Ageist policies, which serve younger people to be in privileged position compared to elder people, is a very controversial topic in politics and health system. Some people including A.B. Shaw think that age is an objective factor in rationing decisions and health care should be preferentially allocated to younger patients whereas some others such as Michael M. Rivlin think that although some form of rationing is necessary in medicine, ageist policies could be inadequate with human civilization since it is the mark of a civilized society to look after its most vulnerable members. In this assignment, I am going to discuss and compare these two opposing views and manifest my own views related to the topic.
Those who are opposed to some aspects of ageist policies accept that age is an objective factor and category in science and age rationing is necessary in medicine. However, what they do not accept is that some of the ageist policies “which deny elderly people treatment on the sole grounds of their age, are both unfair and discriminatory and should therefore be resisted” (Rivlin). Rivlin points out that the percentage of the elderly people will increase regularly in the world especially in the Western world and ignoring or discriminating elderly people’s rights would be right and democratic. He argues that there are some misbelieves who direct us to implement such a discriminatory practice. For instance, we believe that elderly people would willingly give up their lives in favor of younger people although there are many researches (Rivlin gives Evans’ research as an example) who indicate that elderly people value their lives more highly than others. Moreover, without making research we accept that old people will not be able to gain as much benefit from treatment as young people. In many cases, however, elderly people’s response to treatment is as good as young people’s (Rivlin talks about Brandstetter’s research). Another prejudice is caused by the belief that the society could gain less from treating elderly people. However, it is wrong to assume that just because they are older people would contribute less to the society and moreover, this understanding will reduce the moral and democratic standards of this society as a whole. As a conclusion, those who are against ageist policies claim that treating elderly people is the rationing of the civilization of that society and there should not be such thing as discrimination (against any group) in a real democratic country.
Those who defend ageist policies basically claim that the health system should be in favor of younger people because the elderly people already enjoyed more community support than the younger people and a utilitarian approach (a philosophical approach that defends the greatest good for the greatest number of people) is needed in health system in order to increase society’s benefit as a whole. That is why; people like A.B. Shaw think that younger people who could live and contribute more to the society should have privilege in health care system. Shaw accepts that “all lives are of equal value” but he also believes that due to our limited resources in health system in countries’ budgets, we have to be more selective and we have to favor younger people. In his view, this is not a moral matter, but rather a utilitarian matter. He also points out that ageism appeared with the practices of doctors and nurses naturally and older people have also tendency to accept this practice. As a conclusion, A.B. Shaw thinks that age is an objective, ethical and cost-effective criterion for health care system and ageist policies should be supported and expanded.
As far as I am concerned, although both writers and sides have strong arguments, Michael Rivlin and those who oppose to ageist policies are more in conformity with our humanitarian and democratic ideals since they want to abolish all discriminatory laws and practices. Utilitarian approach might be useful in many areas, but in health care system a utilitarian approach is not ethical and humane at all. We should accept all individuals as equal and doctors should stay loyal to their “Hippocrates oath” by treating all people equally. In my opinion, too much utilitarianism could lead us to destroy other social groups too (handicapped people etc.) and could lead to a sick ideology similar to Nazism. That is why, as far as I am concerned ageist policies could be illegalized and people who make such practices should be punished. Moreover, in order to solve the problem states should allocate bigger shares from their budget to the social state especially to their health and education systems. We should never lose or give up from our humane and benevolent characteristics that make us human beings…
- Rivlin, Michael M., “Protecting elderly people: flaws in ageist arguments”, retrieved on January 5, 2009 from http://www.bmj.com/cgi/content/full/310/6988/1179,
- Shaw, A.B., “In defense of ageism”, retrieved on January 5, 2009 from http://jme.bmj.com/cgi/reprint/20/3/188?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=ageism&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT
 Shaw, A.B., “In defense of ageism”
 Rivlin, Michael M., “Protecting elderly people: flaws in ageist arguments”