the conventional model of autonomy is often inadequate to address problems in the chronic care setting. This paper deals with this dilemma through an examination of a clinical scenario. A framework for the exploration of ethical problems in the chronic care setting is thus presented.
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