Forecasting human longevity has important
public policy implications that influences the rate at which
the working population is taxed, the benefits of current beneficiaries
and the financial status of future generations.
Within the European Union, life expectancy is 78.6 years
(74.7 years for males and 82.5 years for females).
In the European Union, the healthy life expectancy however
is 70.4 years for all citizens (68.2 years for men and 72.6
years for women). The Dependency ratio measures how many people
are outside the workforce in relation to those who belong
to the workforce. The Economic Dependency ratio also takes
into account the number of unemployed. In long-term planning,
it is naturally much more difficult to estimate the employment
rate than demographic trends such as birth rate and mortality.
Before looking at the legal differences between the countries,
it is worthwhile comparing the demographic facts and predicted
figures between countries.
Find out about the
following issues.
What percentage of the population is over 65
and what are the predications for this age group in the future?
What is the life expectancy and healthy life expectancy at
the moment?
What is the legal retirement age and what is
the actual average retirement age (due to early pensions etc.)?
How is the basic income of the elderly guaranteed
by law?
Are children liable to give maintenance to their
parents?
Is it legal to refuse medical treatment?
Is assisted suicide or euthanasia legal?
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What
percentage of the population is over 65 and what are the predications
for this age group in the future? What is the life expectancy
and healthy life expectancy at the moment?
United Kingdom
In the UK at the
moment, 18.1% of the population is over 65. By 2031, nearly
a quarter of the UK population (23%) will be over 65. The
boom is expected to slow down and by the year 2051 it is estimated
that only 24% of the UK population will be over 65.
At the moment, the average life expectancy
for a person in the UK is 77.5 years. (75 for men and 79.9
for women). Although the UK has no good measure of healthy
life expectancy, preliminary investigations estimate healthy
life expectancy to be approximately 10 years less than total
life expectancy.
Denmark
In Denmark, 15% of the
population is at the moment over 65. By 2020, 19% of the Danish
people will be over 65 years, by 2030 the share will be 21
% and by 2040 there will be 23%.
Life expectancy is 76,7 years;
74,3 for men and 79,0 for women.
Healthy life expectancy is 63,5 years; 62,9 for men and 64,1
for women.
Finland
In Finland, 15%
of the population is over 65. By 2030, every fourth Finn will
be over 65 years and by 2050, their share is likely to go
down closer to the EU average. At the moment, the average
life expectancy for a Finnish person is 77.4 years (73.7 years
for men and 81.2 years for women). The healthy life expectancy
for a Finnish person is 68.8 years (66.1 years for men and
71.5 years for women).
France
16% of French
people are over 65 (21% are over 60, i.e. 12.1 million people).
This figure may reach nearly 30% in 2050. There could be 4
million people over 80 in 2020 and up to 7 million in 2040.
In France, life expectancy is 74.9 for men and
82.4 for women (1999 INSEE figures). This gap between the
sexes is the highest of any country in the Union. The life
expectancy of French women is the highest in the world after
the Japanese. However, life expectancy for men is average
for the EuropeanUnion.
Women spend a little less than 8 years
in a state of disability or dependency and men around 5.5
years. 1,417,000 people over the age of 60 are in a situation
of physical or mental disability / dependency. This figure
could increase by 6 to 14 % by 2010 and by 50 % by 2040.
Germany
In Germany today,
more than 16% of the population are age 65 or older (19.97
% of the women and 13.17 % of the men). This means that currently
in Germany more people are 65 or older than are 15 or younger.
By the year 2030 more than
26 % of the Germans will be 65 plus (almost 29 % of the women
and 23.4 % of the men). And in 2050 it is expected that almost
every third woman (32 %) and every fourth man (25 %) in Germany
will be 65 or older.
At the moment, the average life expectancy in
Germany is 77.5 years (74.4 for men and 80.6 for women). Statistically,
a man who today is 60 will live an additional 19 years while
a woman of the same age will live ab additional 23.3 years.
