Chapter 9 explores how ageism and midlife bias find expression in allocating life-saving medical care, selecting subjects for clinical trials, and mandating retirement. Subtle expressions of ageism and midlife bias include epistemic justice, internalized ageism, and elderspeak. Around the globe, ageism is not always directed to older people. We review and rebut the chief arguments for old age-based discrimination, including fair innings, cost-benefit analysis, and complete lives egalitarianism. We raise concerns about using age as a proxy, which can foster ageist attitudes. We show that a common form ageism takes is facially neutral policies that systematically disadvantage older adults. The chapter examines “the puzzle of age discrimination,” which is the tendency to oppose race and sex discrimination more strongly than age discrimination and argues that this tendency is unjustified. We rebut age discrimination by appealing to justice between generations, fair subject selection, and respect for dignity.
Keywords: ageism, epistemic justice, age-based rationing, mandatory retirement, fair subject selection, fair innings, complete lives egalitarianism, elderspeak, justice between generations, cost-benefit analysis
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