The Joseph and Rose Kennedy The Kennedy Institute Volume 3, Number 2 Institute for the Study Georgetown University of Human Reproduction Washington, D.C. 20057 and Bioethics Quarterly Report Summer 1977 New Chair Established He is co-organizer of the Symposia on Philosophy and Medicine. This series of Symposia is designed to produce litera Rosemary Kennedy ture in a field which up to this point Endowed Chair in has had a dearth of published material. The proceedings of each symposium is the Philosophy of being published, and together they are Medicine being called the Philosophy of Medicine Series. At this time 3 volumes have H. Tristram Engelhardt, Jr., M.D., been published of at least an 11 volume series. Those volumes now in print are Ph.D ., has been appointed to the first Evaluation and Explanation in the Bio Rosemary Kennedy Endowed Chair in medical Sciences; Philosophical Dimen the Philosophy of Medicine. This professorship sions of the Neuro-Medical Sciences; is being jointly funded by a and Philosophical Medical Ethics: Its grant from the Joseph P. Kennedy, Jr. Nature and Significance. A fourth Foundation and the University. Dr. volume, Mental Health: Philosophical Engelhardt will hold a joint appointment Perspectives, will be out in print in as a professor in the Departments October 1977. of Philosophy and Community Medicine , and as a Senior Research Scholar Dr. H. Tristram Engelhardt Within Georgetown’s Medical Center. of the Joseph and Rose Kennedy Institute Dr. Engelhardt will be working with the for the Study of Human Reproduction This fall Dr. Engelhardt will be directing and Bioethics at Georgetown a seminar sponsored by the National resident staff and the medical students University. Endowment for the Humanities for in the field of pediatric mental health medical practitioners, titled, “The through the University Affiliated Facil Dr. Engelhardt has been a frequent Delivery of Health Care: Physicians’, ity. He is very interested in the concept visitor and contributor to the activities Patients’, and Society’s Rights.” In the of “levels of capacity” for the mentally of the Kennedy Institute for several spring of 1978, he will be teaching a handicapped in the sense that mental years. He is a contributing author and course for graduate and medical students handicaps are generally uneven. That i an associate editor of the Encyclopedia on “Historical and Philosophical a person may be handicapped yet still of Bioethics. Concepts of Disease” in the University. have many areas in which he can develop and flourish as an individual. Within the In his new position here Dr. Engelhardt Dr. Engelhardt is in the process of writing U.A.F. program, Dr. Engelhardt will be working with staff, students and families will be involved in integrating the efforts several books. He anticipates that of a primarily research Institute his textbook of Medical Ethics will be , concentrating on the ethical issue and an ongoing medical school program. finished by the end of the academic arising in the prevention, diagnosis and Teaching, writing and research will all year. He is also involved in writing a treatment of mental retardation. His im portant. book on John Hughling Jackson and interest in mental health has led him t the development of the concept of devote two volumes in the Philosophy cerebral localization in the 19th Century of Medicine Series to the subject of , and is in the process of gathering Mental Health. an anthology of readings on the history Copyright © The Kennedy Institute of the concept of disease. Summer 1977 Dr. Beth Soldo 2 Dr. Beth Soldo Dr. Soldo is also developing a proposal individual differences. The elderly for a cross-cultural comparative study population today is neither a social, Gerontology: The of behavioral aspects of aging. She and economic or demographic monolith. George Myers will again collaborate on It’s a very heterogeneous population. Study of Aging this study, which will not involve a Distinguishing between groups of individuals survey, but will analyze secondary annual simply on the basis of their data sources from the United chronological age negates very fundamental Beth J. Soldo, Ph.D., joined the Institute States and several countries of Western differences between individuals in February as a Research Associate Europe. not simply at the latter end of the life with the Center for Population Re- cycle, but throughout it. search. She received her Ph.D. in Sociology Dr. Soldo has presented papers at meetings from Duke University this year, of the Population Association of Q: What else accounts for the gerontol and her main area of concern is the relationship America and the Gerontological Society ogist’s uneasiness with chronological between gerontology and demography . age? in meeting the needs of the aged. A: Chronological age also masks intra- individual differences. Aging, as a social Dr. Soldo has taught at Duke University concept, refers to both the rate of development , including courses in Urban Sociology and the stage of development and Social Demography. She is Interview with Dr. Beth Soldo along multiple dimensions. There’s teaching “Social and Demographic Q: Gerontology is the study o f aging. the dimension of health status, functional Aspects of Aging” at Georgetown capacity, cognitive acuteness, integration during the summer session. Although Exactly what does aging mean to a of roles, and so on. All these she has no teaching plans for the winter gerontologist? fit into a complex of dimensions that term, she will continue her research at we in society tie up into a neat bundle the Center in a number of ways. A: Aging, fundamentally, is a process, one that is both unidirectional and irreversible and label “age.” And yet an individual can look very old in the sense that all Dr. Soldo, along with George Myers of . Chronological age is used as an of the visual cues are present gray hair, the Duke University Center for Demo- indicator of a developmental stage in wrinkled skin — and yet this same person graphic Studies, is at the midpoint in a that process. Because of its utility, can kill you at tennis. To some extent two-year research project funded by chronological age has widespread administrative the multiple dimensions of aging are the Administration on Aging. This use. interdependent, but they’re not perfectly study is entitled “Changing Household correlated. So somebody could Patterns among the Elderly,” and will Despite its administrative appeal, chronological be very old along a social status dimension examine variations and changes in patterns age is beset with conceptual , and yet relatively young along a of household arrangements over problems. The first, and perhaps most health status dimension. the period 1969-1976. The project is obvious, is its failure to capture inter- also intended to assess determinants of Q: Why then does society continue temporal variations in age-related behavior make so many assumptions about p eo , and to examine the impact of p le based on age? changing economic conditions and pro- gram intervention strategies on changing A: Primarily for its convenience. If I patterns. simply know your age, I don’t need to "The elderly population today is neither a social, economic or demographic monolith." 3 elicit all kinds of detailed information accumulated life history as much as to Q: What can we do to increase their about you. In social interactions, age current circumstances. chances for a good life? serves as a convenient proxy or surrogate variable. I know a lawyer who insists Q: Do you think the post-war “baby A: I would say our primary concern before he goes into the courtroom boom” has aggravated the difficulties should be to give them options, along that he know the age of the opposing of the older generation? every dimension which is of social concern attorney. He’s found this to be a short- to us. But a flexible retirement age hand way of getting a grasp on what A: The baby boom created both problems will generate other problems in other kind of approach the opposing attorney and help for those who are currently places in the life cycle for the population will take, the kind of argument he’ll elderly; problems, for example, as a whole. So when you propose make, how fast you can throw things at in the sense that given a fixed or limited any kind of intervention, you must be where his weaknesses may very amount of societal resources, and given careful that while it may be good for well be. In other words, if he’s a young the large baby boom cohort knocking the elderly, it may also generate a problem attorney, he may be up on book knowledge on the door of the labor force and demanding for the young. , but very inexperienced in terms entry, one of society’s ways of of courtroom maneuvers or staging coping with the problem is to ask (in I think that probably the most vivid techniques, as opposed to an older one fact, provide incentives) for the elderly concern of the elderly is their health who may be very apt at the theatrical to leave the labor force. This can happen care. This is an area where the United aspects of courtroom presentations but 10 years before there’s any health- States can learn a lot from the countries may not be as knowledgeable about the related reason for them to retire, or any of Western Europe who, demographi nuances of legalities as a younger one desire on their part to do so. On the cally speaking, are much older populations may be. And everyone, not just an attorney other hand, I think the baby boom is .