Dementia and end-of-life decisions : the Hastings Center is going to examine the question


Thematic : End of life / Mental Health

News - United States

Published on : 19/06/2019

Author / Source : The Hastings Center, National Institute in Aging

The senior population in the United States is growing, and as such, so is the number of cases of dementia. When a person has dementia, they experience the progressive impairment of cognitive facilities, including memory, problem solving and language. There is no cure yet for dementia and there is no effective way to halt its progression. As the condition progresses, the affected person requires daily assistance and eventually total care. Because dementia causes a loss of many cognitive capabilities, loss of ability to make decisions has caused discussion surrounding end-of-life and dementia. The Hastings Center, based in Garrison, New York, is going to conduct research into end-of-life practices for patients with dementia.

In the United States, a person has the right to refuse treatment. In most cases, this person must be able to make this decision on their own. People who have received a diagnosis of a degenerative disease, such as dementia, and who will lose their decision-making capacity, have the same right to refuse treatment through an advance directive or a surrogate decision maker. Many believe that this provides a lack of full reflection for patients with dementia because of the complexity of the disease. At different stages of the disease, it is difficult to determine the patient's level of competency in making their own decisions, and the possibility of a differing attitude is possible. Therefore, the established criteria for refusal of treatment decisions do not fully address the cases of many persons facing dementia.

Because there is a lack of full reflection on dementia cases, the Hastings Center will conduct research into the ethics of end-of-life choices in the context of dementia. The purpose of this research is to identify areas where additional research or policymaking is necessary. The report will be published in 2021.

A similar observation made Prof.dr. Robbert Huijsman bring together in a freely available book the academic and bibliographic profiles of all Dutch professors specializing in the study of dementia. With this book, he hopes to allow the experts to share their work so they could "give a direction to the understanding of the beginning and the progress of the disease, and possible solutions for the care of the dementia patients". At a time when voices are being heard in Belgium and Canada to allow the euthanasia of demented people, such research is very important and deserves to be relayed broadly.

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