Respect for equality and the treatment of the elderly: declarations of human rights and age-based rationing.

A demographic revolution is taking place in Europe and worldwide. According to World Health Organization (WHO) estimates, the number of people aged 60 and over is growing faster than any other age group.2 This change in the population structure affects disease patterns3 and is deemed to cause an increase in the demands on healthcare systems.4 This raises concerns about the ethics of healthcare delivery (among others). What criteria should direct healthcare distribution? Is it right to meet the demands of an ageing population, to the detriment of the younger strata of population? International organizations, such as the European Union (EU), the World Health Organization (WHO), and the United Nations (UN) have condemned any form of “ageism,” including ageism in healthcare provision.5 Age-based discrimination is deemed to violate the principle of equality. Virtually all declarations, conventions, and charters on human rights stress the fundamental value of equality. Since the earliest documents, the notion of equality has been at the heart of claims of respect for fundamental human rights, such as dignity, life, and integrity. These rights apply equally “to all members of the human family.” 6 In these declarations, equality is understood mainly in terms of nondiscrimination. The Charter of Fundamental Rights of the European Union, for example, reads: