Foundation of Long-term care Ethics –Analysis of needs of Elderly Based on the Difference of Principle

• Main Authors: YU-SHUANG HSIAO, 蕭玉霜
• Other Authors: 李瑞全
• Format: Others
• Language: zh-TW
• Published: 2016
• Online Access: http://ndltd.ncl.edu.tw/handle/86gs3r

博士 === 國立中央大學 === 哲學研究所 === 104 === The disabled elderlies, in addition to the encountering organs degeneration, have to face the situation where they cannot take food, clothing, living by themselves, and facing the problem of the heavy burden of the cost of caring for chronic diseases, medical expenses, social and domestic provisions etc. When family could not provide the necessary financial or human resources to take care the needs, disabled elderlies and their caregivers are under heavy pressure, and may even lead to distortions as human tragedy and improper ways of caring. Disabled elderlies and their caregivers are vulnerable dependent persons. Therefore I take Rawls's difference principle as the basic principle of long-term health care, in order to establish the rights of the elderlies and their caregivers the proper allocation of resources and the responsibility of the government. Thereby setting up the basic health care program meeting their needs and maintain their freedom and dignity. In this thesis, I have examined the discussions between Norman Daniels, Martha C. Nussbaum and Eva F. Kittay, and adopted Kittay’s idea of "dependence " and "derivative dependence ' of the elderlies and their care-takers , and offering them according to their fair equality of opportunities in their medical resources sharing. But I argue that, it need be based on the difference principle, in order to establish and secure the rights of the disability elderlies and caregivers and the sharing of reasonable care resources. For, the difference principle emphasis the caring of the most disadvantaged and disabled elderlies and their careers are among the most disadvantaged. Hence the difference principle could protect them and their needs most appropriately. I go further for an analysis of the nine benchmarks of just health proposed by Daniels, as well as Confucian ideals of health care, in order to enrich and fortify the difference principle in our treatment of disabled elderlies health care. Finally, as an example, I present the Taiwan case of feeding the disabled through nasogastric tube, who cannot chew and swallow food, and try to show that how the adoption of the principle could make a great improvement in the lives of the elderlies. Moreover, I introduce how the Japanese model by improving the feeding method and removal of the nasogastric tube, could help the elderlies returning to a free and dignity personality by taking food through mouth. Thereby establishing proper care resources, by taking seriously the dependence of the elderly and caregivers, could improve the life with dignity and freedom of the elderlies. The present research discovers, in addition to the confirmation that the principle of difference can be made the foundation of long-term care ethics, it could also be used to improve feeding method to meet the health-care needs of the disabled elderly. Furthermore, I propose that when the government plans to legalize long-term care insurance, it should take the democratic procedure with dialogues with experts, scholars, pharmacy industry, opinions of societies, communities and associations, in order to form a proper and just long-term care program.