Ethical issues are often not addressed in national clinical practice guidelines for dementia

August 13, 2013

Twelve national dementia clinical practice guidelines included only half of 31 ethical issues the authors had identified as important in patient care, finds a study by Daniel Strech, of Hannover Medical School, Hannover, Germany, and colleagues, published in this week's issue of PLOS Medicine.

The authors identified current national clinical practice guidelines for published in English or German. They had previously systematically reviewed ethical issues in dementia care and they used thematic text analysis to assess whether and how the ethical issues were addressed in the guidelines. In the 12 national practice guidelines identified, an average of 49.5% of the 31 ethical issues were addressed (range, 22% to 77%). National guidelines differed substantially with respect to which ethical issues were represented, whether ethical recommendations were included, whether justifications or citations were provided to support recommendations, and to what extent the ethical issues were explained.

The clinical practice guidelines were published by a central governmental institution in 6 countries (Australia, France, Malaysia, New Zealand, Singapore, United Kingdom), by a medical association in 4 countries (Canada, Germany, Scotland, United States of America), one by a statutory health insurance body (Austria), and by an expert panel in one country (Switzerland). The authors state, "All guidelines explicitly acknowledged the involvement of experts from different specialties (most often from psychiatry, neurology, gerontology, and )."

Four (13%) ethical issues were not addressed in at least 11 out of 12 CPGs: "Adequate consideration of existing in making.", "Usage of GPS and other monitoring techniques ", "Covert medication" and "Dealing with suicidality."

The authors conclude, "Ethical issues and how to deal with them are important for guidelines to address, for the to understand how to approach care of patients with dementia, and for patients, their relatives, and the general public, all of whom might seek information and advice in national guidelines."

Furthermore, although clinical practice guidelines are "meant to improve standards of clinical competence and professionalism by referring explicitly to evidence-based information on benefits and harms", the authors state that clinical practice guideline development manuals worldwide fail to address how to include disease-specific .

Explore further: Study finds cancer guidelines do not fully meet IOM standards

More information: Knüppel H, Mertz M, Schmidhuber M, Neitzke G, Strech D (2013) Inclusion of Ethical Issues in Dementia Guidelines: A Thematic Text Analysis. PLoS Med 10(8): e1001498. DOI: 10.1371/journal.pmed.1001498

Related Stories

Study finds cancer guidelines do not fully meet IOM standards

June 12, 2013
In an age when evidence-based care is increasingly important, how trustworthy are current clinical practice guidelines?

Committee on Publication Ethics launches ethical guidelines for peer reviewers

March 25, 2013
Scholarly journals need to ensure that their peer reviewers act constructively, respect confidentiality and avoid conflicts of interests, according to new guidelines launched by the Committee on Publication Ethics (COPE)

HIV answers raise new ethical questions

July 31, 2013
The Food and Drug Administration's approval last year of the drug Truvada for prevention of HIV infection was a milestone in the fight against HIV/AIDS, but experts are cautioning that it is only the beginning of new ethical ...

Clinical practice guidelines for bariatric surgery are updated

April 10, 2013
(HealthDay)—Based on a review of relevant evidence, 74 recommendations have been issued in updated clinical practice guidelines for bariatric surgery, according to a study published in the March issue of Surgery for Obesity ...

Ethics framework urged to manage conflicts of interest in medicine

June 13, 2012
A recent international study led by researchers from McGill University and the McGill University Health Centre (MUHC) examines the complex and controversial interplay of conflicts of interest between physician experts, medicine ...

Study discusses ethics of multifetal pregnancy reduction

January 24, 2013
(HealthDay)—Given the risks of multifetal pregnancies, especially high-order multifetal pregnancies, physicians should be aware of the relevant ethical issues in order to support their patients as they make decisions regarding ...

Recommended for you

Lifestyle changes to stave off Alzheimer's? Hints, no proof

July 20, 2017
There are no proven ways to stave off Alzheimer's, but a new report raises the prospect that avoiding nine key risks starting in childhood just might delay or even prevent about a third of dementia cases around the world.

Blood test identifies key Alzheimer's marker

July 19, 2017
A new study led by researchers at Washington University School of Medicine in St. Louis suggests that measures of amyloid beta in the blood have the potential to help identify people with altered levels of amyloid in their ...

Steering an enzyme's 'scissors' shows potential for stopping Alzheimer's disease

July 19, 2017
The old real estate adage about "location, location, location" might also apply to the biochemical genesis of Alzheimer's disease, according to new research from the University of British Columbia.

Brain scans may change care for some people with memory loss

July 19, 2017
Does it really take an expensive brain scan to diagnose Alzheimer's? Not everybody needs one but new research suggests that for a surprising number of patients whose memory problems are hard to pin down, PET scans may lead ...

Can poor sleep boost odds for Alzheimer's?

July 18, 2017
(HealthDay)— Breathing problems during sleep may signal an increased risk for Alzheimer's disease, a trio of studies suggests.

Hearing is believing: Speech may be a clue to mental decline

July 17, 2017
Your speech may, um, help reveal if you're uh ... developing thinking problems. More pauses, filler words and other verbal changes might be an early sign of mental decline, which can lead to Alzheimer's disease, a study suggests.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.