Dependence and Autonomy in Old Age

George Agich is Chairman of the Department of Bioethics at the Cleveland Clinic Foundation, Professor of Clinical Medicine at Ohio State University and Adjunct Professor of Philosophy at Bowling Green State University. His previous books are Responsibility in Health Care (1982), and The Price of Health (1986), and he is a member of the editorial board of The American Journal of Bioethics and other journals.

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.