[Limits of geriatric surgery--where are they, can they be defined?]

Ageing is not a disease; it does not necessarily imply physical and intellectual deterioration. If the possibilities of an adequate training are not exploited the aged person finds himself in a "state of regression". Only the elderly person himself can assess his welfare. His quality of life is not to be objectively judged by others. The elderly person wants to live and to die; he does not fear death but an agonizing death. The limit of surgical treatment is when a patient capable of making his own decision refrains from doing so and the surgeon is certain that there is not even a remote chance of survival. The determination of scientific and clinical limits may be very difficult. This is a question of deliberation, not of ethics.