Dementia is a topic of enormous human, medical, economic, legal and ethical importance. Its importance grows as more of us live longer. The legal and ethical problems it raises are complex, intertwined and under-discussed. This book brings together contributions from clinicians, lawyers and ethicists – all of them world leaders in the field of dementia – and is a comprehensive, scholarly yet accessible library of all the main (and many of the fringe) perspectives. It begins with the medical facts: what is dementia? Who gets it? What are the current and future therapeutic and palliative options? What are the main challenges for medical and nursing care? The story is then taken up by the ethicists, who grapple with questions such as: is it legitimate to lie to dementia patients if that is a kind thing to do? Who is the person whose memory, preferences and personality have all been transformed by their disease? Should any constraints be placed on the sexual activity of patients? Are GPS tracking devices an unpardonable interference with the patient's freedom? These issues, and many more, are then examined through legal lenses. The book closes with accounts from dementia sufferers and their carers. It is the first and only book of its kind, and the authoritative text.
Clinical dilemmas in dementia contexts are often not because the clinical facts are in doubt, but because the ethical and legal underpinnings are uncertain - which can cause worry and confusion. This practical book will help nurses, healthcare assistants and other practitioners to think through their responses clearly in the midst of these difficult situations. The chapters all stand alone, allowing the reader to dip quickly in and out of the book as required. They address complex issues such as abuse, behaviour that challenges, forced care, treatment withdrawal, and contain clinical case vignettes throughout. This is essential reading to give practitioners the confidence that good legal and ethical decisions can be made in the same way as good clinical decisions.
This volume explores the concept of safety as applied in the long term care context. Chapters examine the way in which the quest for safety may work either synergistically or adversely upon other worthy social goals. Among the initiatives considered are promoting the decision-making autonomy of patients/clients and their surrogates, enhancing the quality of care and quality of life available to long term care residents, and providing fair compensation for injured victims when serious harm occurs. Questions addressed that are of concern to legal and ethical theorists, social science researchers, and patient/client advocates include: To what extent do litigation and/or regulation accomplish the safety and other legitimate objectives of public policy in the long term care arena? Do the costs of various approaches outweigh the benefits in promoting safety and other goals? How do litigation and regulation compare with alternative approaches to achieving the same goals, in terms of an acceptable cost/benefit balance?
Although the topic of decision making capacity and older persons has been discussed in the literature, there still is much to be learned about it theoretically and practically. Experts continue to disagree about which standards are important for assessing decision making capacity. Questions such as: ìWhen should a capacity assessment be done on an older person and by whom?î are covered by the editors. Topics included in this volume are the application of an original framework for ethical decision making in long term care; an elder's capacity to decide to remain living alone in the community; the quest for helpful standardized instruments for evaluating decision making capacity; and end-of-life liability issues.
Several million Americans are afflicted with Alzheimer's disease or a related dementing disorder. For families, professional caregivers, policy makers, and the patients themselves, the challenges are immense and the economic costs are staggering. In Dementia and Aging Robert H. Binstock, Stephen G. Post, and Peter J. Whitehouse bring together experts in gerontology, geriatrics, psychiatry, neurology, nursing, ethics, philosophy, public policy, and law to examine the ethical, moral, and policy controversies surrounding dementia. The authors first present background information on dementia and related ethical and policy issues. The remainder of the book is divided into three parts. Part One conveys the difficulties experienced by dementia patients and their caregivers. Part Two deals with ethical and moral issues involved in decisions regarding treatment and care, including the highly controversial subject of euthanasia. Part Three lays out societal choices regarding the allocation of resources for treatment, care, and research on dementia.
In decision-making, health care providers of long-term care regularly face a struggle between moral imperatives, medical technology, and financial considerations. This volume addresses crucial ethical issues, including advance directives (living wills), autonomy of the frail elders, home vs. institutional care, termination of treatment, and comfort care. It also discusses multicultural issues and the treatment of dementia patients. The volume is a vital resource for all long-term care professionals, as well as for academics and students concerned with ethics in health care.
