Ethics, mental health law, and aging

Abstract

The number of older adults has been steadily increasing globally over the past few decades. At the same time, there has been an increasing population of older individuals who suffer from psychiatric illness. This chapter provides some insights and strategies for clinicians who work with this vulnerable population from the perspective of mental health law and ethical theories, principles, and frameworks. While the theory of "therapeutic jurisprudence" has been applied to mental health law, some have suggested that an analogous term "geriatric jurisprudence" has emerged to address the legal and ethical challenges facing this vulnerable group. The issues canvassed in this chapter are non-exhaustive and intended to highlight common ethical themes around how to balance competing rights and ethical dilemmas, including autonomy, self-determination, and liberty with the need for societal values, such as public safety and protection of vulnerable persons. Specific topics include decisional capacity assessments, informed consent, advance directives, guardianship, involuntary commitment, elder abuse, and end-of-life decision-making. The chapter further explores ethical factors related to the use of technology in clinical practice with a geriatric population.