Ethical and legal aspects of dementia.

Medical ethical dilemmas regarding life-sustaining treatment in elderly and demented patients are becoming increasingly commonplace and complex. In dealing with these situations, health care providers must ensure that a patient's rights are balanced against society's needs. To help medical professionals understand these issues, the authors describe the distinction between substantive standards and procedural guidelines as well as the interrelationship between the two. It is only when careful procedural steps are followed after thoughtful consideration is given to the substantive issues that termination of treatment decisions will be made in the best possible context.