According to the World Health Organisation (WHO),
the healthy life expectancy in Germany is 69.4 years (67.4
years for men and 71.5 years for women).
Italy
At the moment, 18% of Italian population
is over 65. According to most expectations, in 2030 this age
group will account for the 30% of total population. In particular,
between 2000 and 2050 there will be a sensitive shift of the
age profile toward ages over 65. In fact, in this period the
population over 65 will increase more than 75%, especially
around 2030. Viceversa, the number of young people and adults
will decrease of 28%.
Presently, the average life expectancy in Italy is 79.12 years,
being the second best Country in Europe. Moreover, it has
the longest healthy life expectancy (71.20 years).
Portugal
In the year 2000,
1,533,800 people in Portugal were over 64 years of age (15.3
% of the total population).
Today, the average life expectancy for a Portuguese
is 76.9 years
(73.47 years for men and 80.30 years for women).
Today, the healthy life expectancy for
a Portuguese is 65.8 years (62.2 years for men and 69.4 years
for women).
Spain
In Spain, 16.2%
of the population is over 65. Some 36,000 people cross this
age threshold every month. Life expectancy is approximately
74.4 years for men and 81.5 years for women.
Life expectancy for those
reaching 65 is 16 years for men and 19.8 years for women.
Spain has undergone a real revolution in life expectancy,
thanks to improved health care, advances in medical science
and improved living conditions. 85% of the population now
reaches 'old age'.
Proportionally, there are now more people
over 65 because child and general mortality rates have fallen
and because there are fewer young people.
European Union
In the EU, the
average life expectancy is 78.6 years (74.7 for men and 82.5
for women).
Things are more complicated with the average
healthy life expectancy for the EU. As life expectancy lengthens,
the quality of that longer life becomes a major issue. The
concept of healthy life expectancy (also called 'active life
expectancy' or 'disability-free life expectancy') refers to
the average number of years that people may expect to be free
of limitations of function due to one or more chronic disease
conditions. It is difficult to precisely compare measures
of healthy life expectancy among nations because of computational
and conceptual differences. More information can be found
at:
http://www.ifa-fiv.org/menu7_demographie/menu7_ageing_ang.htm
http://www.unece.org/stats/links.htm
One in three Europeans is over 50 and
one in five is over 60. At the beginning of the 20th century,
life expectancy in Europe was 47 years while 100 years later
it reached 65 years.
In 2050, the European population is estimated to have a life
expectancy at birth of 77 years, on average.
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What
is the legal retirement age and what is the actual average
retirement age (due to early pensions etc.)?
United Kingdom
In the UK, there
is no fixed age for when you must retire - you can continue
working as long as you wish. However, there is a fixed age
for when you become entitled to receive a state pension; this
is currently 60 for a woman and 65 for a man. Between 2010
and 2020, the state pension age for women will increase. On
6 April 2020, the state pension age will be 65 for both men
and women.
Despite the current gender difference at which
you can receive a state pension, the average retirement age
for both men and women in the UK is around 65. The lowest
in the European Union is 59, for Italian women; the highest
is 67, for Danish men and women.
Britain has one of the lowest participation
rates of older people in the labour market in the industrialised
world. Only 5.2% of people over 65 are in paid employment,
compared with 10.2% in Sweden, 12.4% in the US and 22.1% in
Japan.
Denmark
In Denmark, the legal
retirement age is 65 years. But if you turned 60 before the
1st of July 1999, you cannot retire before you turn 67. The
actual average retirement age is 61-62 years.
Finland
65 years is the
legal and 59 years the actual average retirement age.
France
Since 1983, the
legal retirement age in France has been 60. However, this
age is lower for certain public sector employees (for example,
armed forces personnel or railway workers) and women who have
raised three children or more.
The true average retirement age is actually
61.8. Women retire at 62.5, men at 60.5.
Around 10% of the population retire before the
age of 60, 57.3% between 60 and 64 and 33.2 % at 65 or more.
