Biomedical Life Plans for Aging: Values Between Individual Ethical Reflection and Social Standardisation
Department of Medical Ethics and History of Medicine
Funding: Bundesministerium für Bildung und Forschung (BMBF)
Project Period: 2010 – 2013
Carried out by:
- Dr. Mark Schweda, Lisa Frebel, M.A. (Göttingen)
- Dr. Kai Brauer, Larissa Pfaller M.A. (Erlangen)
Background
Medicine is already a central component in people’s planning of their lives. Especially in the second half of life, they hope to shape and plan their lives with the help of different medical options. This is by no means limited to so-called “lifestyle medicine” (so-called anti-aging medicine) which caters to individual preferences. New diagnostic, therapeutic, or preventive measures generally foster the notion of an autonomous aging process which needs careful planning. This also touches upon preventive medicine to anticipate geriatric diseases and projective planning for medical decisions at the end of life (such as living wills). These new options, which make it possible to autonomously shape aging as well as dying, open up unprecedented opportunities but they also pose new challenges and risks. As a society , we have not yet grasped the ambivalences and complexities of these developments. Especially, insights are lacking which explain actual motivations, moral attitudes, and experiences of those who formulate a desire and demand for medical interventions in aging and dying.
Aims
The interdisciplinary research project Biomedical life plans for aging addresses these issues. The objective of this project is to analyse and evaluate the increasing importance of modern biomedicine for life planning with regard to aging and dying and to provide practical guidance on the basis of our findings. To do so, our research focuses on two exemplary cases: on the one hand, preventive health care (anti-aging medicine in a broader sense), on the other hand, the anticipation and negotiation of decisions at the end of life (e.g. living wills, health care proxies). In this, we pursue two, mutually complementary research perspectives: The first one refers to the role of medicine in aging: As modern medicine produces social and cultural norms, what is its influence on the perception, evaluation, and planning of aging? In turn, the second research perspective asks: is there a connection between age-specific perception and evaluation, and attitudes and decisions on the use of medical measures? Which socio-culturally transmitted and age-specific conceptions of the self and of values are implied, respectively? All in all, the collaborative project pursues the following objectives in its research:
- Identifying self-conceptions and values of both lay persons and those affected on the topic of age in the context of biomedicine using qualitative empirical study designs.
- Sociological analysis: reconstructing central interpretative patterns in biomedical technologies and practices.
- Ethical analysis of the data collected as to conceptions of central ethical notions such as the good life, responsibility, and autonomy.
We pursue these research objectives within two closely integrated sub-projects based in sociology and bioethics. The sub-project (PI: Frank Adloff, Erlangen) explores and analyses life plans and life choices with regard to the possibilities of anti-aging medicine and living wills using qualitative social research methodologies (narrative interviews, group discussions). Additionally, the project uses discourse analysis to reconstruct the institutional framework by interviewing experts representing important health care institutions and by including the institutions’ communications with the public (websites, academic conferences, congresses).
The bioethics sub-project (PI: Silke Schicktanz) analyses and critically reflects on the data collected focusing on three central bioethical categories: a) images of the good life, b) conceptions of responsibility, and c) the relationship between autonomy and vulnerability. Taking the academic discussion into account, the project develops ethical categories which allow for an analysis of the attitudes and opinions evident in the data and which can be flexibly applied to the material collected.
Publications
- Schicktanz, S. & Schweda, M. (Hrsg., 2012): Pro-Age oder Anti-Aging? Altern im Fokus der modernen Medizin, Frankfurt am Main/New York: Campus. Link
- Schweda, S., Pfaller, I., Bauer, K. , Adloff, F. , & Schicktanz, S. (eds.) (2017): Planning Later Life. Bioethics and Public Health in Ageing Societies, Routledge. Link
Journal Articles
- Schweda, M. (2014a): “Wake up! Aging kills!“ – Altersbilder in der Auseinandersetzung um die Anti-Aging-Medizin, in: Jahrbuch für Pädagogik 2014 (1), S. 329-344. [DOI: 10.3726/265764_329] Link
