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Healthcare | Legal

The ageing doctor – ethical and legal implications

22 Feb 2019, by Amy Sarcevic

Dismissing a post-retirement-age doctor on the basis of their age is an offence under the Age Discrimination Act 2004.

However, there are growing concerns that doctors practicing beyond 65-years may be more prone to mistakes, due to the age-related decline of various physical and cognitive faculties.

As such, experts like Professor Erwin Loh of Monash University are calling for the rejuvenation of legal and regulatory frameworks.

“It’s somewhat of an ethical and legal minefield”, said Professor Loh, ahead of the Medico Legal Congress – 6-7 March 2019, Sydney.

“Of course, there are many doctors that are practicing well into their late age and are doing so to a very high standard, given their superior levels of experience in the field.

“But then again, there is that heightened risk of error. Certain age-related deficits could cause doctors to make minor, or even serious mistakes, that really jeopardise the well-being of patients.

“In these cases, the practitioner is treading in murky legal water”, he said.

Finger dexterity, inductive reasoning and memory are important skills required for medical professions, that have been found to deteriorate with age.

“Medical staff are often required to use fine instruments which require precision. You can see how this may present an issue if the eyesight, cognition or finger dexterity of the person performing the procedure is compromised”, said Professor Loh.

“Adept working, episodic, procedural and semantic memory are important aptitudes in medical diagnostics, decision making and in performing procedures”, he continued.

“In diagnostics, practitioners must consider a range of overt and covert symptoms against a myriad of possible health conditions. When prescribing treatments, they must take into account multiple risk factors also.

“In ageing, there is of course a heightened risk of pathological memory conditions such as Dementia and its major form Alzheimer’s. In non-pathological ageing, too, there is often a notable decline in memory function”.

In Australia an increasing number of doctors are opting to work beyond retirement age. Many are forced to do so for financial reasons; others prefer to remain in their profession for psychosocial reasons.

Professor Loh says that the pressure to reassess and adapt regulation is mounting, but as yet, there is no clear right or wrong solution. “This year the debate may well hinge on which ethical arguments shout the loudest and I expect we’ll see significantly more literature coming out before a viable compromise is reached”, he said.

Presenting at the Medico Legal Congress – 6-7 March 2019, Sydney, Professor Erwin Loh will discuss the latest research findings surrounding the ageing doctor debate and discuss his recommendations on how the sector should respond.

You may download the full agenda here.

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