Ethical questions in the treatment of subjects with dementia. Part I. Respecting autonomy: Awareness, competence and behavioural disorders

Neurological Sciences

Volumn 28, Issue 4, 2007, Pages 216-231

  Defanti, Carlo A ^a   Tiezzi, A ^b   Gasparini, M ^c,d   Congedo, M ^e   Tiraboschi, P ^f   Tarquini, D ^g   Pucci, E ^h   Porteri, C ⁱ   Bonito, V ^j   Sacco, L ^j   Stefanini, S ^a   Borghi, L ^k   Colombi, L ^j   Marcello, N ^l   Zanetti, O ⁱ   Causarano, R ^m   Primavera, A ⁿ  

^a Ospedale Briolini   (Italy)

^b IRCCS POLICLINICO SAN DONATO   (Italy)

^c AO Niguarda Ca' Granda   (Italy)

^d Ospedale Marzana   (Italy)

^e ASS 5 Bassa Friulana   (Italy)

^f OSPEDALE NIGUARDA CA GRANDA   (Italy)

^g San Giacomo Hospital   (Italy)

^h Ospedale Generale   (Italy)

ⁱ IRCCS ISTITUTO CENTRO SAN GIOVANNI DI DIO FATEBENEFRATELLI   (Italy)

^j OSPEDALI RIUNITI   (Italy)

^k Fondazione Rui   (Italy)

^l Neurologia   (Italy)

^m Neurologia   (Italy)

ⁿ UNIVERSITY OF GENOA   (Italy)

more..

Author keywords

Awareness; Behavioral and psychological disorders of dementia (BPSD); Competence; Dementia

Indexed keywords

NEUROLEPTIC AGENT; PSYCHOTROPIC AGENT;

ALZHEIMER DISEASE; ARTICLE; AWARENESS; BEHAVIOR DISORDER; COGNITIVE DEFECT; COMPETENCE; CONCEPTUAL FRAMEWORK; DEMENTIA; EMPIRICAL RESEARCH; HUMAN; INFORMED CONSENT; LIVING WILL; MEDICAL ETHICS; PATIENT AUTONOMY; PATIENT DECISION MAKING; PATIENT RIGHT; TREATMENT PLANNING;

COGNITION; DEMENTIA; ETHICS, MEDICAL; HUMANS; MENTAL COMPETENCY; MENTAL DISORDERS; PERSONAL AUTONOMY; SELF CONCEPT;

EID: 34547963039     PISSN: 15901874     EISSN: None     Source Type: Journal    
DOI: 10.1007/s10072-006-0825-x     Document Type: Article

References (46)

