Abstract
A comprehensive discussion of the ethics of caring for persons with the syndrome of dementia must be attentive to key issues that arise following the course of the underlying causative disease, which is most likely to be Alzheimer disease (AD). This analysis will therefore focus upon the progressive course of AD, although what is discussed pertains to dementia generally. Ethical issues beginning with prevention and diagnosis and concluding with a good dying are considered. A chronologically ordered discussion of these issues over the course of AD provides a practically useful framework.
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References
Alzheimer’s Disease and Related Disorders Association. 1997a. Ethical considerations — issues in death and dying. Chicago: Alzheimer’s Disease and Related Disorders Association.
Alzheimer’s Disease and Related Disorders Association. 1997b. Ethical considerations — issues in diagnostic disclosure. Chicago, Alzheimer’s Disease and Related Disorders Association.
Billings, J.A. 1985. Comfort measures for the terminally ill: Is dehydration painful? Journal of the American Geriatrics Society 33: 808–10.
Butler, R. 1994. ApoE: new risk factor for Alzheimer’s. Geriatrics 49: 10–1.
Dresser, R. 1994. Missing persons: Legal perceptions of incompetent patients. Rutgers Law Review 46 (2): 609–719.
Ferris, S.H., G.T. Hofeldt, G. Carbone, P. Masciandaro, W.M. Troetel, B.P. Imbimbo. 1999. Suicide in two patients with a diagnosis of probable Alzheimer disease. Alzheimer’s Disease and Related Disorders Association 13 (2): 88–90.
Finucane, T.E. 1995. Malnutrition, tube feeding and pressure sores: Data are incomplete. Journal of the American Geriatrics Society 43: 447–51.
Finucane, T.E., C. Christmas, and K. Travis K. 1999. Tube feeding in patients with advanced dementia: A review of the evidence. JAMA 282: 1365–70.
Foley, J.M., and S.G. Post. 1994. Ethical issues in dementia. In Handbook of dementing illnesses, ed. J.C. Moms, 3–22. New York, Marcel Dekker.
Gjerdingen, D.K., J.A. Neff, M. Wang, and K. Chaloner. 1999. Older persons’ opinions about life-sustaining procedures in the face of dementia. Archives of Family Medicine 8: 421–5.
Hodges, M.O., and S.W. Tolle. 1994. Tube feeding decisions in the elderly. Clinics in Geriatrics 10: 47588.
Kitwood, T. 1997. Dementia reconsidered: The persons comes first. Buckingham, England: Open University Press.
Klepper, H., and M. Rorty. 1999. Personal identity, advance directives, and genetic testing for Alzheimer disease. Genetic Testing 3 (1): 99–106.
Mitchell, S.L., D.K. Kiely, and L.A. Lipsitz. 1997. The risk factors and impact survival of feeding tube placement in nursing home residents with severe cognitive impairment. Archives of Internal Medicine 157: 327–32.
O’Brien, L.A., J.A. Grisso, G. Maislin, K. LaPann, K.P. Krotki, P.J. Greco, E.A. Siegert, and L.K. Evans. 1995. Nursing home residents’ preferences for life-sustaining treatments. JAMA 274: 1775–9.
Ouslander, J.G., A.J. Tymchuk, and M.D. Krynski. 1993. Decisions about enteral tube feeding among the elderly. Journal of the American Geriatrics Society 41: 70–7.
Post, S.G. 1995. Alzheimer disease and the “then” self. Kennedy Institute of Ethics 5 (4): 307–21.
Post, S.G. 1997a. Physician-assisted suicide in Alzheimer disease. Journal of the American Geriatrics Society 45: 647–51.
Post, S.G. 1997b. Slowing the progression of Alzheimer disease: ethical issues. Alzheimer’s Disease and Related Disorders Association 11 (5): 34–6.
Post, S.G. 2000. The moral challenge of Alzheimer disease: Ethical issues from diagnosis to dying. 2d ed. Baltimore: The Johns Hopkins University Press.
Post, S.G., and P.J. Whitehouse. 1998. Emerging anti-dementia drugs: A preliminary ethical view. Journal of the American Geriatrics Society 46: 784–7.
Post, S.G., P.J. Whitehouse, R.H. Binstock, et al. 1997. The clinical introduction of genetic testing for Alzheimer disease: An ethical perspective. JAMA 277: 832–6.
Printz, L.A. 1992. Terminal dehydration, a compassionate treatment. Archives of Internal Medicine 152: 697–700.
Sano, M., C. Emesto, R.G. Thomas, et al. 1997. A controlled trial of selegiline, alpha-tocopherol, or both as treatment for Alzheimer’s disease. New England Journal of Medicine 336: 1216–22.
Sullivan, R.J. 1993. Accepting death without artificial nutrition or hydration. Journal of General Internal Medicine 8: 220–4.
Volicer, L. 1993. Vignette on enteral feeding (letter). Journal of the American Geriatrics Society 41: 688.
Volicer, L., and A. Hurley. 1998. Hospice care for patients with advanced progressive dementia. New York: Springer.
Zerwekh, J.V. 1983. The dehydration question. Nursing 83: 47–51.
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Post, S.G. (2001). Dementia Care Ethics. In: Weisstub, D.N., Thomasma, D.C., Gauthier, S., Tomossy, G.F. (eds) Aging: Caring for Our Elders. International Library of Ethics, Law, and the New Medicine, vol 11. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-0675-9_11
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DOI: https://doi.org/10.1007/978-94-017-0675-9_11
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