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New VSED Advance Directive: Improved Documentation to Avoid Late-Stage Dementia
Thaddeus Mason Pope1, Lisa E Brodoff2, Erin Mae Glass3
1Mitchell Hamline School of Law, United States.
Summary
Advance directives help express future care wishes. A new dementia directive effectively addresses gaps in traditional forms, enabling individuals to avoid prolonged suffering in advanced dementia by guiding care decisions like cessation of feeding.
Area of Science:
- Medical Ethics
- Geriatric Medicine
- Legal Medicine
Background:
- Advance directives express future care preferences for individuals lacking decision-making capacity.
- Dementia directives specifically address preferences during various stages of dementia, as many wish to avoid advanced progressive dementia.
- Traditional advance directives often fail to reliably achieve the goal of avoiding extended life in advanced dementia.
Purpose of the Study:
- To introduce and explain the value of a newly formulated dementia directive.
- To address the shortcomings of existing dementia directives in preventing prolonged suffering in advanced dementia.
- To provide a comprehensive ethical and legal justification for the new dementia directive.
Main Methods:
- Reviewing the prevalence of advanced dementia.
- Identifying disadvantages of preemptive Voluntary Stopping Eating and Drinking (VSED) as an alternative.
- Analyzing court cases involving unsuccessful dementia directives.
- Evaluating nine prominent dementia directives and highlighting the Northwest Justice Project's Advance Directive for VSED.
- Assessing the legal status of the new directive.
- Articulating the ethical justification for the new dementia directive.
Main Results:
- Existing dementia directives have gaps that hinder the goal of avoiding intolerable life in advanced dementia.
- The Northwest Justice Project's Advance Directive for VSED offers a more effective solution by addressing these shortcomings.
- The new directive provides a more dependable method for individuals to direct their future care and avoid prolonged suffering.
Conclusions:
- A new dementia directive has been formulated to overcome the limitations of traditional advance directives.
- This directive offers a more reliable mechanism for individuals to avoid extended life in advanced dementia.
- The directive is ethically justified and has a defined legal status, providing a valuable tool for end-of-life planning.
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