The main definition of ethics or moral philosophy includes the systematization, defence and recommending concepts of right and wrong behaviour (Parmar, 2021). Ethics deals with issues of human morality and the definition of concepts such as good and evil, right and wrong, virtue and vice, justice and crime (Flexner, 1993).

The availability of partners plays an important role in how the elderly experience sexuality. fullness. It is a fact that women live longer than men all over the world. As a result, older men, in contrast to older women, have significantly more opportunities to partner with the opposite sex and practice sexuality (Carr, 2004). About four out of five women over the age of seventy-five do not male sexual partners. In contrast, more than 60% of men in this same age group have a female partner. The aforementioned difference has major consequences for personal and public health. With the advent of prescription drugs that help men get an erection (Viagra), older men are more sexually active. Public healthcare problems are compounded as men age to seek the services of prostitutes and bring sexually transmitted diseases, including HIV, back to their older partners (Nack, 2006).

Everything is even more difficult for the elderly who suffer from dementia. In a marriage where one spouse suffers from dementia, moral and ethical dilemmas arise very quickly. What happens is that healthy partners leave the marriage more and more often, because they are not emotionally fulfilled, their needs begin to grow. As a result, due to the disease, individuals feel guilt, disapproval from family members, friends who do not have the knowledge and sense of how to deal with a demented person (Wornell, 2014). With the increasing number of institutions dealing with dementia patients, such as the institutions for the elderly, as well as in the home environment, there is a blurring line between guarding against neglect and abuse of residents, particularly those with dementia (Wornell, 2014). This is especially evident when it comes to sexuality in long-term care, and one of the examples of neglect is the ban on residents to express their opinion and sexuality. Also, not preparing residents for unwanted sexual activities by other residents represents abuse again. In this case, abuse can occur both on the part of a member of the medical and other staff or another resident member or resident to a simple case of mistaken identity in a confused dementia patient.

An ethical dilemma also arises in the use of drugs to increase or decrease sex drive in old age. The study showed that sexual activity declines over the years, but still continues in people over 50 (Kalra, Subramanyam, & Pinto, 2011). Moral and cultural values ​​are also important in sexuality, which can also disrupt the normal process of sexuality in old age. A sexually active older woman may feel that her sexual expression is culturally inappropriate for her age, so she may ask her doctor for medication to help reduce her sexual desire. In this case, an ethical dilemma arises for the doctor, since respecting the patient’s autonomy has priority, but prescribing drugs in old age can also have negative consequences (Fujisawa & Sawada, 2004).