Viewing dementia as a distinct disease promotes funding for research but may stigmatize those who have dementia and lead to disinvestment in caregiving.
Meera Balasubramaniam, MD, MPH and Yesne Alici, MD
A 15-year-old advance directive made when the patient was in much better health and not updated can bring more confusion than clarity to the decision-making process.
A 15-year-old advance directive made when the patient was in much better health and not updated can bring more confusion than clarity to the decision-making process.
Jalayne J. Arias, JD, MA and Kathryn L. Weise, MD, MA
Even when external factors such as nonaccidental injury weigh heavily on clinicians' perceptions, they should not lose focus on the patient's best interest when deciding whether to continue or withdraw treatment.
Informed assent, in which the family or surrogate decision makers for a patient are invited to defer to clinicians' judgment rather than specifically consenting to withholding or withdrawing futile treatments, is consistent with quality care and may protect surrogates from feeling responsible for the patient’s death.
Because maintaining strict confidentiality is often untenable, or even illegal, determining the extent of protections in the postmortem context ultimately entails a weighing of the various interests at stake.
By failing to follow informed consent protocols and regulations, a researcher engaging in CBPR may inflict permanent harm on the participating community and chill future research among disadvantaged populations.