Setting Limits: Medical Goals in an Aging Society with "A Response to My Critics" [Paperback]

Daniel Callahan (Author)

Book Description

Publication Date: March 1, 1995

A provocative call to rethink America's values in health care.

Editorial Reviews

From Publishers Weekly

In this wise and thought-provoking review of present attitudes and public policy toward aging and death, Callahan, author of Abortion: Law, Choice and Morality, etc., faults our health care system for devoting disproportionate resources and technology on extending the lives of the elderly regardless of the quality of their lives. He also warns against the social and economic consequences of the increased ratio of old people in the population. Medical care, he suggests, should be allocated based on standards of need and priorities to meet them over a "normal life-span opportunity range," limiting the use of new technology to that which improves the quality of life. He also discusses the ethics of withholding artificial sustenance from the terminally ill, euthanasia and assisted suicide. "The proper question is not whether we are succeeding in giving a longer life to the aged," he argues, but "whether we are making of old age a decent and honorable time of life."
Copyright 1987 Reed Business Information, Inc. --This text refers to an out of print or unavailable edition of this title.

Review

"Callahan addresses the problems of aging in a clear, comprehensive, sensitive, and compassionate manner. This is a pivotal work that poses hard questions and proposes provocative answers. Setting Limits promises to be the benchmark for future moral, medical and policy discussions of aging." -- New York Times Book Review

"Logical and persuasive.... Provocative, well-based arguments from a respected voice." -- Kirkus Reviews

"A thought-provoking and heart-jarring assessment of medical goals and aging in the United States today." -- America

"A thought-provoking, in some ways profound, work....a morally courageous book, challenging current widespread assumptions that we should prolong life by increasing medical care even if the result is worsening health throughout the United States." -- New York Review of Books

"An intelligent, profound, and challenging volume that should be assiduously chewed and digested by medical, legal, ethical, and policy professionals and all others who have a stake in the vital issues it raises." -- Journal of Legal Medicine

"Callahan's book should be read -- but very carefully -- by anyone interested in aging, older persons, health care, and issues of morality in American society....This book is likely to be a point of reference in such discussions for some time to come." -- Robert H. Binstock and Jeff Kahana, The Gerontologist

Product Details

• Paperback: 272 pages
• Publisher: Georgetown University Press (March 1, 1995)
• Language: English
• ISBN-10: 0878405720
• ISBN-13: 978-0878405725
• Product Dimensions: 8.4 x 5.5 x 0.7 inches
• Shipping Weight: 12.8 ounces (View shipping rates and policies)
• Average Customer Review: 3.4 out of 5 stars  See all reviews (5 customer reviews)
• Amazon Best Sellers Rank: #879,650 in Books (See Top 100 in Books)

More About the Author

Discover books, learn about writers, read author blogs, and more.

Customer Reviews

Most Helpful Customer Reviews

8 of 10 people found the following review helpful:

5.0 out of 5 stars Setting Limits, February 26, 2006

By 

APK - See all my reviews

Amazon Verified Purchase

This review is from: Setting Limits: Medical Goals in an Aging Society with "A Response to My Critics" (Paperback)

This is an important book. Many of Daniel Callahan's statements about health care for older people (75 and older, for example), if taken out of context, can be chilling (especially if you are 75 or older). But Callahan, a philosopher, views death as a necessary part of life. His opposition is not to health care for old people. Instead, his opposition is to the use of biomedicine for old people.

Biomedicine is expensive and interferes with the natural life cycle. Callahan maintains that biomedicine should not be used for old people who are seriously ill and who would otherwise die. Callahan questions the value of extending life without improving life.

Some readers might conclude that Callahan's approach is intended to cut the cost of health care. I think Callahan would disagree. Money might be saved if biomedicine were denied old people who are seriously ill. But, per Callahan, more money would be spent on improving their end-of-life care. Be careful of people who quote Callahan as a way to save money. They have minunderstood him.

2 of 2 people found the following review helpful:

5.0 out of 5 stars If we had courage we would discuss this book in congress, May 28, 2011

By 

Kavyo - See all my reviews

Amazon Verified Purchase

This review is from: Setting Limits: Medical Goals in an Aging Society with "A Response to My Critics" (Paperback)

Callahan approaches a difficult and controversial subject with both good thinking and feeling. He approaches the issue of dealing with the price we all pay by being unwilling to deal with our own mortality. His writing style is engaging and well- considered.

5 of 7 people found the following review helpful:

5.0 out of 5 stars Thought provoking and challenging, November 25, 2005

By 

Tara Nipe "Informed reader" (Australia) - See all my reviews
(REAL NAME)   

This review is from: Setting Limits: Medical Goals in an Aging Society (Paperback)

Daniel Callahan, ethicist and co-founder of the Hastings Center, has written a provocative book which discusses and evaluates the problem of resource allocation in Western society. Essentially, we spend a significant percentage of health care costs on the last few years of life, regardless of the quality of life being prolonged.
Dr Callahan warns that we will not be able to support these policies indefinitely, particularly as Western populations continue to age. The more tests and procedures we develop, and the greater our skill at extending life, the more expensive terminal health care becomes.
This is not a popular perspective. Many people believe that anything short of providing full available health care to all is morally reprehensible. However, it is undeniable that we are already unable to provide all people with even basic medical care with the current resources available. Indeed, we have only to look at the US to see a future of medicine - sky-rocketing costs, and massively disproportionate services depending on location and financial capacity.
As a nurse I have seen first-hand how focusing on prolonging life can be a worse, and certainly more expensive, outcome for the elderly. As an ethicist I find Callahan's arguments sound and convincing.