ETHICAL FOUNDATIONS OF PALLIATIVE CARE FOR ALZHEIMER DISEASE
Ruth B. Purtilo and Henk A.M.J. ten Have (Eds)
Johns Hopkins University Press, 2004
368 pp
ISBN 0-8018-7870-5
RRP $US49.95, £35.50
More Info & Purchase
Dementia challenges all of the principles upon which Western medical ethics is based. This thoughtful collection of essays by leading clinicians, ethicists, philosophers, and theologians from North America and Europe was more than five years in the making. First, the editors initiated a dialogue that lasted for at three years, following which each contributor’s essay was critiqued at a meeting in the Netherlands in 2001, after which the dialogue was continued for another two years before the final submissions were peer-reviewed.
The book is divided into six sections, which cover the clinical, philosophical, theological, ethical, organisational, and research aspects of dementia. Some of the contributions have more questions than answers, although I was pleased to note that the contributor from The Netherlands who wrote the chapter on Alzheimer disease and euthanasia concluded that ‘euthanasia cannot be convincingly ethically justified in the treatment of persons with Alzheimer disease.’
This book will be useful and thought-provoking to anyone involved in the fields of dementia care, palliative care and bioethics.
Roger Woodruff,
Director Palliative Care, Austin Health, Melbourne Australia
(July 2005)
Author Information
Ruth B. Purtilo is Professor and Director, Center for Health Policy and Ethics, Creighton University Medical Centre, Omaha, Nebraska, USA
Henk A.M.J. ten Have is Professor of Medical Ethics, University Medical Centre, Nijmegen, The Netherlands.
Table of Contents
Part I – The Healthcare Challenge of Alzheimer’s Disease: Basic Societal, Pathological, and Clinical Issues
Darkness Commeth: Personal, Social and Economic Burdens of Alzheimer Disease
Neuropathology and Symptomatology in Alzheimer Disease: Implications for Care Giving and Competence
The Clinical Challenge of Uncertain Diagnosis and Prognosis in Patients with Dementia
Part II – European Voices on USA and European Models of Palliative Care
Expanding the Scope of Palliative Care
Hospital-based Palliative Care and Dementia, or what do we treat patients for and how do we do it?
Elderly Persons with Advanced Dementia: An Opportunity for a Palliative Culture in Medicine
Part III – Philosophical and Theological Explorations
Autonomy and the Lived Body in Cases of Severe Dementia
The Moral Self as Patient
The Practice of Palliative Care and the Theory of Medical Ethics: Alzheimer Disease as an Example
Part IV – Clinical Ethics Issues: Focus on Patients and Care Givers
The Tendency of Contemporary Decision-Making Strategies to Deny the Condition of Alzheimer Disease
Advanced Directives and End-of-Life Decision-Making in Alzheimer Disease: Practical Challenges
Saying No to Patients with Alzheimer Disease: Re-thinking Relations Among Personhood, Autonomy and World
The Ethical Challenge of Treating Pain in Alzheimer Disease: A Dental Case
Alzheimer Disease and Euthanasia.
Part V – Organisational Ethics Issues: Educational Initiatives, Laws and Allocation Decisions
The Role of Nurses and Nursing Education in the Palliative Care of Patients and Their Families
Ethical Dimensions of Alzheimer Disease Decision-Making: The Need for Early Patient and Family Education
Changing Patterns for Protection and Care for Incapacitated Adults: Perspectives from a European Society in Transition
Social Marginalisation of Persons with Disability: Justice Considerations for Alzheimer Disease
Part VI – Research Underpinnings for an Ethical Model of Palliative Care
Biomedical Research in Alzheimer Disease
Conducting Research in the Alzheimer Disease Population: Balancing Individual, Group, Family, and Societal Interests
Drugs and Dementia: Pharmacotherapy and Decision-Making by Primary Care Givers
Index
