Bioethics and Law Observatory of the University of Barcelona launches a Document that aims at improving quality of life of elderly people

One of the most important issues that western societies have to tackle is the ageing. The increase in life expectancy results in an increase in the population with physical and psychological dependencies and with multiple ailments. In a society such as ours, which idolizes consumption and youth, there’s a lake of awareness about the situation of elderly people and frequently it seems to be a taboo subject. Thus, public policies must address the adaptation of all society to the process of ageing by taking an approach to the issue actively. In order to promote raising awareness on this issue and effective proposals, the Opinion Group of the Observatory on Bioethics and Law has analysed the bioethical issues related to vulnerability and limited autonomy that the elderly face, and presents this "Document on ageing and vulnerability". Thus document aims at improving the quality of life of older people, promoting early decision-making ― both individual and social ― and fostering solidarity and values of non-discrimination.

This document is the result of collaboration among Miriam Andújar, Pilar Antón, Fina Castaño, Ignasi Coll, Itziar de Lecuona, Joaquim Martínez-Montauti, Mónica Navarro-Michel, María José Plana, Albert Royes, Pilar Rodríguez, Antoni Vilà and María Casado, the work coordinated by the latter three.

On vulnerability and ageing

The actual system is based on the assumption that after childhood and adolescence we are fully autonomous beings and will always be so. However, this is not always the case and every day we see persons who are dependent and need the care and support of others. The ageing process gradually transforms a healthy adult into a fragile individual less able to carry out their own wishes. Most older persons are in conditions to make decisions for themselves. However, usually vulnerability and dependency increase when persons reach their 80s. Thus, many elderly persons may need support to exercise their capacities and measures of protection in order to avoid becoming victims of extortion or deception. However, supporting does not mean substitution and autonomy of elderly people should be protected for the benefit of their freedom and dignity.

Among the causes that difficult the autonomy of older persons it is important to highlight the overprotection resulting from paternalistic attitudes from familiars and socio-health services, the lack of information or the lack of comprehensible information adapted to the real situation of those who it is aimed at or the interference from third parties. There are diverse consequences related to heteronomy, for example, a loss of control over one's own life, a loss of intimacy and privacy and in the worst cases, mistreatment or abuse.

Capacity and incapacity

All adult persons have the legal capacity and standing to act, without age per se altering this. Thus, ageing is not in itself a cause for loss of capacity. However, older persons who have physical, mental or sensory impairment, which may hinder their full and effective participation in society could loss their legal capacity (Convention on the Rights of Persons with Disabilities (UN, 2006)). The impact of the Convention to the Spanish law and the necessity of modify or substitute the legal incapacity. Intense debate has taken place regarding its impact on Spanish law and the need to modify or substitute the existing system of legal incapacity for one based  on the establishment of supports to capacitate the individual. In order to achieve this goal, a wide range of services that aims at fostering the autonomy of older persons is needed. There are different mechanisms for self-protection designed to enforce the rights of the elderly; however they are still largely unknown. Autotutela (self-protection), preventive powers or the appointment of an assistant are just a few examples.

The use of Information and Communications Technologies (ICTs) and ageing

This Document also aims at highlighting the impact the ICTs are having to support older persons. This tools offer important services that can help older persons because they foster personal autonomy and independent life and promote communication and social Integration. However, the role of ITCs just will be positive i fits application is ethically acceptable.  A bad use of ICTs can present some risks, for example, intrusion, with a loss of privacy and intimacy, or a lack of control regarding the data gathered. Injustice and inequality because of ICTs price or the isolation of the elderly by replacing direct human contact with remote communication are other examples. Moreover, in the technological sphere, usually there is a lack of sensitivity among developers and companies to address such problems in a context of great economic impact, where large communications companies make huge profits.

Finally, the Document provides some recommendations that aims at raising awareness in society and government so that a culture of respect for and recognition of the elderly is provided and it highlights the preferences of elderly persons in making decisions that concern them. Moreover it brings to light that it is necessary to invest in resources in order to guarantee a diversity of options and a life with dignity for the elderly. The Document ends with some indications that aims at promoting a good use of ICTs.

The Document on ageing and vulnerability will be available in three languages (catalan, spanish and english) November 9th at 12 hours at the following link: www.bioethicsandlaw.es/documents.

• Document [PDF]
• See the document presentation event