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Dementia in Our Midst: The Moral Community

Published online by Cambridge University Press:  29 July 2009

Stephen G. Post
Stephen G. Post
Affiliation:
Associate Professor of Biomedical Ethics and Associate Professor of Religion and Philosophy in the Center for Biomedical Ethics, Case Western Reserve University School of Medicine, Cleveland, Ohio
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Extract

This article focuses on the elderly patient with a progressive and irreversible dementia, most often of the Alzheimer type. However dementia, the decline in mental function from a previous state, can occur in all ages. For example, if Alzheimer's disease (AD) is the dementia of the elderly, increasingly AIDS is the dementia of many who are relatively young. I will not present the major ethical issues relating to dementia care following the progression of disease from the mild to the severe stages, for I have done this elsewhere. Among the issues included are: presymptomatic testing, both psychological and genetic; responsible diag- nostic disclosure and use of support groups; restrictions on driving and other activities; preemptive assisted suicide; advance directives for research and treatment; quality of life in relation to the use of life-extending technologies; and euthanasia.

Type
Special Section: Elder Ethics
Information
Cambridge Quarterly of Healthcare Ethics , Volume 4 , Issue 2 , Spring 1995 , pp. 142 - 147
Copyright
Copyright © Cambridge University Press 1995

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References

Notes

1. Post, SG. Alzheimer's disease: Ethics and the progression of dementia. Clinics in Geriatric Medicine 1994;10:379–94.Google Scholar

2. Hauerwas, S. Suffering Presence: Theological Reflections on Medicine, the Church, and the Mentally Handicapped. Notre Dame: University of Notre Dame Press, 1986:162.Google Scholar

3. See note 2. Hauerwas, . 1986:176.Google Scholar

4. See note 2. Hauerwas, . 1986:178.Google Scholar

5. Swift, J. Gulliver's Travels. Garden City, New York: Doubleday, 1945:214–6.Google Scholar

6. U.S. Office of Technology Assessment. Special Care Units for People with Alzheimer's and Other Dementias. Washington, D.C.: U.S. Government Printing Office, 1992:17–21.Google Scholar

7. David, KL, Thall, LJ, Gamzu, ER, et al. A double-blind, placebo-controlled multicenter study of Tacrine for Alzheimer's disease. New England Journal of Medicine 1992;327:1253–9.Google Scholar This study indicates statis- tically significant reduction in decline of cognitive function, but undetected reduction in physicians’ global assessment of patients. In contrast, Farlow, M, Gracon, SI, Hershey, LA, et al. A controlled trial of Tacrine in Alzheimer's disease. Journal of the American Medical Association 1992;268:2523–9. This study suggests improvement in global assessment.CrossRefGoogle ScholarPubMed

8. Podolsky, D. New drugs for once unyielding diseases. U. S. News & World Report 1992;05 10:67–8.Google Scholar