Realizing and Maintaining Capabilities: Late Life as a Social Project.

One central and unfortunately unavoidable characteristic of the aging process is its association with chronic physiological deterioration. Frailty, cognitive impairment, and physical conditions such as cardiovascular disease and vision and hearing loss are more frequent in this phase of life, and these conditions translate into an increasing need for care and support of multiple kinds. In traditional bioethical scholarship, these distinctive features of aging have been examined predominantly through a health-focused lens. My main contention in this essay, however, is that viewing aging within bioethics as primarily a health problem, to be addressed through frameworks for decision-making or for resource allocation, is inadequate. My aim is to consider how the health conditions associated with aging affect older people's lives in a much more expansive way than has typically been acknowledged. Just as importantly, I intend to show how shifting our bioethical imagination in this way raises different and challenging questions about what a good life in late life consists in and about what is owed to older people, in their personal and social lives, as a matter of justice.