Published 6 July 2009, doi:10.1136/bmj.b2720
Cite this as: BMJ 2009;339:b2720

Letters

Video tool in dementia

Ethical concerns

The first 150 words of the full text of this article appear below.

The use of videos to help in imagining dementia has its merits,1 but it is not without concerns.

Firstly, data from the behavioural sciences show that healthy people often overestimate their negative affect and quality of life in a proposed disease state. Patients receiving dialysis were not less happy than healthy people, and the healthy people failed to anticipate this adaptation.2 Becoming disabled seems to be a horrible prospect, but data show that people who are disabled are not feeling horrible. Brickman et al famously found that happiness levels did not vary much before and after paraplegia or quadriplegia.3 Thus patients may watch the videos and think that they would be miserable living with advanced dementia, but this may be an inaccurate prediction. To measure the accuracy of the prediction, we would need to measure affect and quality of life in patients living with advanced dementia, which is not possible . . . [Full text of this article]

J S Swindell, assistant professor1

1 Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX 77030, USA

jsswinde@bcm.edu


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Video decision support tool for advance care planning in dementia: randomised controlled trial
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