Elder Law Prof Blog

Chinese leaders meet to discussing medical care, insurance for elderly

Via Xinhuanet:

China's national political advisors called for better care and proper medical services to be provided for the country's senior citizens at a meeting in Beijing on Thursday.  Members of the Chinese People's Political Consultative Conference (CPPCC) National Committee have called on the government to formulate proper standards and promote the access of such services in grassroots communities, according to a statement issued after the meeting, presided over  by Yu Zhengsheng, chairman of the CPPCC National Committee.  As China's population ages, elderly care integrated with health services will be a vital and a common need for senior citizens.  The political advisors also urged the government to provide better basic medicare insurance for disabled elderly in poverty.  Medicare policies need to be adjusted to suit the needs of seniors. Hospitals should also be encouraged to provide elder care services and nursing homes could be included in the medicare insurance system, the group said.  Civil Affairs Minister Li Liguo and Sun Zhigang, deputy head of National Health and Family Planning Commission, gave reports on relevant issues to the political advisors at the meeting.

Read more here.

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Yu Zhengsheng elected as the chairman of the CPPCC

Dying to Visit

Naomi Cahn, our colleague at GW Law who frequently alerts us to interesting stories, sent me a note about this recent story from the Washington Post on suicide tourism.  Tourism to Switzerland for assisted suicide is growing, often for nonfatal diseases reports on an ongoing study in Switzerland that shows an increases in tourists in the Zurich area seeking assisted suicide.

The study, on "Suicide Tourism",  was reported in the Journal of Medical Ethics.  The August volume contains the article about the study:  Suicide tourism: a pilot study on the Swiss phenomenon. The full article requires purchase (or subscription) but the abstract of the article is available and summarizes the article:

While assisted suicide (AS) is strictly restricted in many countries, it is not clearly regulated by law in Switzerland. This imbalance leads to an influx of people—‘suicide tourists’—coming to Switzerland, mainly to the Canton of Zurich, for the sole purpose of committing suicide. Political debate regarding ‘suicide tourism’ is taking place in many countries. Swiss medicolegal experts are confronted with these cases almost daily, which prompted our scientific investigation of the phenomenon. The present study has three aims: (1) to determine selected details about AS in the study group (age, gender and country of residence of the suicide tourists, the organisation involved, the ingested substance leading to death and any diseases that were the main reason for AS); (2) to find out the countries from which suicide tourists come and to review existing laws in the top three in order to test the hypothesis that suicide tourism leads to the amendment of existing regulations in foreign countries; and (3) to compare our results with those of earlier studies in Zurich. We did a retrospective data analysis of the Zurich Institute of Legal Medicine database on AS of non-Swiss residents in the last 5 years (2008–2012), and internet research for current legislation and political debate in the three foreign countries most concerned. We analysed 611 cases from 31 countries all over the world. Non-terminal conditions such as neurological and rheumatic diseases are increasing among suicide tourists. The unique phenomenon of suicide tourism in Switzerland may indeed result in the amendment or supplementary guidelines to existing regulations in foreign countries.

The Washington Post story discusses some possibilities for individuals seeking assisted suicide when they are not terminal; traveling while they are still able and having a terminal condition but not yet in the terminal phase were two of the reasons mentioned in the story. The Post story was produced by NewScientist and is also available here.

Thanks Naomi!

 

 

 

 

 

Health & Science

Tourism to Switzerland for assisted suicide is growing, often for nonfatal diseases

ADA settlement in behalf of disabled park worker in Las Vegas

The Justice Department announced today that it has reached a settlement with the City of North Las Vegas, Nevada to resolve allegations that the City violated the ADA by failing to accommodate, and constructively discharging, a Parks Department Maintenance Crew Leader with monocular vision. The Department alleged that the City unjustifiably revoked the employee's long standing reasonable accommodation, which exempted him from obtaining a Commercial Driver's License. The consent decree, which must be approved by the Court, requires the City to pay the employee compensatory damages, provide training on Title I of the ADA, and file periodic reports with the Department.

To find out more about this agreement or the ADA, call the Justice Department's toll-free ADA Information Line at 800-514-0301 or 800-514-0383 (TDD), or access its ADA website at www.ada.gov.

On the Escalator of An Aging Society?

A few days ago I blogged about an article in The Atlantic explaining one person's thinking of 75 being his optimal "old age". In that same issue of The Atlantic is another article--about longevity and 100 year olds--what it will mean for society as more of us reach that age.  What Happens When We All Live to 100? was published on September 17, 2014.