The average age of retired persons is 72.
Today, the French live an average of 20
years after retirement, compared with 10.6 years in 1975.
Germany
The legal retirement
age in Germany is 65 but there are several aberrant regulations
for special occupational groups. Due to the way in which old-age
provision is organised in Germany there is no data available
for a general average retirement age.
In the year 2000, the average retirement age
for people whose pensions are paid by the state was 57. The
average retirement age for people whose pensions are paid
by the statutory pension insurance ('gesetzliche Rentenversicherung';
mainly employees) in 2000 was 60.2 (59.8 for men, 60.5 for
women).
Italy
In Italy, there are two kinds of pensions:
the old-age and the seniority pension. In the first case,
the pension is guaranteed if three conditions are satisfied:
the age minimum (65 years for men, 60 years for women), a
minimum number of years paid into the National Insurance scheme
(INPS), and the conclusion of any working activity. The latter
is not necessary for independent workers who can retire and
continue their work.
The seniority pension is obtained before reaching the age
necessary for the old-age pension. In this case, workers need
35 years of payments to INPS and 57 years of age if subordinate
workers; 35 years of payments to INPS and 57 years of age
if independent workers (craftspeople, tradespeople and farmers).
In addition, in case subordinate and independent workers have,
respectively, 37 and 40 years of payments to INPS, they can
retire independently from their age.
In 2008 the number of years of payments required to subordinate
workers to retire will equal that required to independent
ones.
Portugal
In Portugal, the
legal retirement age is 65. However, people can take early
retirement from the age of 55 so long as they have worked
for 30 complete years. In this case there is a reduction in
the amount of the pension.
In Portugal, the actual average
retirement age is 65 for men and 62 for women.
10.7 % of the total Portuguese population
over 64 years still work.
Spain
In Spain, the
general rule is for people to retire at the age of 65. This
is the legal requirement, although exceptions exist in the
form of early retirement.
Ageing is exercising considerable
pressure on social protection systems (pensions and health
care expenditure).
European Union
Although the systems
vary among the countries, most European countries have a legal
retirement age of 65. Today, the actual average retirement
age in Europe is 60 years for women and 59.5 for men.
Note: Data related to EU-15.
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How
is the basic income of the elderly guaranteed by law?
United Kingdom
Currently a full
basic state pension is £75.50 per week (119.09 Euros).
If a person has not paid into the National Insurance scheme
for enough years (perhaps, for example, they have worked abroad
for much of their life) they will only be entitled to part
of the full state pension.
In these cases, and in cases where a person
has no pension other than the state pension, the government
will top up their income to £98.15 (154.76 Euros) for
a single person or £149.80 (236.21 Euros) for a couple.
This is called 'the minimum income guarantee'.
As of April 2003, the Pension Credit will reward
pensioners for saving during their working lives, or for carrying
on working beyond retirement age.
The National Health Service provides free health
care to all UK residents including those on a pension. Where
a disability is involved, extra assistance is provided.
Denmark
The national Danish pension
law (Lov om social pension) from 2001 guarantees flat-rate
benefits for everyone over 65. The national pension is based
on a residency criterion and is paid to anyone, who has lived
in Denmark for at least ten years between the age of 15 and
65. Five of these ten years must be immediately before the
pension is paid.
In addition there is a supplementary
Labour Market Pension Fund (ATP) according to the national
Danish law on supplementary pension (Lov om Arbejdsmarkedets
Tillægspension) from 2001. It is a compulsory social
insurance scheme for employees with benefits depending on
the duration of affiliation and on the contributions paid.
Finland
The National Pensions
Act (1956) guarantees a basic income for everyone over 65
together with social assistance and a constitutional right
for services. Additionally, all economically active persons
are covered by an insurance system. When this employment pension
exceeds a given limit, no national pension is paid.
