Examining the ethical challenges in managing elder abuse: a systematic review
AbstractElder abuse is an increasingly intangible phenomenon that has created numerous ethical issues for care teams and caregivers. Although different studies have concentrated on various ethical issues regarding abuse, no study has arrived at a comprehensive conclusion. Therefore, the present study aimed to determine the existing ethical challenges in this context. For this purpose, two researchers familiar with systematic search approach examined national and international journals on PubMed, Excerpta Medica Database (EMBASE), Scientific Information Database (SID) and similar databases between January and February 2017. They were able to find 116 articles that met the inclusion and exclusion criteria, and finally selected 15 articles based on the predesigned questions. The findings were classified in five subtitles as follow: 1) the common definition of elder abuse, 2) a comprehensive legislation on elder abuse, 3) comprehensive ethical principles about elder abuse, 4) ethical considerations regarding patients without competency, and 5) reporting and sharing information about elder abuse. The study results revealed no common definition and no legislation about elder abuse, and also showed that health care providers’ observance of ethical principles depends on the ethical and legal conditions of the community. Nowadays, elder abuse is a serious problem in many countries. Cultural and religious differences are the reasons for lack of a common definition and legislations, which comprises the biggest obstacle to protecting the rights of elderly people. It is clear that ethical principles should be respected as far as a person has competency. Furthermore, localization of clinical guidelines related to this issue leads to proper functioning of health care providers, especially nurses as the first line of treatment.
Anonymous. Elder abuse World health organization. [cited 2017 June]; Available from: http://www.who.int/mediacentre/factsheets/fs357/en/.
Yunus RM, Hairi NN, Choo WY, et al. Mortality among elder abuse victims in rural Malaysia: a two-year population-based descriptive study. J Elder Abuse Negl. 2017; 29(1): 59-71.
Luzny J, Jurickova L. Prevalence of elder ebuse and neglect in seniors with psychiatric morbidity - example from central moravia, Czech Republic. Iran J Public Health. 2012; 41(8): 27-32.
Brandl B, Dyer CB, Dyer CB, Heisler CJ, Otto JM, Stiegel LA, Thomas RW. Elder abuse detection and intervention: A Collaborative Approach, 1st ed. USA: Springer Publishing Company; 2006.
Scheiderer EM. Elder abuse: ethical and related considerations for professionals in psychology. Ethics & Behavior. 2012; 22(1):75-87.
Garnham B, Bryant L. Epistemological erasure: the subject of abuse in the problematization of ‘elder abuse’. J Aging Stud. 2017; 41: 52-9.
Chan KL, Brownridge DA, Fong DY, Tiwari A, Leung WC, Ho PC. Violence against pregnant women can increase the risk of child abuse: a longitudinal study. Child Abuse Negl. 2012; 36(4): 275-84.
Adams JA, Bailey DE, Anderson RA, Docherty SL. Nursing roles and strategies in end-of-life decision making in acute care: a systematic review of the literature. Nurs Res Pract. 2011; 2011: 527834.
Almogue A, Weiss A, Marcus E-L, Beloosesky Y. Attitudes and knowledge of medical and nursing staff toward elder abuse. Arch Gerontol Geriatr. 2010; 51(1):86-91.
Mauk KL. Ethical perspectives on self‐neglect among older adults. Rehabil Nurs. 2011; 36(2): 60-5.
Donovan K, Regehr C. Elder abuse: Clinical, ethical, and legal considerations in social work practice. Clinical Social Work Journal. 2010; 38(2):174-82.
Finfgeld-Connett D. Intimate partner abuse among older women: Qualitative systematic review. Clin Nurs Res. 2014; 23(6): 664-83.
Anonymous. Practice standard: ethics. [cited 2017 June]; Available from: http://www.cno.org/globalassets/docs/prac/41034_ethics.pdf
Lowenstein A. Caregiving and elder abuse and neglect—developing a new conceptual perspective. Ageing International. 2010; 35(3):215-27.
Schofield MJ, Mishra GD. Three year health outcomes among older women at risk of elder abuse: women's health Australia. Quality of Life Research. 2004; 13(6): 1043-52.
Swagerty DL, Takahashi PY, Evans JM. Elder mistreatment. American Family Physician. 1999; 59(10): 2804-08.
Olson JM, Hoglund BA. Elder Abuse: speak out for justice. J Christ Nurs. 2014; 31(1):14-21.
Zeranski L, Halgin RP. Ethical issues in elder abuse reporting: a professional psychologist's guide. Professional Psychology: Research and Practice. 2011; 42(4): 294-300.
Doe SS, Han HK, McCaslin R. Cultural and ethical issues in Korea's recent elder abuse reporting system. J Elder Abuse Negl. 2009; 21(2): 170-85.
Mohebbi L, Zahednejad S, Javadi Pour S, Saki A. Domestic elder abuse in rural area of Dezful, Iran and its relation with their quality of Life. Iranian Journal of Ageing. 2016; 10(4): 50-9.
Ash A. Ethics and the street-level bureaucrat: implementing policy to protect elders from abuse. Ethics and Social Welfare. 2010; 4(2): 201-9.
Koenig TL, Rinfrette ES, Lutz WA. Female caregivers’ reflections on ethical decision-making: the intersection of domestic violence and elder care. Clinical Social Work Journal. 2006; 34(3): 361-72.
Bergeron LR, Gray B. Ethical dilemmas of reporting suspected elder abuse. Soc Work. 2003; 48(1): 96-105.
