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Ageing, Meaning and the Allocation of Resources

Published online by Cambridge University Press:  14 November 2008

Harry R. Moody
Harry R. Moody
Affiliation:
Brookdale Center on Aging of Hunter College, 425 East 25th Street, New York, N.Y. 10010–2590, U.S.A.
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Abstract

Different scenarios for an ageing society presume different approaches to the meaning of old age. One scenario anticipates a Prolongation of Morbidity, where quality of life concerns might permit active euthanasia or suicide as a means of saving money. Those who believe in a Compression of Morbidity opt for health promotion to delay morbidity in favour of productive ageing. Optimists look to a scenario of Lifespan Extension, where scarce health resources are not expended for incremental gains in life expectancy but rather for basic research to postpone or eliminate ageing. Finally, those who emphasize Voluntary Acceptance of Limits identify the meaning of old age with voluntary acceptance of finitude, where claims of future generations might limit longevity for any one generation. Thus, contrasting meanings such as quality of life, productive ageing, indefinite survival and voluntary limits entail very different consequences for the allocation of scarce resources across age-groups and among sub-groups of the elderly population.

Keywords

Meaningcompression of morbiditylifespan extensionpopulation ageingcost containmentgenerational equityquality of lifeproductive ageing.
Type
Research Article
Information
Ageing & Society , Volume 15 , Issue 2 , June 1995 , pp. 163 - 184
Copyright
Copyright Cambridge University Press 1995

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References

1 Kukathas, C. and Pettit, P., Rawls: A Theory of Justice and Its Critics, Stanford Univ. Press, 1990.Google Scholar

2 Neugarten, B.Age or Need? Public Policies for Older People, Sage, Beverly Hills, California, 1983.Google Scholar

3 Habermas, J., Legitimation Crisis, Beacon Press, Boston, 1975.Google Scholar

4 Fries, J. F. and Crapo, , Vitality and Aging, San Francisco, 1980;Google Scholar and Fries, J. F., Aging, Illness, and Health Policy: Implications of the Compression of Morbidity. Perspectives in Biology and Medicine (Spring, 1988), 31:3.CrossRefGoogle ScholarPubMed

5 See Olshansky, S., Carnes, B. and Cassel, C., In Search of Methuselah: Estimating the Upper Limits to Longevity. Science 250 (1990), 634–640CrossRefGoogle ScholarPubMed; Barinaga, M. Mortality: Overturning Received Wisdom. Science ( 10. 16, 1992), 258:398–399;Google ScholarKolata, G., New Views on Life Spans Alter Forecasts on Elderly. New York Times (11 16, 1992), A–1, A–15.Google Scholar

6 Emanuel, E. and Emanuel, L.The Economics of Dying: The Illusion of Cost Savings at the End of Life. New England Journal of Medicine 330:8, (1994), 540–544.CrossRefGoogle ScholarPubMed

7 Avorn, J. The Life and Death of Oliver Shay. In Pifer, A. and Bronte, L., Our Aging Society, Norton, New York, 1986.Google Scholar

8 Rowe, J. W. and Kahn, R. I., Human Aging: Usual and Successful. Science 237 (1987), 143–149.CrossRefGoogle ScholarPubMed

9 Butler, R. N. and Gleason, H. P., Productive Aging: Enhancing Vitality in Later Life, Springer, New York, 1985.Google Scholar

10 Fries, J. F., Koop, C. E. et al. , Reducing Health Care Costs by Reducing the Need and Demand for Medical Services. New England Journal of Medicine 329 (1993), 321–5.CrossRefGoogle ScholarPubMed

11 Daniels, N., Am I My Parents' Keeper?, Oxford University Press, New York, 1987.Google Scholar

12 Rosenfeld, A., Prolongevity, Knopf, New York, 1976;Google ScholarGruman, G. J., A History of Ideas about the Prolongation of Life: The Evolution of Prolongevity Hypothesis to 1800, American Philisophical Society, Philadelphia, 1966.Google Scholar

13 Shock, N., Greulich, R. C., Cosa, P. T., JrAndres, R., Lakatta, E.G., Arenberg, D. & Tobin, J. D., Normal Human Aging: The Baltimore Longitudinal Study of Aging, U.S. Government Printing Office, Washington, DC, 1984;Google ScholarCaplan, A., Is Aging a Disease? In Spicker, S. and Ingman, S., Vitalizing Long Term Care, Springer, New York, 1983.Google Scholar

14 Finch, C., Longevity, Senescence and the Genome, University of Chicago Press, Chicago, 1990.Google Scholar

15 Anderson, W. F., Human Gene Therapy. Science 256 (1992), 808–813.CrossRefGoogle ScholarPubMed

16 Walford, R., Maximum Life Span, Norton, New York, 1983Google Scholar; Rose, M., Evolutionary Biology of Aging, Oxford University Press, New York, 1991.Google Scholar

17 Ludwig, F.Lifespan Extension: Consequences and Open Questions. Springer, New York, 1991.Google Scholar

18 Callahan, D., Setting Limits, Simon & Schuster, New York, 1987.Google Scholar

19 Estes, C. L. and Binney, E. A., The Biomedicalization of Aging: Dangers and Dilemmas. The Gerontologist 29:5 (1989), 587–96.CrossRefGoogle ScholarPubMed

20 Cole, T., The Journey of Life: A Cultural History of Aging in America. Cambridge University Press, Cambridge, 1992;Google ScholarBurrows, J., The Ages of Man, Oxford University Press, New York, 1986.Google Scholar

21 Erikson, E., Erikson, J., and Kivnick, H., Vital Involvement in Old Age, W. W. Norton, New York, 1986;Google ScholarKotre, J., Outliving the Self: Generativity and the Interpretation of Lives, Johns Hopkins Press, Baltimore, 1984.Google Scholar

22 Moody, Harry R., Abundance of Life: Human Development Policies for an Aging Society, Columbia University Press, 1988.Google Scholar

23 Christine, Cassel, Rudberg, M. and Olshansky, J., ‘The Price of Success: Health Care in an Aging Society,’ Health Affairs (1992), 11(2): 87–99.Google Scholar

24 Prado, C. G., The Last Choice: Preemptive Suicide in Advanced Age. Greenwood Press, New York, 1990.Google Scholar

25 Fries, J. F., Green, L. W. and Levine, S., Health Promotion and the Compression of Morbidity. The Lancet (03, 1989), 481–483.Google Scholar

26 Cole T., op. cit.

27 Calabresi, G. and Bobbitt, P., Tragic Choices, W. W. Norton, New York, 1978.Google Scholar

28 Foucault, M., Politics, Philosophy, Culture: Interviews and Other Writings, 1977–1984 (trans. Sheridan, Alan), ed. with an introduction by Lawrence D. Kritzman, Routledge, Chapman & Hall, New York, 1988, p. 172.Google Scholar

29 Foucault, op. cit., p. 173.

30 Thomas, Halper, The Misfortunes of Others: End-Stage Renal Disease in the United Kingdom, Cambridge: Cambridge University Press, 1989.Google Scholar

31 Foucault, op. cit., p. 174.

32 Laslett, P., The Emergence of the Third Age: A Fresh Map of Life. Harvard University Press, Cambridge, Massachusetts, 1991.Google Scholar

33 Daniels N., op. cit.