Excerpt From Medical Ethics: Real-World Application By Afshin Nasser

Elder Abuse

Mistreatment of the elderly has become a matter of public concern over the past few decades. Mistreatment of older persons may occur both within home and community settings, and institutional environments. The definition of elder abuse and neglect is a matter of state law, and each state has its own statutory schema.

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Mistreatment of the elderly has become a matter of public concern over the past few decades. Mistreatment of older persons may occur both within home and community settings, and institutional environments. The definition of elder abuse and neglect is a matter of state law, and each state has its own statutory schema.

The National Research Council has described elder mistreatment as:
(a) intentional actions that cause harm or create a serious risk of harm (whether harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trusted relationship to the elder or
(b) failure of a caregiver to satisfy the elder’s basic needs or to protect the elder from harm.

Elder mistreatment is physical (e.g., assault, forced sexual contact, overmedication, inappropriate physical restraints); psychological, or emotional. This includes denial of basic human needs by the caregiver (e.g., withholding indicated medical care or food), deprivation of civil rights (e.g., freedom of movement and communication), and financial exploitation.

In addition, a significant proportion of reported cases of elder mistreatment fall into the category of self-neglect where older persons are living alone. Self-neglect may be suspected in the presence of dehydration, malnourishment, decubitus ulcers, poor personal hygiene, or lack of compliance with basic medical recommendations.

In recognition of the potential for elder abuse and neglect, states have created a wide variety of programs under the general heading of Adult Protective Services (APS). This is a system of preventive and supportive services for older persons living in the community to enable them to remain as independent as possible, while avoiding abuse and exploitation by others.

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State Medical Boards

The medical board’s duty is to protect the public, not the physician. State medical boards today focus on licensed physicians who violate professional ethics, and their mandate has significantly evolved to focus on disciplining physicians.

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Boundary Violation

Boundaries create a therapeutic distance between physician and patient and clarify their respective roles and expectations. Boundaries define limits of the therapeutic relationship.

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Medical Ethics: Real-World Application By Afshin Nasser

You may have acquired this book as a result of conflicts with peers, administrators, patients, or State Medical Boards, where the outcomes of those interactions have left you wondering, “…what if I had done things differently?”

In that case, I hope that this book answers some of your questions and guides you with regards to any future quandaries you may encounter.


If you are a healthcare worker seeking to understand the subject of medical ethics, then I hope this book helps you acquire the clarity you seek.
If you are an individual simply curious about medical ethics, then I raise my hat to you for your pursuit of knowledge.