Advance Directives for Euthanasia in Dementia: How Do They Affect Resident Care in Dutch Nursing Homes? Experiences of Physicians and Relatives

Boer, M.E. de; Dröes, Rose-Marie; Jonker, Cees; Eefsting, Jan A.; Hertogh, Cees M.P.M.

doi:10.1111/j.1532-5415.2011.03414.x

Cited by 63 publications

(84 citation statements)

References 9 publications

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“…From the response concerning the applicability of advance directives it is possible to suggest that some physicians seem to lack knowledge, especially regarding the applicability of advance directives and euthanasia in dementia. Some physicians see the advance directive only as a helpful document, as also reported in earlier research 1 3 12. Although the law provides a possibility to act, based solely on an advance directive, several reasons have been identified in literature why physicians seldom do.…”

Section: Discussionmentioning

confidence: 62%

“…In a society where information concerning euthanasia is widely available we suggest that a physician, although not bound to reach the desired point but advised to refer when necessary, should consider it his job to talk about options at the end of life. Nevertheless, it is clear that a patient with such a request sometimes has difficulty finding a physician 3 8 12 13. Thus, even when the law only affirms the physician's obligation to inform about the prospects of the disease, and recognises the conflict of duties, we argue that a physician could have a moral obligation to re-evaluate his opinion about euthanasia or PAS and his response to patients asking for it.…”

Section: Discussionmentioning

confidence: 86%

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A plea for end-of-life discussions with patients suffering from Huntington's disease: the role of the physician

Booij

Engberts²,

Rödig

et al. 2012

J Med Ethics

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Euthanasia and physician-assisted suicide (PAS) by request and/or based on an advance directive are legal in The Netherlands under strict conditions, thus providing options for patients with Huntington's disease (HD) and other neurodegenerative diseases to stay in control and choose their end of life. HD is an inherited progressive disease characterised by chorea and hypokinesia, psychiatric symptoms and dementia. From a qualitative study based on interviews with 15 physicians experienced in treating HD, several ethical issues emerged. Consideration of these aspects leads to a discussion about the professional role of a physician in relation to the personal autonomy of a patient. Such a discussion can raise awareness that talking about end-of-life wishes with an HD patient is part of the legal, professional and moral responsibility of the physician, and that a letter of intent on behalf of the physician can improve active participation in the process. Discussion of these issues can help to advance the debate on euthanasia and PAS in HD and other neurodegenerative diseases.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 86%

A plea for end-of-life discussions with patients suffering from Huntington's disease: the role of the physician

Booij

Engberts²,

Rödig

et al. 2012

J Med Ethics

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show abstract

“…In The Netherlands, where ADs are advisory, rather than legally mandated, and where physician-assisted dying is legal, it can be requested as part of an AD-meaning that people do not have to wait for untreated infection or disease to end their lives. Evidence suggests, however, that both physicians and family members are reluctant to comply with ADs requesting physician-assisted death in such cases (de Boer, Droes, Jonker, Eeefsting, & Hertogh, 2011; for an overview see also Lewis and Black, 2013).…”

Section: Prospective Decision-making: Advance Decisionsmentioning

confidence: 98%

X. Refusing to live with advanced dementia: Contemporaneous and prospective decision-making

Wilkinson

2015

Feminism & Psychology

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Two-thirds of those diagnosed with Alzheimer's disease and other dementias are women, predominantly older women. Current estimates are that 600,000 women in the UK (Alzheimer's Society, 2013) and 3.2 million women in the USA (Alzheimer's Association, 2014) are living with diagnosed dementia-and the figures are rising as life expectancy rises. It is likely that the situation is the same across the world but many countries do not have the resources to make or record such medical diagnoses-and dementia charities suggest that even in the industrialized west around half of those with dementia remain undiagnosed (Alzheimer's Association, 2014; Alzheimer's Society, 2013).A person in the USA with Alzheimer's will spend 40% of their post-diagnosis life in the most severe stage of the disease -and most informal (i.e. unpaid) carers are women (Alzheimer's Association, 2014). The majority of these carers report ''high'' or ''very high'' levels of emotional and/or physical stress due to caregiving, as well as concerns about their own mental and physical health (Alzheimer's Association, 2014). The predominance of women both as dementia patients and as carers for people with dementia means that living with dementia is a feminist

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“…Même lorsque l'on en tient compte, comme aux Pays-Bas, elles sont rarement appliquées. Comme le concluait une étude : « les directives anticipées pour l'euthanasie ne sont jamais suivies aux Pays-Bas dans le cas des gens présentant une démence au stade avancé » (De Boer et al 2011). Lorsque, dans de rares cas, les directives anticipées ont été suivies, cela a provoqué des tollés (Euthanasia s.d.…”

Section: Paul 9 Février 2015 Ottawaunclassified

Mourir comme mode de vie

Gandsman

Herington

Przybylak-Brouillard

et al. 2017

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On considère que le droit de mourir, en tant que mouvement social contemporain d’importance, s’est constitué en réaction aux interventions biomédicales préoccupantes qui cherchent à prolonger la vie à tout prix. Cependant, l’aide médicale à mourir est elle aussi une intervention biomédicale reposant sur des technologies biomédicales et qui se fonde sur le langage de la technique biomédicale. Bien que les partisans du droit de mourir aient souvent recours à ce langage dans l’énoncé de leurs arguments, une écoute attentive des voix de ces activistes permet de nuancer et d’affiner l’approche des aspects contradictoires et multiples de cette expérience. La façon dont ils parlent de la mort révèle des préoccupations implicites se rapprochant davantage des notions heideggériennes de « l’art » et un prolongement des anciennes conceptions de « l’art de mourir ». Acceptant l’inéluctabilité de la mort, ou de vivre de façon à être vers la mort, les activistes se soucient souvent bien davantage de l’art de vivre et de mourir que de technique biomédicale.

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Advance Directives for Euthanasia in Dementia: How Do They Affect Resident Care in Dutch Nursing Homes? Experiences of Physicians and Relatives

Cited by 63 publications

References 9 publications

A plea for end-of-life discussions with patients suffering from Huntington's disease: the role of the physician

A plea for end-of-life discussions with patients suffering from Huntington's disease: the role of the physician

X. Refusing to live with advanced dementia: Contemporaneous and prospective decision-making

Mourir comme mode de vie

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