- Schweda, M. (2014b): „Ein Jegliches hat seine Zeit“ – Altern und die Ethik des Lebensverlaufs, in: Schweda, M. & Bozzaro, C. (Hrsg.): Altern als Paradigma: Neue Zugänge zur Zeitlichkeit des Menschen in der Praktischen Philosophie [= Themenschwerpunkt der Zeitschrift für Praktische Philosophie 1 (1)], S.253-300. Link
- Schweda, M. & Pfaller, L. (2014): Colonization of later life? Laypersons’ and users’ agency regarding anti-aging medicine in Germany, in: Social Science & Medicine, 118 (2014), S. 159-165. [DOI: 10.1016/j.socscimed.2014.07.064] Link
- Schweda, M. & Frebel, L. (2014): Wie ist es, dement zu sein? Epistemologische Probleme und filmästhetische Lösungsperspektiven in der Demenzethik, in: Ethik in der Medizin, (2015) 27, S. 47-57. [DOI: 10.1007/s00481-014-0332-6] Link
- Pfaller, L., Schweda, M., Schicktanz, S. (2013), Anti-Aging und die Ethik biomedizinischer Lebensplanung, in: FIPH-Journal 22, S. 22 f. Link
- Portacolone, E., Berridge, C., Johnson, J.K. & Schicktanz, S. (2013): Time to Reinvent the Science of Dementia. The Need for Care and Social Integration, in: Aging & Mental Health, 18 (3), S.269-275. [DOI:10.1080/13607863.2013.837149] Link
- Schweda, M. (2013a): Sollten wir das Altern Bekämpfen? Contra, in: Philosophie indebate. Link
- Schicktanz, S. & Schweda, M. (2012b): The diversity of responsibility: The value of explication and pluralization, in: Medicine Studies 3(3), S. 131-145. [DOI: 10.1007/s12376-011-0070-8] Link
Chapters in books
- Pfaller, L. & Schweda, M. (2014): Art. „Ewige Jugend“, in: Metzler Lexikon Moderner Mythen, Stuttgart, Weimar: J.B. Metzler, S. 119-121. BookLink
- Schweda, M. (2013b): Zwischen universalistischem Egalitarismus und gerontologischem Separatismus. Themenschwerpunkte und theoretische Perspektiven des medizinethischen Alter(n)sdiskurses, in: Seidler, M. / Brandes, S. (Hrsg.): Perspektiven der Alter(n)sforschung, Bielefeld: transcript, S. 53-72.
- Schweda, M. (2013c): Ethik für eine alternde Gesellschaft? Die Diskussion um die Würde des alten Menschen zwischen Autonomie und Fürsorge, in: H. Baranzke/G. Duttge (Hrsg.), Würde und Autonomie als Leitprinzipien der Bioethik. Grundzüge einer moralphilosophischen Verständigung, Würzburg: Königshausen & Neumann, S. 271-289.
- Schweda, M. (2013d): Zu alt für die Hüftprothese, zu jung zum Sterben? Die Rolle von Altersbildern in der ethisch-politischen Debatte um eine altersabhängige Begrenzung medizinischer Leistungen, in: G. Duttge/M. Zimmermann-Acklin (Hrsg.): Gerecht Sorgen. Verständigungsprozesse über einen gerechten Einsatz knapper Ressourcen bei Patienten am Lebensende, Göttingen: Göttingen University Press, S. 149-167.
- Adloff, F. (2012): Zwischen Aktivität und Scham: Eine kultur- und emotionssoziologische Perspektive auf die Anti-Aging-Medizin. In: Silke Schicktanz/ Mark Schweda (Hg.): Pro-Age oder Anti-Aging? Altern im Fokus der modernen Medizin. Frankfurt/New York: Campus, S. 327-343.
- Schicktanz, S. & Schweda, M. (2012a): Im Spannungsfeld von Pro-Age und Anti-Aging. Interdisziplinäre Diskurse über das Altern und die Rolle der Medizin, in: S. Schicktanz/M. Schweda (Hrsg.): Pro-Age oder Anti-Aging? Altern im Fokus der modernen Medizin, Frankfurt am Main/New York: Campus, S. 11-21.
- Schweda, M. & Schicktanz, S. (2012): Das Unbehagen an der Medikalisierung. Theoretische und ethische Aspekte der biomedizinischen Altersplanung, in: S. Schicktanz/M. Schweda (Hrsg.): Pro-Age oder Anti-Aging? Altern im Fokus der modernen Medizin, Frankfurt am Main/New York, S. 23-40.
- Schweda, M. & Weiß, A. (2012): Probleme der Risikobewertung: Das Beispiel der Hormontherapie und der Telomeraseforschung, in: S. Schicktanz/M. Schweda (Hrsg.) (2012): Pro-Age oder Anti-Aging? Altern im Fokus der modernen Medizin, Frankfurt am Main/New York, S. 269-288.
Cooperation Partners
Going beyond the integration of ethical and sociological research within the collaborative project, the cooperation with scientists in the US (Prof. Dr. Anita Silvers [Philosophy, San Francisco State University], Prof. Dr. Mary Rorty [Medical Sciences, Stanford University Medical Center], Prof. Dr. Leslie Pickering Francis [Philosophy and Law, University of Utah], and Dr. Harry R. Moody [Director of Academic Affairs, AARP, Washington, DC.]) opens up a transnational and comparative perspective. Finally, the results of the ethical analysis will be collected in a synoptic comparison. This will be complemented by a methodological reflection on the integration of descriptive and normative research. The combination of these sub-projects is designed to yield both academically and socio-politically relevant findings which will be made available to both experts and the public. Our project will further contribute to establishing an interdisciplinary and international network connecting research and research institutions.
