Dementia medical test rules slammed in Germany

DW, 2 June 2016
Source: Deutsche Welle
“Amendments to Germany’s Medicines Act planned by Health Minister would allow clinical testing if prior to the onset of dementia the person had signed a consent form. The draft German law has been slammed by former Health Minister Ulla Schmidt as “highly dangerous.” Clinical testing is a highly sensitive topic in Germany because of murderous experiments conducted during Hitler’s 12-year Nazi regime. The legislative change stems from a modernized EU regulation.”
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First Do No Harm: Euthanasia of Patients with Dementia in Belgium

J Med Philos published 8 December 2015, 10.1093/jmp/jhv031
Author: Raphael Cohen-Almagor
“Euthanasia in Belgium is not limited to terminally ill patients. It may be applied to patients with chronic degenerative diseases. Currently, people in Belgium wish to make it possible to euthanize incompetent patients who suffer from dementia. This article explains the Belgian law and then explores arguments for and against euthanasia of patients with dementia. It probes the dementia paradox by elucidating Dworkin’s distinction between critical and experiential interests, arguing that at the end-of-life this distinction is not clearcut.”
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A Study of the First Year of the End-of-Life Clinic for Physician-Assisted Dying in the Netherlands

Authors: Marianne C. Snijdewind, MA; Dick L. Willems, MD, PhD; Luc Deliens, PhD; Bregje D. Onwuteaka-Philipsen, PhD; Kenneth Chambaere, PhD
JAMA Intern Med. Published online August 10, 2015. doi:10.1001/jamainternmed.2015.3978
Importance  Right to Die NL, an organization in the Netherlands that advocates for the option of euthanasia, founded the End-of-Life Clinic in 2012 to provide euthanasia or physician-assisted suicide for patients who meet all legal requirements but whose regular physicians rejected their request. Many patients whose requests are rejected have less common situations, such as a psychiatric or psychological condition, dementia, or being tired of living.  Objective  To study outcomes of requests for euthanasia or physician-assisted suicide received by the clinic and factors associated with granting or rejecting requests.”
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Beyond the “Silver Tsunami”: Toward an Ethic for Aging Societies

Bioethics Forum, 21 July 2015
Author: Nancy Berlinger
“Singapore is the fastest-aging society in the world. Being ranked number one is usually a matter of local pride, but in this case, it means that this highly developed city-state of 5.5 million is ahead of other nations in grappling with the reality that if your society is aging, it includes a lot of people facing dementia. Our team, led by Singaporean bioethics scholar Jacqueline Chin, has begun these discussions with local physicians, nurses, social workers, program administrators, and policy-makers as background for the second edition of the Singapore Casebook, which will focus on the ethics of care transitions in aging societies.”
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Can physicians conceive of performing euthanasia in case of psychiatric disease, dementia or being tired of living?

J Med Ethics doi:10.1136/medethics-2014-102150
Authors:  Eva Elizabeth Bolt, Marianne C Snijdewind, Dick L Willems, Agnes van der Heide, Bregje D Onwuteaka-Philipsen
Background Euthanasia and physician-assisted suicide (EAS) in patients with psychiatric disease, dementia or patients who are tired of living (without severe morbidity) is highly controversial. Although such cases can fall under the Dutch Euthanasia Act, Dutch physicians seem reluctant to perform EAS, and it is not clear whether or not physicians reject the possibility of EAS in these cases.”
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Complexities of Choosing an End Game for Dementia

NYT Health, 19 January 2015
Author: Paula Span
“Jerome Medalie keeps his advance directive hanging in a plastic sleeve in his front hall closet, as his retirement community recommends. That’s where the paramedics will look if someone calls 911. Like many such documents, it declares that if he is terminally ill, he declines cardiopulmonary resuscitation, a ventilator and a feeding tube. But Mr. Medalie’s directive also specifies something more unusual: If he develops Alzheimer’s disease or another form of dementia, he refuses “ordinary means of nutrition and hydration.”
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Patchy dementia care puts patients at risk of unnecessary suffering, says CQC

The Guardian, 13 October 2014
Author: Haroon Siddique
“Nine out of 10 care homes and hospitals in England have aspects of care for people with dementia that are variable or poor, making those with the condition likely to receive substandard treatment at some point, according to an important review by the NHS regulator.”
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Dementia: a false promise

The Lancet, Volume 384, Issue 9948, Page 1072, 20 September 2014
“On Sept 11—12, 2014, the pharmaceutical and biotechnology industries met with academics and politicians at Global Action Against Dementia, an event hosted by Canada and France. Following on from the 2013 G8 Summit on Dementia—which set an ambitious goal to find a dementia cure by 2025—their focus was to maximise “academia—industry synergies”. Yet, in the same week, researchers from King’s College London and the London School of Economics emphasised the reality on the ground for people living with dementia.”
Find editorial here.

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