The Hastings Center

The Over 65 Blog

This is an archive. The Hastings Center is no longer currently maintaining this project.

  • By Any Other Name: Physician-Assisted Suicide

    Some 30 years or so I was far more sympathetic to euthanasia and physician assisted suicide (PAS) than I am now, and will use this occasion to say why I changed my mind, growing slowly disillusioned.

  • Should We Accept Kidney Donations from our Children?

    I’ve been looking into the phenomenon of organ donation from children to parents. Since I believe our national approach to Medicare injures future generations on behalf of us in the over 65 cohort, I wanted to see how we’re dealing with the most tangible form of intergenerational transfer – organ donation.

  • The Passing of the Generations

    Probably like everyone else, the older I get the more conscious I become that I am part of a generation whose time came – and is going. My parents died some years ago as did my uncles and aunts. The “greatest generation” is rapidly dying off. The tears and memories of parents whose children died…

  • Aging, Autonomy, and Social Determinants of Health

    A few weeks ago I came across notes I had written five decades ago on the subject of aging. I had been struck by a distinction drawn by David Riesman, in an essay on “Clinical and Cultural Aspects of Aging,” between the different ways in which aging takes place for three types of people.

  • Magical Thinking, Overtreatment, and Neglect of Patient and Family Values

    My friend and college classmate Ted Marmor (see his recent post here) and Jonathan Oberlander have a short but illuminating article in a recent issue of the Journal of General Internal Medicine – “From HMOs to ACOs: The Quest for the Holy Grail in U.S. Health Policy.”  They offer a chastening analysis of our almost…

  • Struggling to Meet Seniors’ Behavioral Health Needs

    In July the Institute of Medicine issued a report, The Mental Health and Substance Use Workforce for Older Adults: In Whose Hands?  The point of the report was to call serious attention to the growing inability of the health care workforce to meet the behavioral health needs of the senior population.

  • Trying to Practice What I Preached: Helping my Parents at the End of Their Lives

    Once again, the challenge of how to constrain rising health care expenditures has caught the public interest, stimulated by concerns over rising federal debt and limited ability to generate tax revenues. I recently chronicled my unsuccessful efforts at stimulating medical cost containment from both academic and foundation positions (1971–2002) in the April 23, 2011 issue…

  • Medicare and Social Security: Conjoined Twins

    Although I grew up in a middle class family in Washington, D.C., my father, one of the pioneers in the early days of radio, was in and out of jobs over the years, usually fired. We went from elegant parties with small orchestras in our home one year to taking in a boarder the next.…

  • Screening Paid Caregivers: “A False Sense of Security”

    A recent article described what happened when researchers at Northwestern School of Medicine, posing as prospective clients seeking a caregiver for an elderly adult relative, contacted 180 agencies and asked about hiring, screening, and supervisory practices. Their findings aren’t pretty.

  • A Lesson in How to Die and How to Live

    In the summer of 2005, my mother was 82 and had been in frail health for a while. Angina, hypertension, and chronic congestive heart failure were under control following an aortic valve replacement six years previously. Upon her return to Boston from a trip to New York for our daughter’s wedding, we noticed that her…