France
In France, the
general retirement scheme guarantees a full pension (50%)
for persons who have contributed for 40 years. If not, the
rate is lower. There is a minimum benefit of 6,800 Euros per
year and a minimum income, called RMI, of around 400 Euros
per month for a single person. In addition, social services
grant many supplementary benefits for elderly persons on low
income: housing benefit, payment of medical costs, home helps,
nursing auxiliaries for home care, etc.
Germany
In Germany, many
people who work directly for the state or in organisations
under public law ('Beamte', e.g. civil servants, public servants,
soldiers, judges etc.) are eligible for pensions paid by the
state ('öffentlich-rechtliches Altersicherungssystem').
Most ordinary employees are legally bound to
invest in a system of statutory pension insurance ('gesetzliche
Rentenversicherung') which after their retirement will pay
a monthly sum in correlation to their prior wages. In this
system, the people currently in a job have to earn the money
which pays for retirement pensions of the elderly in the same
time period. Due to the changing age pattern of the population
and the resulting growing strain on the people in work, this
system has been one of the most discussed political issues
in Germany in recent years in Germany. Self-employed people
are not legally bound to invest in this system but can do
so on a voluntary basis.
In addition, many Germans have private
old-age provision to secure an appropriate monthly income
once they are retired.
Italy
In Italy, there is a basic state pension.This
kind of income is guaranteed through the INPS, the "National
Insurance Institute", if a person did not pay enough
into the National Insurance scheme. In this case, the Institute
tops up the current pension to the minimal pension, which
is fixed yearly (in 2003, it is € 402.12).
In Italy, a pension for chronic infirmity and inability to
work is also available.
Portugal
In Portugal, the
Constitution explicitly states that all Portuguese have the
right to social security, and that the responsibility for
protection of the elderly lies with the State. All employers,
including the State itself, make monthly contributions to
a fund that later in life reverts to the employee in the form
of a pension.
Apart from this system, individuals
are free to complement these pensions in the private sector
(such as banks and insurers). The demand for these complements
(generally called PPR's) is increasing.
Spain
In Spain, an average
old age pension is approximately 555 Euros. The exact amount
depends on how long an individual has worked and their social
security payments.
European Union
In Europe, social
security systems differ from country to country. However,
the European Union has recently produced a great number of
reports and studies to promote a more common policy.
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Are
children liable to give maintenance to their parents?
United Kingdom
No. In the UK,
if an elderly person has to go into a residential home, he
or she is likely to have to sell their house to pay for their
care. If an elderly person has no home to sell, the state
will pay for all or part of their care.
Denmark
No.
Finland
No.
France
No, there is no
law that forces children - even if they have a large income
- to provide for their parents, whatever their age or state
of dependency. On the other hand, children can ask a judge
to place their parents under guardianship and so manage their
parents' property when their parents are no longer capable
of doing it themselves.
Germany
At the moment
in Germany, under certain circumstances children are in fact
legally obliged to support their parents. Elderly people who
are not eligible for pensions of any kind and don't have any
private old-age provision or any assets can - like anybody
else who is in need - apply for social welfare. In this case,
the authorities will reclaim the money paid from these people's
children, if their monthly income exceeds a specific amount.
From 1st January 2003 a new law will guarantee
a basic income for everyone over 65 who needs it. However,
if a child of such a person earns more than 100,000 Euros
per year, he or she will be liable for the support of the
parent.
Italy
Yes. In Italy, parents in need have the
right to receive alimonies from their children, or to be welcome
in their houses. If they have more than one child, all of
them must contribute to their support, according to their
financial possibilities.
Portugal
No.
Spain
In Spain, relatives
are required to provide maintenance for each other according
to the provisions of Title VI, articles 143-144 of the Spanish
Civil Code 'On maintenance between relatives'.
European Union
The European Commission
or Parliament has not produced any legislation or recommendations
on this matter.
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Is
it legal to refuse medical treatment?
United Kingdom
In the UK, it
is legal for a competent adult to refuse treatment, even if
this action would clearly reduce their life expectancy. Exceptions
to this include patients being treated for mental disorders
and detained under the Mental Health Act, 1983.
