Dorothea P. Touwen

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The care of older persons can have negative impact on the caregiver. The objective of this population-based observational study is to identify problems experienced by informal caregivers, and the extent of related difficulties, in their care of older care-dependent recipients with and without cognitive impairment. Caregivers (n = 2,704) caring for a(More)
OBJECTIVES To explore the decision-making process involving elderly subjects with mild cognitive impairment and a relative when asked to participate in a clinical trial. DESIGN, SETTING, AND PARTICIPANTS In this qualitative study, we investigated the decision-making process during the informed consent conversations between the researchers of a clinical(More)
Placebo fascinates and mystifies. Even with today's medical science we still do not know how and if it works. The use of placebo both in therapy and in research evokes ethical problems that are not easily resolved either. Placebo is intrinsically linked to deception, while veracity is a basic tenet in today's thinking of a doctor-patient relationship. In(More)
It is a funny thing with the Dutch. On one hand, they seem preoccupied with death and adamant that patients be allowed to decide for themselves in what way they want to die. On the other, contrary to popular belief, the Dutch physician is allotted a very influential role in treatment decisions, far more prominent than in many other Western countries. From(More)
BACKGROUND Metaphors are often used within the context of ethics and healthcare but have hardly been explored in relation to moral reasoning. OBJECTIVE To describe a central set of metaphors in one case and to explore their contribution to moral reasoning. METHOD Semi-structured interviews were conducted with 16 parents of a child suffering from the(More)
Research into the role of family members in the decision making process concerning medical treatment of incompetent patients in nursing home care, shows that the involvement of a proxy decision maker implies a greater responsibility of the physician. It is the duty of the proxy decision-maker (mostly a family member) to look after the incompetent patient's(More)
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