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Ethical Dilemma

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An ethical dilemma refers to a complex situation that represents two conflicting mental decisions. However, the choice has to be made out of the available alternatives.  The decision to prefer one situation may result in transgression of the other with dire consequences. Ethical dilemmas occur in everyday life and people should make their choices regardless of the outcome. The journal article “Ethical Dilemmas: should antipsychotics ever be prescribed for people with dementia?” represents an example of the ethical dilemma. The article queries the moral imperative of administering antipsychotics in controlling and managing the psychological and behavioral symptoms of dementia. Studies have shown that the administration of antipsychotics is harmful to dementia patients. As a matter of fact, evidence-based guidelines advice against the administration of antipsychotics in dementia patients. However, dementia is a debilitating illness and its symptoms can only be controlled or managed effectively by using antipsychotics.

Excruciating pain that intensifies as the illness progresses is a serious symptom of dementia. The only other alternative available to control the illness is palliative management. Nevertheless, there are remarkably few models of palliative treatment that can be effectively used to manage the symptoms of dementia. Additionally, the models transform depending on the individual patient and, therefore, palliative management cannot be generalized as a universal method of treatment. The dilemma arises upon the realization that the administration of antipsychotic drugs is extremely problematic, and in many a number of cases, it ultimately results in the death of the patient.  Consequently, medical personnel have to choose between administering antipsychotics or palliative techniques (Treloar, Crugel, Prasanna, Solomons, Fox, Paton & Katona, 2010).

 From a personal standpoint, the use of antipsychotics should be encouraged and used in patients suffering from dementia. To begin with, dementia is an irreversible condition that takes the patient through a lot of pain and suffering both psychologically and physically, yet they eventually end up dying. Therefore, use of antipsychotics makes their final moments worthwhile. Rather than trying to contain the effects of the ailments that are largely psychological and behavioral, the patient can be treated using antipsychotics and live their final days normally.

The use of antipsychotics in patients with dementia has received support and opposition in equal measure. There are groups which suppose that the use of antipsychotics is an assured death sentence to the neighbour. Others suggest that it is a means through which the patient’s quality of life can be improved. The American Healthcare Association, in February 2012, produced a quality initiative to assist nursing homes in improving person-centered care for their patients (Beers, Ouslander, Rollingher, Reuben, Brooks & Beck 1991)..  The Centers for Medicare and Medicaid Services released the Initiative to Improve Behavioral Health and Reduce the Use of Antipsychotic Medications in Nursing Home Residents webinar on March 29, 2012. They find palliative techniques better than the use of antipsychotic drugs in managing dementia. German researchers found out that there were significant benefits of treating residents in nursing homes suffering from dementia with antipsychotics. Additionally, the Alzheimer’s Association of Southeastern Wisconsin initiated a task force to study the challenges of dealing with behaviors associated with dementia. The task force advocated controlled use of antipsychotics.

There are several contexts that the dilemma affects. From the viewpoint that supports the use of antipsychotics, there are heavy economic consequences. The medication is terribly expensive and the caregivers may begin to feel the financial burden, with the lapse of time. The patient’s health also deteriorates progressively and may end up dying sooner. Politically, the issue divides people into the pro-antipsychotic group and those against their use (Jeste, Blazer, Casey, Meeks, Salzman, Schneider, Yaffe, 2007).

In conclusion, it is highly unethical to make the assumption that every case of dementia requires antipsychotic treatment. However, it is equally unethical to assume that all cases do not require antipsychotic medications. Therefore, finding the best treatment model based on the patient’s condition remains to be the prerogative of the medical personnel or the caregiver of the patient . However, the consequences of either choice remain inevitable as the patient has to be taken care of, one way or the other.

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