Frits de Lange is professor of ethics at the Protestant Theological University in the Netherlands and Extraordinary Professor in Systematic Theology and Ecclesiology at the University of Stellenbosch, South Africa. His book on the ethics of aging needs no apology for its relevance in the graying of our world, a phenomenon more immediate affluent societies but moving inexorably forward in all societies. This widespread development with its issues of justice, economic challenges, filial responsibilities, quality of life, and dignity for the elderly is the first reason de Lange says we need an ethics of aging.
 The second reason he allows is somewhat surprising, the fact that gerontology avoids making any normative claims given the observation that different people have different ideas about how to live their lives. There is in gerontology an implicit set of norms, nonetheless: “successful,” “healthy,” “active”and“productive aging.” (3) These optimistic prescriptions seek to postpone deep aging. This is good news for the Third Stage of the younger old who are continuing to live an active and productive life well beyond the age at which their ancestors were slowing down. However, the agency and choice that drives “successful aging” in the third stage is eroded in the Fourth stage of the frail elderly. The outlook and policies of successful aging no longer speak to the reality of the Fourth Stage; “The oldest old are scientifically and politically abandoned.” (10)
 The third reason for an ethics of aging is theological. Kantian, utilitarian, virtue, and eudaemonist ethics for all their positive features do not measure up to the task of a normative ethics of aging, particularly as regards the Fourth Stage of deep old age. Eudaemonism is a case in point with its emphasis on the individual’s active engagement in flourishing through living well, a function of agency that fits best with the active lifestyle of the young old. For de Lange what is needed is an ethics of care blended with the biblical ethic of love, which in contrast to the ethics of self-realization in “successful aging,” speaks to the relationality of all life across its total life span. Moreover, he contends that this ethical perspective is not restricted in its relevance to believers.
 In Chapter Two de Lange unpacks the threefold nature of the love command: God, neighbor, and self. Love of God presumes an experience of God’s love in the giftedness of life. The command therefore entails that we love life as it is given to us. This implies that we have a relationship with ourselves, a self-love that respects our God-given worth and dignity. Loving neighbor involves relationships of mutual trust. Ultimately this means that do not judge our neighbor in terms of what they have done but in terms of what relieves their sufferings and attends to their well-being. A healthy love of self, then, is presented as a stepping stone to love of neighbor and, though love of neighbor has priority is agapism, self-love, as respect and care for the worth and dignity of one’s God-given life is essential to one’s capacity for self-giving love of neighbor. In de Lange’s account, this linkage of self-love and love of neighbor persists in our relation to our own aging and in our care for the aging others in our lives. It entails a sense of the good life that love seeks for self and others. Respect for autonomy dictates that the subjective and diverse understandings of the nature of the good in the life of each individual be respected. As autonomy slips away in the dependency of old age, love’s ethic of care respects autonomy is expressed in seeking as much as possible the enhancement of the other’s love of life.
 Having offered an account of love’s ethic as foundational to an ethic of aging, de Lange moves forward on the path of application. In Chapter Three, “Why We Do Not Love the Elderly,” the initial focus is on our relationship to the frail elderly. “Love your aging neighbor, as you love your aging self.” (61) This maxim carries forward the linkage of self-love and love of neighbor. The dependent condition of the frail elderly makes of the command to love a duty to care for them the priority. This duty can be burdensome as so many are aware from experience. De Lange believes that loving our own aging can help our loving the aging other. However, the fact that we do not love our own aging is at the heart of why loving the aging is often so problematic. “There is a deep-seated aversion toward aging – and consequently toward old people – that is widespread throughout human culture….the idea of old age as horrific, disgusting, and tainted by mortality has a long history in Western classical traditions as well as Eastern cultures.” (62)
 Recent empirical studies on aging anxiety have uncovered three modes of aversion to aging and the aged. Not surprisingly, one is fear of the impacts of aging on oneself, especially the loss of self-control and self-direction in the Fourth Stage of deep old age. The second is disgust in the presence of the aged. The third is hatred. Here we encounter the sad realities of abandonment and abuse. Some of this may come from the fact that some very old persons can be nasty and hard to get along with. However, de Lange is focused rather on the dislike of people because they are old. They remind younger people and their vulnerability and their own mortality. This is ageism, a prejudice like racism and sexism that serves as a buffer against one’s own anxiety.
