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dc.creatorHertogh, Cees M.P.M.en
dc.date.accessioned2016-01-08T23:09:10Zen
dc.date.available2016-01-08T23:09:10Zen
dc.date.created2009-02en
dc.date.issued2009-02en
dc.identifierdoi:10.1136/jme.2007.024109en
dc.identifier.bibliographicCitationJournal of Medical Ethics 2009 February; 35(2): 100-103en
dc.identifier.urihttp://worldcatlibraries.org/registry/gateway?version=1.0&url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&atitle=The+role+of+advance+euthanasia+directives+as+an+aid+to+communication+and+shared+decision-making+in+dementia.&title=Journal+of+Medical+Ethics+&volume=35&issue=2&date=2009-02&au=Hertogh,+Cees+M.P.M.en
dc.identifier.urihttp://dx.doi.org/10.1136/jme.2007.024109en
dc.identifier.urihttp://hdl.handle.net/10822/951862en
dc.description.abstractRecent evaluation of the practice of euthanasia and related medical decisions at the end of life in the Netherlands has shown a slight decrease in the frequency of physician-assisted death since the enactment of the Euthanasia Law in 2002. This paper focuses on the absence of euthanasia cases concerning patients with dementia and a written advance euthanasia directive, despite the fact that the only real innovation of the Euthanasia Law consisted precisely in allowing physicians to act upon such directives. The author discusses two principal reasons for this absence. One relates to the uncertainty about whether patients with advanced dementia truly experience the suffering they formerly feared. There is reason to assume that they don't, as a consequence of psychological adaptation and progressive unawareness (anosognosia). The second, more fundamental reason touches upon the ethical relevance of shared understanding and reciprocity. The author argues that, next to autonomy and mercifulness, "reciprocity" is a condition sine qua non for euthanasia. The absence thereof in advanced dementia renders euthanasia morally inconceivable, even if there are signs of suffering and notwithstanding the presence of an advance euthanasia directive. This does not mean, however, that advance euthanasia directives of patients with dementia are worthless. They might very well have a role in the earlier stages of certain subtypes of the disease. To illustrate this point the author presents a case in which the advance directive helped to create a window of opportunity for reciprocity and shared decision-making.en
dc.formatArticleen
dc.languageenen
dc.sourceeweb:323414en
dc.subjectAutonomyen
dc.subjectCommunicationen
dc.subjectDeathen
dc.subjectDementiaen
dc.subjectDiseaseen
dc.subjectEuthanasiaen
dc.subjectEvaluationen
dc.subjectLawen
dc.subjectLifeen
dc.subjectPatientsen
dc.subjectPhysiciansen
dc.subjectSufferingen
dc.subjectUncertaintyen
dc.subject.classificationProlongation of Life and Euthanasiaen
dc.subject.classificationLiving Wills / Advance Directivesen
dc.subject.classificationHealth Care for Mentally Disabled Personsen
dc.titleThe Role of Advance Euthanasia Directives as an Aid to Communication and Shared Decision-Making in Dementiaen
dc.provenanceCitation prepared by the Library and Information Services group of the Kennedy Institute of Ethics, Georgetown University for the ETHXWeb database.en
dc.provenanceCitation migrated from OpenText LiveLink Discovery Server database named EWEB hosted by the Bioethics Research Library to the DSpace collection EthxWeb hosted by DigitalGeorgetown.en


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