Highlights
- •What is the primary question addressed by this study?—We explore why older people with mental health conditions and psychosocial disabilities are vulnerable to human rights violations at the end of life and examine existing and potential solutions.
- •What is the main finding of this study?—Key to best practice end of life care are the actualization of human rights to dignity, autonomy, self-determination and respect for will and preferences, equitable access to quality health care that is needs-based, and respect for family and relationships. Older people with dementia, those with serious mental illness, and those with intellectual disability are variably afforded these rights at the end of life.
- •What is the meaning of the finding?—An integrated care model that encompasses physical and mental health, palliative care, social and spiritual support must be on offer, while recognizing that good dying is needs-based and self-determined.
Abstract
The human right to a good death and dying well is as important as the right to life.
At stake at the end of life are human rights to dignity, autonomy, self-determination
and respect for will and preferences, equitable access to quality health care that
is needs-based, and respect for family and relationships. Older people with dementia,
those with serious mental illness, and those with intellectual disability are vulnerable
to “bad deaths” due to violations of these rights. In this paper we explore why this
is so and examine existing and potential solutions. A human rights-approach to end-of-life
care and policy for older persons with mental health conditions and psychosocial disability
is one that is needs-based, encompassing physical and mental health, palliative care,
social, and spiritual support services provided in the context of inclusive living.
Most importantly, end of life care must be self-determined, and not “one size fits
all.” An important remedy to existing violations is to strengthen human rights frameworks
to cater specifically to older persons’ needs with a UN convention on the rights of
older persons. Finally, as health professionals we have important contributions to
make at the coalface by accepting our responsibilities in the area of death and dying.
With the concept of the palliative psychiatrist gaining traction and recognition that
death is our business, we add that human rights is also our business.
Key Words
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Article info
Publication history
Published online: May 30, 2021
Accepted:
May 22,
2021
Received:
May 20,
2021
Identification
Copyright
© 2021 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.