About 4-5 million people in the United States have some degree of dementia, and Alzheimer s is the most common form. This timely new resource gives lawyers the information they need to understand both the law and the emotions of working with a client who has Alzheimer s disease. You'll find valuable information on: The ethics of working with clients with Alzheimer s Health care options and how they affect the patient, the family and spouse The long-term legal outlook, and protecting the family assets and much, much more This ground-breaking book will provide the knowledge you need to answer client questions, and guide them through the arduous journey of dealing with dementia. The book also includes interviews with doctors, a hospice nurse, and the leaders of the Alzheimer s Association."
This concise, introductory handbook discusses the basic principles of medical ethics, and includes practical, realistic guidance on how to evaluate and manage common ethical problems, focusing on the care of elderly patients Typical scenarios faced in clinical practice, such as issues of mental capacity and consent, resuscitation, near death decisions, quality of life, and health care expenditure, are discussed
“In this masterful book, Julian Hughes makes a convincing case that many acts in clinical and care practice are ethical matters. Hughes takes us gently through a jungle of philosophical ideas and explores a series of ethical issues in dementia care, such as diagnosis, covert medication and end of life care. His humanity shines through as he favours a values-based approach to care, and concludes by declaring (in the spirit of Tom Kitwood) that the person must be placed first in order to do what is right and good for people living with dementia. A must-have volume for practitioners, social scientists and enlightened general readers.” Tom Dening, Professor of Dementia Research, School of Medicine, University of Nottingham, UK “This book is totally brilliant. The outstanding author Dr. Julian Hughes must now be considered the foremost ethicist of his generation when it comes to caring for individuals with dementia … This is now the book that everyone who cares about dementia and ethics must read, discuss, and implement. It is a huge contribution.” Stephen G. Post PhD, Director, Center for Medical Humanities, Compassionate Care & Bioethics Stony Brook University School of Medicine, USA “This book should be an essential read for all of us who support and navigate the ethical issues relating to people with dementia and their families.” Paul Edwards, Director of Clinical Services, Dementia UK Ethical issues are involved in every decision that is made in connection with someone living with dementia – from decisions about care and treatment to decisions about research and funding. This book encourages the reader to reconsider ethics in dementia care with the use of ‘patterns of practice’, an innovative idea developed by the author. The book highlights the importance of understanding the person’s narrative, of good communication, high quality care, and expert interpretation of the meaning of situations for people living with dementia. This book: • Reviews ethical theories and approaches in connection with dementia care • Considers issues such as such as stigma, quality of life, personhood, and citizenship in relation to dementia • Looks at issues relevant to research ethics • Presents case vignettes to highlight a complete spectrum of ethical issues that arise in dementia care • Is accessibly written for multiple audiences – from people living with dementia to practitioners Dementia and Ethics Reconsidered is a comprehensive account of thought and practice in relation to ethical issues that arise in the context of dementia care, which seeks to show how ethical thinking can be put into practice and prove relevant to day-to-day experience. The Reconsidering Dementia Series is an interdisciplinary series published by Open University Press that covers contemporary issues to challenge and engage readers in thinking deeply about the topic. The dementia fi eld has developed rapidly in its scope and practice over the past ten years and books in this series will unpack not only what this means for the student, academic and practitioner, but also for all those affected by dementia. Series Editors: Dr Keith Oliver and Professor Dawn Brooker MBE. Julian C. Hughes was a consultant in old age psychiatry. Having trained in both philosophy and medicine, he was appointed honorary professor of philosophy of ageing at Newcastle University, UK and subsequently professor of old age psychiatry at the University of Bristol, UK. He was deputy chair of the Nuffield Council on Bioethics, UK.
Perplexing ethical questions emerge when conducting research involving older adult participants. Fundamental ethical concerns often grappled with include the ability to obtain truly voluntary and competent informed consent, the proper role of surrogate decision making in the research context, and the equitable selection of research subjects. This volume brings to the forefront a discussion of how to encourage essential research specifically designed to benefit older persons while protecting the legal and ethical rights of actual and potential older research participants. Highly qualified and diverse contributors analyze and explain some of the most salient and legal conundrums implicated in the design, conduct, interpretation, and application of research protocols that touch on these problems of aging and the aged.
