Physicians’ Characteristics and Attitudes Towards Medically Assisted Dying for Non-Competent Patients with Dementia

Bravo, Gina; Trottier, Lise; Arcand, Marcel

doi:10.1017/s0714980821000088

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…There are many unanswered questions regarding how attitudes correlate with actual practice, how utilization patterns shift and change over time, how permissive jurisdictions compare, experiences with MAID among historically marginalized groups, and the extent to which access barriers limit opportunities for MAID. Among the next frontiers for further social scientific analysis are investigations concerning the availability of MAID to people with dementia, psychiatric conditions, or those who are just tired of living (Bolt et al 2015, Bravo et al 2022, Dekker 2021. Researchers considering venturing into this space should be forewarned of the high political and ethical stakes of working in this area.…”

Section: Discussionmentioning

confidence: 99%

Medical Aid in Dying: New Frontiers in Medicine, Law, and Culture

Buchbinder

Cain

2023

Annu. Rev. Law. Soc. Sci.

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Medical aid in dying (MAID) has been a productive target for social scientific inquiry at the intersections of law and medicine over the past two decades. Insofar as MAID crystallizes and reflects personal and cultural understandings of key concepts such as individualism, dependency, dignity, and care, it is a rich site for social scientific theorizing. This article reviews and assesses the contributions of social scientific perspectives to research on MAID. We propose that social scientific research on MAID offers four distinctive contributions: its descriptive (rather than normative) orientation, its focus on cultural meanings, its insights into processes of knowledge production, and its comparative lens. The article's major sections describe ( a) attitudes toward MAID, ( b) MAID-related social movements, ( c) legalization approaches, and ( d) lived experiences of MAID in permissive jurisdictions. We conclude by reflecting on how MAID scholarship can inform social inquiry into other areas in which law and medicine converge. Expected final online publication date for the Annual Review of Law and Social Science, Volume 19 is October 2023. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

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Section: Discussionmentioning

confidence: 99%

Medical Aid in Dying: New Frontiers in Medicine, Law, and Culture

Buchbinder

Cain

2023

Annu. Rev. Law. Soc. Sci.

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“…34 As the need for palliative care increases, this research supports the critical nature of these conversations in developing and understanding clinical and social interventions. 35 Additionally, patient-centered care offers holistic approaches to care extending beyond symptom-based approaches and considers people in their context. It is with patient-centered approaches that bring about positive experiences and patient and caregiver well-being.…”

Section: Discussionmentioning

confidence: 99%

The Social Construction of Dementia: Implications for Healthcare Experiences of Caregivers and People Living with Dementia

Farhana,

Peckham,

Marani

et al. 2023

Journal of Patient Experience

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Globally, systems have invested in a variety of dementia care programs in response to the aging population and those who have been diagnosed with dementia. This study is a qualitative secondary analysis of interview data from a larger study investigating stakeholder perceptions of programs that support caregivers and people living with an Alzheimer's Disease or Alzheimer's Disease-related dementia (AD/ADRD) in five North American jurisdictions. This study analyzed interviews with individuals living with an AD/ADRD and caregivers of individuals living with an AD/ADRD (n = 11). Thematic analysis was conducted to understand how the perception of dementia may have shaped their engagement and experience with healthcare systems. Our analysis resulted in three main themes of care users’ experience: (i) undesirable experience owing to the overarching negative shared understanding and stereotyping of dementia; (ii) dismissal throughout disease progression when seeking health and social care support; and (iii) dehumanization during care interactions. The findings carry critical social and clinical implications, for example, in informing person-centered approaches to care, and communication tools clinicians can use to enhance provider, patient, and caregiver well-being.

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“…Consensus among experts regarding the value of PAS for dementia, and the feasibility of safeguards against abuse of this practice, is relatively easy to obtain ( Dehkhoda et al, 2021 ). On the other hand, disagreements and disapprovals of this practice among physicians and the general public, who are more aware of concrete realities and of the illusory nature of these safeguards, have been well documented across several settings and countries ( Owen et al, 2001 ; Pereira, 2011 ; Wicher and Meeker, 2012 ; Alsolamy, 2014 ; van Wijmen et al, 2015 ; Cohen-Mansfield and Brill, 2020 ; Bravo et al, 2021 ; Schuurmans et al, 2021 ). A recent systematic review of studies of older adults underlined this lack of consensus, with only a minority consistently expressing acceptance of PAS, and a significant influence of age, religiosity, education and socio-economic status ( Castelli Dransart et al, 2021 ).…”

Section: Additional Arguments That Require Consideration When Considering Pas In Dementiamentioning

confidence: 99%

Physician-Assisted Suicide in Dementia: Paradoxes, Pitfalls and the Need for Prudence

Rajkumar

2021

Front. Sociol.

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There has been an increasing drive towards the legalization of physician-assisted suicide (PAS) in patients with dementia, particularly in patients with advanced disease and severe cognitive impairment. Advocacy for this position is often based on utilitarian philosophical principles, on appeals to the quality of life of the patient and their caregiver(s), or on economic constraints faced by caregivers as well as healthcare systems. In this paper, two lines of evidence against this position are presented. First, data on attitudes towards euthanasia for twenty-eight countries, obtained from the World Values Survey, is analyzed. An examination of this data shows that, paradoxically, positive attitudes towards this procedure are found in more economically advanced countries, and are strongly associated with specific cultural factors. Second, the literature on existing attitudes towards PAS in cases of dementia, along with ethical arguments for and against the practice, is reviewed and specific hazards for patients, caregivers and healthcare professionals are identified. On the basis of these findings, the author suggests that the practice of PAS in dementia is not one that can be widely or safely endorsed, on both cultural and ethical grounds. Instead, the medical field should work in collaboration with governmental, social welfare and patient advocacy services to ensure optimal physical, emotional and financial support to this group of patients and their caregivers.

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Physicians’ Characteristics and Attitudes Towards Medically Assisted Dying for Non-Competent Patients with Dementia

Cited by 4 publications

References 21 publications

Medical Aid in Dying: New Frontiers in Medicine, Law, and Culture

Medical Aid in Dying: New Frontiers in Medicine, Law, and Culture

The Social Construction of Dementia: Implications for Healthcare Experiences of Caregivers and People Living with Dementia

Physician-Assisted Suicide in Dementia: Paradoxes, Pitfalls and the Need for Prudence

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