ABSTRACT
The process and activities of rehabilitation are fundamentally ethical in nature, as the preservation, restoration, and enhancement of abilities foster autonomy—living one’s life as he/she sees fit, at his/her own direction. Ethical issues may become magnified in elderly patients. Despite the limited duration of benefit a procedure might have for an elderly person, the benefit may be of great consequence. The frailties and limitations of the elderly, both physical and mental, may make the assessment of the patient’s values and therapeutic options challenging. Some people use the term “living will” interchangeably with advance directive. The living will was first proposed by Luis Kutner in 1969 as an instrument to limit medical treatments for those who have lost the capacity to make medical decisions. Clinical education includes instruction on the four principles of bioethics—justice, beneficence, nonmaleficence, and autonomy. Physicians rely on these principles in clinical decision-making.
