Advance care planning with people living with dementia: Ethical considerations of physicians in the United States and the Netherlands

09/27/25 at 03:35 AM

Advance care planning with people living with dementia: Ethical considerations of physicians in the United States and the Netherlands
The Journals of Gerontology; by Jingyuan Xu, David R Mehr, Marieke Perry, K Taylor Bosworth, Kate McGough, Wilco P Achterberg, Hanneke Smaling, Jenny T van der Steen; 8/25
Interviews with 50 Dutch physicians and 47 American physicians and 3 nurse practitioners generated three themes of ethical considerations: 1) Respecting the autonomy of the person with dementia, 2) Rationality as the basis for decisions and subsequent actions, and 3) Minimizing burden and suffering. The complexity of ACP [advance care planning] for people living with dementia is reflected in the challenges within each ethical consideration and the tensions between them, especially between autonomy and rationality. We recommend an approach to ACP that balances the ethical considerations, focusing on the values of the people living with dementia and allowing flexibility in future decision-making to take the current best interest of the person into account.

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