Dependence and Autonomy in Old Age (rev. ed.)

An Ethical Framework for Long-Term Care

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by George Agich

Cambridge University Press

Due/Published June 2003, 208 pages, paper

ISBN 0521009200

To reveal the concrete threats to personal autonomy in long-term care, George Agich's book offers a framework for developing an ethic of long-term care within the complex environment in which many dependent and aged people find themselves. (The first edition was published as Autonomy and Long-term Care by Oxford, in 1993.)

Contents

1. Introduction; Long-term care images; Autonomy; Autonomy and long-term care: the problem; 2. The liberal theory of autonomy; Pluralism, toleration, and neutrality; The State and positive autonomy; Some problems of positive autonomy; Liberal principles in long-term care; Nursing home admission practices; The use of restraints; The perils of liberal theory; Communitarianism and the contextualist alternative; Practical implications of the debate over the foundation of ethics; Conflict and conversation; The function of rights; Limitation of rights; Paternalism and the development of persons; From paternalism to parentalism; Summary; 3. Long-term care: myth and reality; Myths of old age; Nursing homes; Therapeutic relationships; Concepts of illness and disease; Models of care; The concept of a practice; Home care; Summary; 4. Actual autonomy; Result-oriented theories; Action-oriented theories; The concrete view of persons; Autonomy: a developmental perspective; Narrative approaches; Dependence in human development; Sickness as dependence; Autonomy and identification; The paradox of development and problems of identification; Implications for long-term care; Summary; 5. A phenomenological view of social action; Sociality and the everyday world; General Features of the social nature of persons; Space; Time; Communication; Affectivity; Summary; 6. Autonomy and long-term care: another look; Social reality of Eastside; Appeal to autonomy as independence; A phenomenologically informed analysis; Lessons from Eastside; Conclusion; Bibliography; Index.