Wilson G. Dilemmas and ethics: social work practice in the detection and management of abused older women and men. Journal of Elder Abuse & Neglect. 2004; 14(1): 79-94.
Simon ML. An Exploratory Study of Adult Protective Services Programs' Repeat Elder Abuse Clients. USA: American Association of Retired Persons; 1992.
Forman JM, McBride RG. Counselors' role in preventing abuse of older adults: Clinical, ethical, and legal considerations. Adult Span Journal. 2010; 9(1): 4-13.
Anonymous. Guidelines for psychological practice with older adults. [cited 2017 June]. Available from: https://www.apa.org/pubs/journals/features/older-adults.pdf
Bužgová R, Ivanová K. Elder abuse and mistreatment in residential settings. Nurs Ethics. 2009; 16(1):110-26.
Childress JF, Beauchamp TL. Principles of Biomedical Ethics, 5th ed. UK: Oxford University Press; 2001.
Marsha F. Guide to the Code of Ethics for Nurses: With Interpretive Statements: Development, Interpretation, and Application, 2nd ed. USA: American Nurses Association; 2001.
Regehr C, Antle B. Coercive influences: informed consent in court-mandated social work practice. Social Work. 1997; 42(3):300-6.
Anonymous. Highlighted revisions to the code of ethics. [cited 2017 August ]. Available from: https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Highlighted-Revisions-to-the-Code-of-Ethics
Beaulieu M, Leclerc N. Ethical and psychosocial issues raised by the practice in cases of mistreatment of older adults. J Gerontol Soc Work. 2006; 46(3-4): 161-86.
Sabat SR. Capacity for decision-making in Alzheimer's disease: selfhood, positioning and semiotic people. Aust N Z J Psychiatry. 2005; 39(11-12): 1030-5.
Defanti C, Tiezzi A, Gasparini Mf, et al. Ethical questions in the treatment of subjects with dementia. part I. respecting autonomy: awareness, competence and behavioral disorders. Neurological Sciences. 2007; 28(4): 216-31.
Gevers S. Dementia and the law. European journal of health law. 2006; 13(3): 209-17.
Dick C. Self-neglect: diogenes syndrome and dementia. Kans Nurse. 2006; 81(9): 12-3.
Dakin E, Pearlmutter S. Older women's perceptions of elder maltreatment and ethical dilemmas in adult protective services: a cross-cultural, exploratory study. J Elder Abuse Negl. 2009; 21(1): 15-57.
François I, Moutel G, Plu I, Pfitzenmeyer P, Hervé C. Concerning mistreatment of older people: clinical and ethical thoughts based on a study of known cases. Archives of Gerontology and Geriatrics. 2006; 42(3): 257-63.
Johnson TF. Ethics in addressing mistreatment of elders: can we have ethics for all? Generations. 2000; 24(2): 81.
Dong X. Advancing the field of elder abuse: future directions and policy implications. J Am Geriatr Soc. 2012; 60(11): 2151-6.
Cohen M, Levin SH, Gagin R, Friedman G. Elder abuse: disparities between older people's disclosure of abuse, evident signs of abuse, and high risk of abuse. J Am Geriatr Soc. 2007; 55(8): 1224-30.
Anetzberger GJ. The reality of elder abuse. Clinical Gerontologist. 2005; 28(1-2): 1-25.
Melchiorre MG, Chiatti C, Lamura G. Tackling the phenomenon of elder abuse in Italy: a review of existing legislation and policies as a learning resource. Educational Gerontology. 2012; 38(10): 699-712.
Quinn MJ, Heisler CJ. The legal response to elder abuse and neglect. Journal of Elder Abuse & Neglect. 2004; 14(1): 61-77.
Daly JM, Merchant ML, Jogerst GJ. Elder abuse research: a systematic review. J Elder Abuse Negl 2011; 23(4): 348-65.
Meara NM, Schmidt LD, Day JD. Principles and virtues: a foundation for ethical decisions, policies, and character. The counseling psychologist. 1996; 24(1): 4-77.
Schwiebert VL, Myers JE, Dice C. Ethical guidelines for counselors working with older adults. Journal of Counseling & Development. 2000; 78(2): 123-9.
Healy TC. Ethical decision making: Pressure and uncertainty as complicating factors. Health Soc Work. 2003; 28(4): 293-301.
Rodríguez MA, Wallace SP, Woolf NH, Mangione CM. Mandatory reporting of elder abuse: between a rock and a hard place. Ann Fam Med. 2006; 4(5): 403-9.
Gelfand DE, Kutzik AJ, eds. Ethnicity and Aging: Theory, Research, and Policy. USA: Springer Publishing Company; 1979.
Xu G, Meyer JS, Thornby J, Chowdhury M, Quach M. Screening for mild cognitive impairment (MCI) utilizing combined mini‐mental‐cognitive capacity examinations for identifying dementia prodromes. Int J Geriatr Psychiatry. 2002; 17(11): 1027-33.
Heravi-Karimooi M, Rejeh N, Foroughan M, Ebadi A. Designing and determining psychometric properties of the elder neglect checklist. Iranian Journal of Ageing. 2013; 8(3): 25-34.
Ramazani RK. Constitution of the Islamic Republic of Iran. Middle East Journal. 1980; 34(2): 181-204.
Meghdadi MM, Delavari MH. The Civil Liability Due to Revealing Medical Secrets in Iran's Law and Common Law. Medical Law Journal. 2014; 8(30): 99-145.
Akbari MA, Ramezani A. The status of delinquent infants and children in Iran criminal law. Survey of Malaysian Law. 2017; 14(2): 104-13.