Ethical Challenges in Elderly Care: A Narrative Review

Abstract

With increasing life expectancy and a growing elderly populationworldwide, elder care has become a major priority for health systems. Thesecare services are accompanied by numerous ethical challenges, andneglecting them can negatively affect the dignity, rights, and quality of lifeof older adults. This study aimed to address the question: “What ethicalchallenges are faced in elder care?” Accordingly, a systematic review wasconducted guided by PRISMA guidelines. To identify relevant studies,PubMed, Scopus, Web of Science, SID, and Google Scholar were searchedfor the period 2013–2025, using the keywords “Ethical Challenges”,“Elderly Care”, “Nursing”, and their Persian equivalents. Inclusion criteriawere original articles (qualitative, quantitative, experimental, or quasi-experimental) with a direct focus on ethical challenges in elder care, writtenin Persian or English, and with full-text availability. Exclusion criteriaincluded letters to the editor and conference abstracts. The quality of thestudies was assessed using the appraisal tool proposed by Gifford. In total,31 eligible articles were included in the final analysis. The results indicatedthat ethical challenges in elder care can be classified into four maincategories, including autonomy, justice, beneficence, and non-maleficence.Subthemes included privacy preservation, shared decision-making, end-of-life care, equitable resource allocation, and the prevention of physical andpsychological harm. The findings underscored the necessity ofstrengthening ethics education and informing policymaking in elder care.