The situation with children under 18 is
not as clear, and favours children receiving treatment. In
some cases, children under the age of 18 can give their consent
for a treatment to proceed, even if this is against the wishes
of their parents. However, if a child under 18 refuses treatment,
it is possible for parents to override that decision. In extreme
cases, the court's opinion can be sought to decide whether
the doctor should proceed.
Denmark
The national Danish law
on patient rights (Lov om patienters retsstilling) from 1998
states that no treatment can begin or be continued without
the patient's consent. It is possible for a person to make
a living will, where they write their desires according to
treatment.
There are two exceptions in Denmark where patients cannot
refuse treatment. In cases of epidemics the Minister of the
Interior can, on recommendation from the National Board of
Health, order that compulsory treatment is initiated. That
is stated by the national Danish law on order of the authorities
against catching illnesses (Lov om foranstaltninger mod smitsomme
sygdomme) from 1979.
The other exception is the case of a person
who is mentally ill and a danger to himself or his surroundings.
This person can be forced to receive treatment. This is stated
by the national Danish law on loss of liberty and other compulsions
in Psychiatry (Lov om frihedsberøvelse og anden tvang
i psykiatrien) from 1998.
Finland
The Patient law
entered into force in Finland in 1993. It includes regulations
about a patient's right to medical treatment, as well as their
right to refuse treatment if they wish. It is possible to
make a written treatment will which can, for example, guarantee
that the patient will not be resuscitated against his or her
will.
France
In France, a patient
can refuse treatment but a doctor cannot. According to the
principles laid down in the Civil Code (articles 16-1 and
16-3) related to the inviolability and integrity of the human
body, a doctor cannot force a person in a position to express
their wishes to accept medical examinations or treatment.
But the doctor must inform the patient of all the consequences
of their refusal and attempt to persuade them otherwise (article
35 of the Code of Medical Ethics). If, exceptionally, a doctor
decides to stop treating a patient, they must ensure continuity
of care by entrusting the patient to another doctor. Doctors
can only act without taking a patient's wishes into account
if there is extreme urgency, the patient's life is at stake
or the patient is mentally ill and a danger to themselves
or others. Any doctor who refuses to help an injured or sick
person at risk can be prosecuted.
Germany
In Germany, any
patient has the right to choose the amount and comprehensiveness
of medical treatment given to him or herself. Any person capable
of consent can make a 'living will' which regulates medical
treatment in cases where the patient might not be in a condition
to tell doctors what he or she wants. This can be done in
writing or by naming another person as a confidant. People
under 18 can also make a living will but in this case, doctors
have to obtain the consent of their legal guardian.
However, active euthanasia is illegal
in Germany and can't be given, even if the living will of
the patient asks for it.
Italy
Yes. The article 32 of the Italian constitution,
section "Duties and Rights of Citizens", protects
the right to life, stating that nobody can be forced to receive
medical treatments, if not under the provisions of the law.
For minors (under 18 years old), the decision of medical treatment
denial is up to their parents. If such a denial leads to a
worsening of their children's health conditions, or death,
the Juvenile Court, called by the family physician, assumes
the temporary responsibility of the minors.
Portugal
Yes. However,
if life is endangered, refusal of immediate treatment may
only be undertaken by the patient or by their family, if the
patient is incapable of expressing his or her will. In such
cases, doctors are entitled to refuse continuing their care
of the patient.
Portugal has no specific legislation on
Patient Wills. However, there is nothing to prevent someone
from making a Living Will stating, for example, that he or
she wants to be allowed to die if in a chronic vegetative
state.
Spain
In Spain, it is
legal to refuse treatment according to Article 10.9 of General
Health Law 14/1986, of April 25:
All have the following rights
with regard to the respective public health administrations:
(9) To refuse treatment, except in the cases indicated in
Section 6; for which they must request voluntary discharge
according to the terms established in Section 4 of the following
article.
