Setting Limits: Medical Goals in an Aging Society

by Daniel Callahan

Book Overview

A provocative call to rethink America's values in health care. This description may be from another edition of this product.

• Format: Hardcover
• Language: English
• ISBN: 0671224778
• ISBN13: 9780671224776
• Release Date: January 1987
• Publisher: Simon & Schuster
• Length: 256 Pages
• Weight: 1.15 lbs.

Customer Reviews

Setting Limits

This is an important book. Many of Daniel Callahan's statements about health care for older people (75 and older, for example), if taken out of context, can be chilling (especially if you are 75 or older). But Callahan, a philosopher, views death as a necessary part of life. His opposition is not to health care for old people. Instead, his opposition is to the use of biomedicine for old people. Biomedicine is expensive and interferes with the natural life cycle. Callahan maintains that biomedicine should not be used for old people who are seriously ill and who would otherwise die. Callahan questions the value of extending life without improving life. Some readers might conclude that Callahan's approach is intended to cut the cost of health care. I think Callahan would disagree. Money might be saved if biomedicine were denied old people who are seriously ill. But, per Callahan, more money would be spent on improving their end-of-life care. Be careful of people who quote Callahan as a way to save money. They have minunderstood him.

Thought provoking and challenging

Daniel Callahan, ethicist and co-founder of the Hastings Center, has written a provocative book which discusses and evaluates the problem of resource allocation in Western society. Essentially, we spend a significant percentage of health care costs on the last few years of life, regardless of the quality of life being prolonged. Dr Callahan warns that we will not be able to support these policies indefinitely, particularly as Western populations continue to age. The more tests and procedures we develop, and the greater our skill at extending life, the more expensive terminal health care becomes. This is not a popular perspective. Many people believe that anything short of providing full available health care to all is morally reprehensible. However, it is undeniable that we are already unable to provide all people with even basic medical care with the current resources available. Indeed, we have only to look at the US to see a future of medicine - sky-rocketing costs, and massively disproportionate services depending on location and financial capacity. As a nurse I have seen first-hand how focusing on prolonging life can be a worse, and certainly more expensive, outcome for the elderly. As an ethicist I find Callahan's arguments sound and convincing.