Addressing the Ethical, Legal, and Social Issues Raised by Voting by Persons With Dementia
Karlawish, Jason H.
Bonnie, Richard J.
Appelbaum, Paul S.
Kane, Rosalie A.
Karlan, Pamela S.
JAMA: The Journal of the American Medical Association 2004 September 15; 292(11): 1345-1350
This article addresses an emerging policy problem in the United States participation in the electoral process by citizens with dementia. At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be precluded from or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud. Three subsidiary issues warrant special attention: development of a method to assess capacity to vote; identification of appropriate kinds of assistance to enable persons with cognitive impairment to vote; and formulation of uniform and workable policies for voting in long-term care settings. In some instances, extrapolation from existing policies and research permits reasonable recommendations to guide policy and practice. However, in other instances, additional research is necessary.
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