RESUMO
Dementia is a terminal disease, associated with great suffering and difficult decisions in the severe stage. The decision-making process is characterized by uncertainty because of lack of scientific evidence in treatments and by the need to reconcile conflicting points of view. In intercurrent diseases, aggressive interventions are used without consideration of its futility; in comparison with cancer, several consequences of physicians' attitude not to consider dementia as a terminal disease have been reported, especially concerning pain relief. Lack of evidence of artificial nutrition and hydration effectiveness makes advance care planning relevant.
Assuntos
Demência/terapia , Cuidados Paliativos/ética , Assistência Terminal/ética , Tomada de Decisões , Humanos , Cuidados Paliativos/métodos , Guias de Prática Clínica como Assunto , Assistência Terminal/métodosRESUMO
The document deals with some ethical issues raised by the treatment of demented people. In particular the conceptual and empirical aspects of the assessment of awareness and competence of these patients are analysed, as well as the dilemmas related to the treatment of behavioral disorders.
Assuntos
Cognição , Demência/psicologia , Ética Médica , Competência Mental , Transtornos Mentais , Autonomia Pessoal , Demência/terapia , Humanos , AutoimagemRESUMO
Twenty-eight chronic alcoholic subjects were submitted to our Mental Deterioration Battery. The scores obtained by this group, corrected for age and educational level, were compared with those achieved by a control group. Our data do not confirm a selective impairment of the functions related to the right hemisphere; they show a diffuse cerebral damage and suggest, perhaps, a major impairment of the verbal functions subserved by the left hemisphere. Therefore, according to our data the question of selective hemispheric impairment as opposed to more diffuse cerebral damage in chronic alcoholism still remains open.