1. Aalten P, Van Valen E, Clare L et al (2005) Awareness in dementia: In the eye of the beholder. Aging Mental Health 9:414-422
2. Barrett AM, Eslinger PJ, Ballentine NH, Heilman KM (2005) Unawareness of cognitive deficit (cognitive anosognosia) in probable AD and control subjects. Neurology 64:693-699
3. Lope OL, Becker JT, Somsak D et al (1994) Awareness of cognitive deficits and anosognosia in probable Alzheimer's disease. Eur Neurol 34:277-282.
4. Dalla Barba G, Parlato V, Lavarone A, Boller F (1995) Anosognosia, intrusions and 'frontal' functions in Alzheimer's disease and depression. Neuropsychologia 33:247-259
5. Starkstein SE, Sabe L, Chemerinski E et al (1996) Two domains of anosognosia in Alzheimer's disease. J Neurol Neurosurg Psychiatry 61:485-490
6. Starkstein SE, Mizrahi R (2006) Depression in Alzheimer's disease. Exp Rev Neurother 6:887-895
7. Migliorelli R, Teson A, Sabe L et al (1995) Anosognosia in Alzheimer's disease: A study of associated factors. J Neuropsychiatry Clin Neurosci 7:338-344
8. Markova IS, Berrios GE (1995) Insight in clinical psychiatry revisited. Compr Psychiatry 36:367-376
9. Ott BR, Fogel BS (1992) Measurement of depression in dementia: Self vs clinician rating. Int J Geriatr Psychiatry 7:899-904
10. Fritsh T, McClendon MJ, Smyth KA, Ogrocki PK (2002) Effects of educational attainment and occupational status on cognitive and functional decline in persons with Alzheimertype dementia. Int Psychogeriatr 14:347-363
11. McDaniel KD, Edland SD, Heyman A (1995) Relationship between level of insight and severity of dementia in Alzheimer disease. CERAD Clinical Investigators. Consortium to Establish a Registry for Alzheimer's Disease. Alzheimer Dis Assoc Disord 9:101-104
12. Zanetti O, Vallotti B, Frisoni GB et al (1999) Insight in dementia: When does it occur? Evidence for a nonlinear relationship between insight and cognitive status. J Gerontol Psychol Sci 54:100-106
13. Harwood DG, Sultzer DL, Wheatley MV (2000) Impaired insight in Alzheimer disease: Association with cognitive deficits, psychiatric symptoms, and behavioral disturbances. Neuropsychiatry Neuropsychol Behav Neurol 13:82-88
14. Derouesné C, Thibault S, Lagha-Pierucci S et al (1999) Decreased awareness of cognitive deficits in patients with mild dementia of the Alzheimer type. Int J Geriatr Psychiatry 14:1019-1030
15. Ott BR, Laflèche G, Whelihan WM et al (1996) Impaired awareness of deficits in Alzheimer disease. Alzheimer Dis Assoc Disord 10:68-76
16. Mega MS, Lee L, Dinov I et al (2000) Cerebral correlates of psychotic symptoms in Alzheimer's disease. J Neurol Neurosurg Psychiatry 69:167-171
17. Petersen RC, Smith GE, Waring SC et al (1997) Aging, memory, and mild cognitive impairment. Int Psychogeriatr 9:65-69
18. Kalbe E, Salmon E, Perani D et al (2005) Anosognosia in very mild Alzheimer's disease but not in mild cognitive impairment. Dement Geriatr Cogn Disord 19:349-356
19. Vogel A, Stokholm J, Gade A et al (2004) Awareness of deficits in mild cognitive impairment and Alzheimer's disease: Do MCI patients have impaired insight? Dement Geriatr Cogn Disord 17:181-187
20. Mental Capacity Act (2005) www.opsi.gov.uk/-acts/acts2005/20050009.htm
21. Wong JG, Clare CH, Gunn Ng, Holland AJ (1999) Capacity to make health care decisions: Its importance in clinical practice. Psychol Med 29:437-446
22. Beauchamp TL, Childress JF (2001) Principles of biomedical ethics, 5th edn. Oxford University Press, New York
23. Appelbaum PS, Grisso T (1988) Assessing patients' capacities to consent to treatment. N Engl J Med 319:163-168
24. Karlawish JH, Casarett DJ, James BD et al (2005) The ability of persons with Alzheimer disease to make a decision about taking a AD treatment. Neurol 64:1514-1519
25. Marson D, Cody HA, Ingram KK, Harrell LE (1995) Neuropsychological predictors of competency in Alzheimer's disease using a rational reasons legal standard. Arch Neurol 52:955-959
26. Marson D, Chatterjee A, Ingram KK, Harrell LE (1996) Toward a neurologic model of competency: Cognitive predictors of capacity to consent in Alzheimer's disease using three different legal standards. Neurology 46:666-672
27. Cairns R, Maddock C, Buchanan A et al (2005). Prevalence and predictors of mental incapacity in psychiatric in-patients. Br J Psych 187:379-385
28. Pucci E, Belardinelli N, Borsetti G et al (2001) Information and competency for consent to pharmacological trials in Alzheimer disease: an empirical analysis in patients and family caregivers. Alzheimer Dis Assoc Disord 15:146-154
29. Stewart R (2006) Mental health legislation and decision making capacity. Autonomy in Alzheimer's disease is ignored and neglected. BMJ 332:118-119
30. Etchells E, Darzins P, Silberfeld M et al (1999) Assessment of patient capacity to consent to treatment. J Gen Intern Med 14:27-34
31. Marson DC, Earnst KS, Jamil F et al (2000) Consistency of physicians' legal standard and personal judgments of competency in patients with Alzheimer's disease. J Am Geriatr Soc 48:911-918
32. Vellinga A, Smit JH, van Leeuwen E et al (2005) Decision-making capacity of elderly patients assessed through the vignette method: Imagination or reality? Aging and Mental Health 9:40-48
33. Grisso T, Appelbaum PS, Hill-Fotouhi C (1997) The MacCAT-T: A clinical tool to assess patients' capacities to make treatment decisions. Psychiatr Serv 48:1415-1419
34. Brock D, Buchanan A (1989) Deciding for others: The ethics of surrogate decision-making. Cambridge University Press, Cambridge
35. Ditto PH, Danks JH, Smucker WD et al (2001) Advance directives as acts of communication. Arch Intern Med 161:421-430
36. Emanuel EJ, Emanuel LL (1992) Proxy decision making for incompetent patients. JAMA 267:2067-2071
37. Hereinafter "Oviedo Convention": http://conventions.coe.int/ -Treaty/ita/Treaties/Html/164.htm
38. Defanti CA (2004) In Voltz R, Bernat JL, Borasio GD et al (eds) Palliative care in neurology. Oxford University Press, New York
39. Caltagirone C, Bianchetti A, Trabucchi M et al; Italian Association of Psychogeriatrics (2005) Guidelines for the treatment of Alzheimer's disease from the Italian Association of Psychogeriatrics. Drug Aging 22[Suppl 1]:26
40. Caltagirone C, Bianchetti A, Trabucchi M et al; (2006) Recommendations on how to improve the legal rights and protection of adults with incapacity due to dementia. http://www.alzheimer-europe.org/ ?lm2=6A55EAF2CD2F#
41. Post SG (2000) The moral challenge of Alzheimer disease, 2nd edn. The Johns Hopkins University Press, Baltimore, MD
42. Jones M (2005) GentleCare. Carocci Faber Ed, Roma
43. Valla P (ed) (2002) Alzheimer. Architetture e Giardini come Strumento Terapeutico. Angelo Guerini Ed, Milan
44. Cannara A, Brizioli C, Brizioli E (2004) Progettare l'ambiente per l'Alzheimer. Specifiche progettuali per l'ambiente terapeutico. FrancoAngeli Ed, Milan
45. Lee PE, Gill SS, Freedman M et al (2004) Atypical antipsychotic drugs in the treatment of behavioural and psychological symptoms of dementia: A systematic review. BMJ 329:75-79
46. Tannsjö T (2004) The Convention on Human rights and Biomedicine and the Use of Coercion in Psychiatry. Journal of Med Ethics 30:430-434