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This paper discusses the neglect of old people as an element of mistreatment. It considers the definition and prevalence of neglect and issues arising both in self‐neglect and in the context of professional and personal relationships. It is argued that the underlying reasons for ‘omissions of care’ are various and complex and that distinctions between ‘intentional’ and ‘unintentional’ neglect may be unhelpful. Present evidence suggests that it is the oldest and most vulnerable of elderly citizens who are most likely to experience neglect and that the numbers are not inconsiderable. This has far reaching implications for society and for many aspects of social policy and poses a moral challenge to us all.

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