Why is dementia different? Medical students’ views about deceiving people with dementia

Ellen Stclair Tullo, Richard Philip Lee, Louise Robinson, Louise Allan

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)

Abstract

Objectives: Care of patients with dementia raises challenging ethical issues, including the use of deception in clinical practice. This study aimed to determine the extent to which medical students agree that ethical arguments for and against deceiving patients in general apply to patients with dementia.

Method: Qualitative study using six focus groups (n = 21) and 10 interviews (n = 10) with undergraduate students in years 1, 3 and 5 at a UK medical school. Analysis using initial coding followed by comparison of data with a pre-existing framework concerning deception in clinical practice.

Results: Arguments for and against deceiving patients with dementia overlapped with those previously described in relation to clinical practice in general. However, the majority of participants highlighted issues unique to dementia care that warranted additional consideration. Three key dementia-specific considerations identified were capacity (understanding, retaining and emotional processing), perceived vulnerability and family dynamics. Students expressed uncertainty as to their ability to make judgements about honest communication with patients with dementia and their families.

Conclusion: Dementia adds additional complexity to clinical judgements about the acceptability of deception in practice. Medical students have a number of unmet learning needs with regard to communicating with patients with dementia and their families. Existing ethical frameworks may provide a helpful starting point for education about dementia care.
Original languageEnglish
Pages (from-to)731-738
Number of pages8
JournalAging & Mental Health
Volume19
Issue number8
Early online date27 Oct 2014
DOIs
Publication statusPublished - 2015

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