 Chapter Four take up the findings of aversion to the aged and turns again to the divine command to love oneself. The more we love our own aging self the better we will be able to love and care for the aged, especially the frail elderly. The command is not to fight aging but to love life to the end. He speaks of Paul Ricoeur whose embrace of life even in his frail old age provides an example of saying yes to life even as it ebbs away and capacities are dissipated. He quotes Karl Barth at some length on the passionate love of God’s gift of life, life in its entirety, as a striving to endure and a readiness for joy under all conditions.
 However, how are we to continue to love our bodies in frail old age with all their infirmities and lost capacities? Loving life to the end and readiness for joy seems easier to say than to experience. De Lange finds the book, The Wounded Storyteller, by Arthur W. Frank to be helpful. Frank thinks we should look at our relationship to our bodies not simply in physical terms but as a moral problem, a matter of choosing the good for our bodies at all stages. For the frail elderly Frank’s idea of a communicative body seems to fit in de Lange’s view. The choice for the good is to share oneself as one is rather than to withdraw into isolation. Good self-care under the love imperative is simply to continue expressing one’s worth in the eyes of God. While the young may see self-fulfillment, self-realization, and self-respect in terms of future goals which are no longer the possibility for the frail elderly in the same way, “Self-realization is not a luxurious privilege for those in the prime of life; it is the expression of an elementary human desire to endure as a person. It is decisive for self-respect to have some future perspective and the will to live up to death, even if that future is restricted to a couple years or months.” (101)This is our Christian vocation: “We are called to care today about ourselves tomorrow because God also cares.”(102)
 The final chapter, “Love for Aging Neighbors,” reiterates that love for the aging neighbor is the moral priority for which self-love is the stepping stone. Love for the aging neighbor is a matter of compassionate concern for their well-being but the challenge is to do so and yet respect their autonomy and their individual uniqueness. In the service of a more deeply relational love he wants to argue for the beauty of old age over against the tendency to feel disgust. Aesthetically speaking, how can the diminished bodies of the old compete with the beautiful bodies of the young? De Lange likes the view Roger Scruton who speaks of the beauty of a body not simply in terms of the body as such but rather as the beautiful embodiment of a person. He quotes Eleanor Roosevelt in support, “beautiful young people are accidents of nature, but beautiful old people are works of art.” (115)
 Among the most vexing questions many adult children face is the question of their responsibility for their aged parents. De Lange explores but rejects both indebtedness and gratitude as the right motives. Rather, love, perhaps in some cases including friendship, is the answer once again. But one must finally get specific as to what love entails. He like the distinction between “generic duties” like getting groceries, housekeeping, etc. which anyone can fulfill and “special duties” of caring arising from the bond between parent and child. In this discussion and throughout the book, de Lange recognizes the diversity of circumstances that characterize our lives and relationships.
 The book is enlivened by references to classical Greek philosophers, theologians ancient and modern, philosophers, researchers, and scripture. Because de Lange has chosen an ethical approach to aging, we are engaged personally rather than abstractly about the issue of aging. People in the Third Stage of aging and anticipating the looming Fourth Stage can find insight and help in their growing old. Families involved in the care of aged parents will find help in de Lange’s carefully drawn distinctions and guidance for a healthy caring relationship for both care giver and cared for.
James M. Childs, Jr. is Joseph A. Sittler Professor Emeritus of Theology and Ethics at Trinity Lutheran Seminary, Columbus, Ohio and book review editor for the Journal of Lutheran Ethics