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    Dementia and End-of-Life Decision Making: A Case-Based Approach to the Clinical Application of Bioethical Principles

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    Genre
    Thesis/Dissertation
    Date
    2019
    Author
    Houghton, Lindsey C.
    Advisor
    Rocco, Providenza Loera
    Department
    Urban Bioethics
    Subject
    Medical Ethics
    Aging
    Health Care Management
    Dementia
    End-of-life
    Hospitalization
    Informed Consent
    Medical Capacity
    Medical Care
    Permanent link to this record
    http://hdl.handle.net/20.500.12613/3027
    
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    DOI
    http://dx.doi.org/10.34944/dspace/3009
    Abstract
    People with dementia account for a growing number of patients requiring end-of-life medical care each year in the United States. The clinical application of bioethical principles is rarely more important than in the context of end-of-life decision making, and determining the appropriate clinical treatment plan can be difficult and complex for clinicians, patients, and medical proxies. While the current bioethical literature offers a wealth of information on the principles underlying ethical medical practice, real-world clinical scenarios are often fraught with confusion, complexity, and conflicting understandings of best practices. There is a need for clinical decision-making tools that are both comprehensive yet simple, and broadly-applicable enough to be clinically useful. This thesis explores the cultural factors that necessitate further discussion and understanding of the issues surrounding end-of-life care for people with dementia, uses a clinical case to demonstrate a real-world approach to the ethical complexities surrounding such care, and proposes a basic ethical decision-making algorithm with the potential for broad application by students and clinicians encountering complex ethical scenarios.
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