The article starts with a history of sorts of life expectancies from human origins and notes that

Viewed globally, the lengthening of life spans seems independent of any single, specific event. It didn’t accelerate much as antibiotics and vaccines became common. Nor did it retreat much during wars or disease outbreaks. A graph of global life expectancy over time looks like an escalator rising smoothly. The trend holds, in most years, in individual nations rich and poor; the whole world is riding the escalator.

Projections of ever-longer life spans assume no incredible medical discoveries—rather, that the escalator ride simply continues. If anti-aging drugs or genetic therapies are found, the climb could accelerate. Centenarians may become the norm, rather than rarities who generate a headline in the local newspaper.

The article then moves to a discussion of those institutions intentionally working on increasing life spans, the Buck Institute, the U of Michigan, the U of Texas, UC-San Francisco, and the Mayo Clinic for example. Long-term readers of this blog may also remember a post about CALICO (Google's "spin-off called the California Life Company (known as Calico) to specialize in longevity research."). The article has a fascinating section about the research being done, including some interesting consideration of other life forms that excel in longevity (worm genes, anyone?).

I particular enjoyed reading the quote of one of the leaders in the field in describing the nascent nature of the research. "'[M]edically, we do not know what ‘age’ is. The sole means to determine age is by asking for date of birth. That’s what a basic level this research still is at.'”  There seems to be some debate amongst the experts about whether life expectancy will continue to rise at the steady escalator-smooth rate as in years past.  The article also mentions some of the theories advanced over time on increasingly longevity: vitamins, low calorie diets, education, exercise, etc.

One section of the article bears significant possibilities for class discussion, the political implications of an older society.

Society is dominated by the old—old political leaders, old judges. With each passing year, as longevity increases, the intergenerational imbalance worsens. The old demand benefits for which the young must pay, while people in their 20s become disenchanted, feeling that the deck is stacked against them. National debt increases at an alarming rate. Innovation and fresh thinking disappear as energies are devoted to defending current pie-slicing arrangements.

The author reveals this is a description of what is actually occurring in Japan. Consider as the author does, what increased longevity may also do to the judicial branch--especially the Supreme Court with lifetime appointments.

This article may be viewed as a bit of a wake-up alarm, although I suspect many of the folks in the US will just hit the snooze button

People’s retirement savings simply must increase, though this means financial self-discipline, which Americans are not known for. Beyond that, most individuals will likely need to take a new view of what retirement should be: not a toggle switch—no work at all, after years of full-time labor—but a continuum on which a person gradually downshifts to half-time, then to working now and then. Let’s call it the “retirement track” rather than retirement: a phase of continuing to earn and save as full-time work winds down.

Widespread adoption of a retirement track would necessitate changes in public policy and in employers’ attitudes. Banks don’t think in terms of smallish loans to help a person in the second half of life start a home-based business, but such lending might be vital to a graying population. Many employers are required to continue offering health insurance to those who stay on the job past 65, even though they are eligible for Medicare. Employers’ premiums for these workers are much higher than for young workers, which means employers may have a logical reason to want anyone past 65 off the payroll. Ending this requirement would make seniors more attractive to employers.

Back to the reasons for increasing longevity. One in the list above, education, seems to have a solid correlation and maybe not as obvious as other reasons that come to mind (vaccines, antibiotics, improved health care, public services, etc.).  The author considers the role of education in longevity and examining budget cuts by states, suggests

Many of the social developments that improve longevity—better sanitation, less pollution, improved emergency rooms—are provided to all on an egalitarian basis. But today’s public high schools are dreadful in many inner-city areas, and broadly across states ... Legislatures are cutting support for public universities, while the cost of higher education rises faster than inflation. These issues are discussed in terms of fairness; perhaps health should be added as a concern in the debate. If education is the trump card of longevity, the top quintile may pull away from the rest

The last section of the article hypothesizes on the impact of an aging society if the escalator continues its ascent, achieving perhaps a "grey utopia" of sorts. The article is well worth reading, but it makes me think about how society values, or devalues, aging. Is getting old a challenge or disease to be conquered?  For example, the author writes, "[i]f the passage of time itself turns out to be the challenge, interdisciplinary study of aging might overtake the disease-by-disease approach. As recently as a generation ago, it would have seemed totally crazy to suppose that aging could be “cured.” Now curing aging seems, well, only somewhat crazy."  Read this article and have your students read it, too.