Article 6. On the free election
amongst the options presented to them by the medical worker
responsible for the case. The user's prior written consent
is required for any intervention to be carried out, except
in the following cases:
a) When non-intervention
entails a risk to public health.
b) When the patient is not capable of taking decisions, in
which case the right to decide is transferred to the patient's
family or closest relatives.
c) When the urgency of the situation does not permit delays
as irreversible injuries might be caused or where there is
danger to life.
European Union
The European Commission
or Parliament has not produced any legislation or recommendations
on this matter.
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Is
assisted suicide or euthanasia legal?
United Kingdom
The Human Rights
Act, 1998, requires that a person's right to life is protected
by the law.
In the UK, it is illegal to assist someone in
taking his or her life. In a recent case, Diane Pretty, a
severely disabled woman, was refused permission from the courts
to let her husband help her to end her own life. The nature
of her disability meant she was unable to end her life without
assistance. Under English law, she could choose to die only
if she were physically capable of carrying it out herself.
Euthanasia is a criminal act and treated as
murder, punishable by a possible life sentence. However, it
is lawful for a patient to refuse life-prolonging treatment.
In some cases, medical treatment can legally
and ethically be withdrawn by doctors when it is futile to
continue, or when it cannot accomplish any improvements.
Denmark
The national Danish law
on patient rights (Lov om patienters retsstilling) from 1998
states that passive euthanasia, such as stopping a terminally
ill patients treatment, is legal. Active euthanasia and assisted
suicide is not legal.
Finland
The Patient law
also includes regulations about euthanasia. In Finland, a
distinction is made between active and passive euthanasia.
Active euthanasia is not legal. Passive euthanasia on the
other hand, such as stopping a terminally ill patient's treatment,
is allowed.
France
No. Euthanasia
is forbidden in France, whether it is carried out by a carer
or anyone else, since'"no person has the right to deliberately
cause death' (Code of Medical Ethics, article 38). Euthanasia
is judged to be incompatible with the law, medical practice
and ethics, and lays the carer open to criminal and disciplinary
proceedings. In practice, 'therapeutic abstention' (also known
as 'passive' euthanasia) is tolerated. This consists of withdrawing
treatment (such as heart or respiratory support) from terminal
patients.
Germany
Since suicide
is not a statutory offence in Germany, assisted suicide in
general is not considered a crime sol as long as the last
step of the killing (e.g. the swallowing of poison) is done
by the person. However, if the person assisting is a close
relative or a doctor he or she makes him or herself liable
to prosecution because such a person is considered to be a
guarantor of the patient's or relative's life.
Any kind of active euthanasia is illegal
in Germany, even if a person insists on it. However, euthanasia
has been discussed in Germany every now and then, especially
since active euthanasia became legal in the Netherlands.
Italy
No, the Italian legislation considers active
euthanasia (assisted suicide) as a criminal act, punishable
by imprisonment (from 5 to 16 years). This principle is the
expression of the article 5 of the Italian Civil Code. Euthanasia
is possible only in specific cases, such as in cerebral death.
If that occurs, however, it is considered passive euthanasia,
therefore not punishable by law.
Portugal
In Portugal, the
debate about euthanasia is not particularly active. A distinction
is made between active and passive euthanasia (also designated
assisted suicide). Both are illegal in Portugal, and both
are, if confirmed, punished with imprisonment of up to 3 years.
Spain
In Spain, euthanasia
or assisted suicide are considered crimes under Article 143.4
of the Penal Code, Organic Law 10/1995, of November 23. This
states that 'Anyone who causes or actively cooperates through
direct and necessary action to the death of another through
the express, serious and unequivocal request of this person,
should the victim suffer from a serious illness that would
necessarily lead to their death, or that causes serious, permanent
suffering which is difficult to withstand, shall receive a
punishment one or two degrees lower than those indicated in
numbers 2 and 3 of this Article'.
European Union
The European Commission
or Parliament has not produced any legislation or recommendations
on this matter.
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