Ethics consultation in patients with behavioral and psychological symptoms of dementia

Author:

Makhinson Michael12,Gomez-Makhinson Juliana12,Jennings Catherine3,Huerta Sergio4ORCID

Affiliation:

1. Department of Psychiatry and Biobehavioral Science, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA

2. Department of Psychiatry, Harbor-UCLA Medical Center, Torrance, CA, USA

3. Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA

4. Ethics Consultation Service, VA North Texas Health Care System, Dallas, TX, USA

Abstract

The increasing age of the patient population around the globe and in the United States has resulted in a growing number of patients with dementia. In this manuscript, we examined the role of the ethics consultation service in patients who have dementia and associated cognitive and neuropsychiatric sequelae. We addressed a particularly challenging case presenting with behavioral and psychological symptoms of dementia. We discussed the ethical questions and challenges considered by the ethics consultation service and compared these with current suggestions and expectations from the research literature regarding the role of ethics consultation service in dementia management. We demonstrated two potentially useful approaches of clinical ethical analysis, the principalist theorem and Jonsen's four quadrants approach. While the number of consults in patients with behavioral and psychological symptoms of dementia is likely to increase in clinical ethics, the role of the ethics consultation service in this cohort of patients still remains to be determined. There are significant gaps in understanding of the ethics consultation service role in dementia management, and much work remains to be undertaken on the part of regulatory and healthcare systems in clarifying their roles, expectations, and competencies.

Publisher

SAGE Publications

Subject

Philosophy,Issues, ethics and legal aspects,Medicine (miscellaneous)

Reference39 articles.

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2. Prince MJ, Wimo A, Guerchet MM, et al. World Alzheimer Report 2015-The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends. 2015.

3. Discharging to the Street: When Patients Refuse Medically Safer Options

4. Management of Behavioral and Psychological Symptoms of Dementia

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