TY - JOUR T1 - Dealing with the brain-damaged old--dignity before sanctity. JF - Journal of Medical Ethics JO - J Med Ethics SP - 173 LP - 179 DO - 10.1136/jme.8.4.173 VL - 8 IS - 4 AU - G S Robertson Y1 - 1982/12/01 UR - http://jme.bmj.com/content/8/4/173.abstract N2 - The present and future rapid increase in the hospital population of geriatric patients is discussed with particular reference to the problem of advanced brain degeneration. The consequences of various clinical management options are outlined and it is suggested that extreme attempts either to preserve or terminate life are medically, morally and socially unacceptable. The preservation of life in senile patients has important economic consequences. In achieving a decision on the medical management of patients with advanced brain decay it is suggested that substantial help would be derived from: knowledge of the previously declared wishes of individual patients; improvements in geriatric assessments; broader consultation with relatives, and greater use of inter-disciplinary discussion in the preparation of criteria for terminating medical efforts to maintain survival. ER -