Shelton Wayne, Tenenbaum Evelyn, Costello Kevin, Hoffman David
1 Alden March Bioethics Institute, Albany Medical College, Albany, NY, USA.
2 Albany Law School, Alden March Bioethics Institute, Albany, NY, USA.
Am J Alzheimers Dis Other Demen. 2018 Dec 13;34(2):1533317518817614. doi: 10.1177/1533317518817614.
Patients with Alzheimer's disease and other types of dementia with acute medical problems, who have lost capacity and are without advance directives, are at risk of being over treated inhospitals. To deal with this growing demographic and ethical crisis, patients with dementia need to plan for their future medical care while they have capacity to do so. This article will examine the role of each member of the dementia care triad and how to empower the patient to participate in planning future medical care. A case will be made that physicians have the same professional disclosure obligations to dementia patients as they do to all other capable patients with terminal illnesses. Because there is little consensus about what facts should be included in a diagnostic disclosure, this article will offer a proposal to empower newly diagnosed patients with dementia with capacity to plan for their future medical care.
患有阿尔茨海默病及其他伴有急性医疗问题的痴呆症患者,若已丧失行为能力且未制定预先医疗指示,在医院存在接受过度治疗的风险。为应对这一日益增长的人口和伦理危机,痴呆症患者需要在有能力时为自己未来的医疗护理做好规划。本文将探讨痴呆症护理三元组中各成员的角色,以及如何使患者有能力参与未来医疗护理规划。本文将论证,医生对痴呆症患者负有与对所有其他有行为能力的绝症患者相同的专业告知义务。由于对于诊断告知应包含哪些事实几乎没有共识,本文将提出一项建议,以使新诊断出患有痴呆症且有能力的患者能够为自己未来的医疗护理做好规划。