ETHICAL DILEMMAS IN TREATING ELDERLY PATIENTS AT RISK OF POLYPRAGMASY AND POLYPHARMACY

In this study we focused on the ethical dilemmas that confront physicians while approaching therapeutical management of elderly patients, especially those exposed to polypragmasy and iatrogeny. We explore the main universal ethical principles such as autonomy, beneficence, non-maleficence, justice and equity and the challenges the medical team faces while trying to reconcile them with several particular aspects characteristic to elderly patients such as: fragility, disability, comorbidity, cognitive and functional impairment, and a greater risk of polypharmacy, polypragmasy, and iatrogeny. Building a strong physician – patient relationship based on mutual trust and respect is the key to understanding the needs and desires of the elderly, which may be completely different from other age groups, and their possibilities to adhere to medical recommendations. Multidisciplinary teams, representing professionals from diverse disciplines coordinated by the general practitioner and/or the geriatrician should help solving difficult ethical dilemmas.