Long-term care for ill and disabled presents difficult ethical questions, UN reports

Asserting that long-term care for people with chronic illnesses and disabilities presents an urgent challenge around the world, the United Nations lead health agency said today there is a fundamental ethical obligation to provide care for all, particularly the weak and vulnerable.

The existing systems of care have come under great strain and are unable to fully meet growing demands, according to a report launched by the World Health Organization (WHO) in Geneva.

The report, entitled "Ethical Choices in Long-Term Care: What Does Justice Require?" illuminates the many ethical and social issues at stake, and is a product of a July 2002 consultation at the University of Chicago that brought together philosophers, experts in public health and long-term care and professionals knowledgeable about developing countries.

Noting that most societies are faced with resource limitations and difficult decisions about which of the competing needs to meet, the report discusses answers to such questions with the hope of providing guidance in the design of long-term care systems that are responsible, accessible, efficient and accountable, and address the wide variety of human needs with dignity and respect.

The report calls on societies to invite dialogue about the ethical framework within which equitable, fair, rational, and transparent decisions about long-term care can be made. It also says that governments have a crucial role as they must anticipate needs, ensure that resources are available and distribute them equitably and efficiently. Little has been done to address the current challenges, much less to prepare for the future.

The universal problem of long-term care is intensifying, due to a combination of demographic and epidemiological forces.