Towards a more adequate moral framework: Elements of 'ethic of care' nursing home care for people with dementia
Modem healthcare ethics has its roots in the movement for patient rights and the process of patient emandpation that started in the 1970s. Its core concepts are the principles of respect for autonomy and the right to free and uncoerced self-determination. In the Netherlands, these rights and the correlated duties of healthcare professionals are embedded in the Medical Treatment Act (WGBO) and related legislation such as the Special Admissions to Psychiatric Hospitals Act (BOPZ) that stipulates the rights of patients admitted against their will to psychiatric hospitals and psychogeriatric (wards of) nursing homes. This emancipatory process and the subsequent 'juridification' of the relation between patients and healthcare professionals thoroughly influenced the healthcare system and certainly changed the role of the physidan: from a paternalistic figure who knows what is best for his patients, the physidan has become a careful deliberator who informs about the pros and cons of treatment options, thus letting patients dedde for themselves what is best. Hence, there is an emphasis in the contemporary training of medical students not only on technical skills but also on communicative skills.