{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,14]],"date-time":"2025-12-14T15:53:52Z","timestamp":1765727632795},"reference-count":23,"publisher":"BMJ","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Med Ethics"],"published-print":{"date-parts":[[2000,4]]},"abstract":"<jats:p>Non-treatment decisions concerning demented patients are complex: in addition to issues concerning the health of patients, ethical and legal issues are involved. This paper describes a method for the development of a guideline that clarifies the steps to be taken in the decision making process whether to forgo curative treatment of pneumonia in psychogeriatric nursing home patients.<\/jats:p><jats:p>The method of development consisted of seven steps. Step 1 was a literature study from which ethical, juridical and medical factors concerning the patient's health and prognosis were identified. In step 2, a questionnaire was sent to 26 nursing home physicians to determine the relative importance of these factors in clinical practice. In a meeting of nine experienced physicians (step 3), the factors identified in step 2 were confirmed by most of these professionals. To prevent the final guideline being too directive, a concept guideline that included ethical and legal aspects was designed in the form of a \u201cchecklist of considerations\u201d (step 4). Experts in the fields of nursing home medicine, ethics and law reviewed and commented on the concept guideline (step 5). The accordingly adapted \u201cchecklist of considerations\u201d was tested in a pilot study (step 6), after which all experts endorsed the checklist (step 7).<\/jats:p><jats:p>The resulting \u201cchecklist of considerations\u201d structures the decision making process according to three primary domains: medical aspects, patient's autonomy, and patient's best interest (see annex at end of paper).<\/jats:p>","DOI":"10.1136\/jme.26.2.114","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:37:59Z","timestamp":1027766279000},"page":"114-120","source":"Crossref","is-referenced-by-count":27,"title":["Decisions to treat or not to treat pneumonia in demented psychogeriatric nursing home patients: development of a guideline"],"prefix":"10.1136","volume":"26","author":[{"given":"Jenny T","family":"van der Steen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martien T","family":"Muller","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marcel E","family":"Ooms","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerrit","family":"van der Wal","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miel W","family":"Ribbe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2000,4,1]]},"reference":[{"key":"2024052311130962000_26.2.114.1","first-page":"11","volume":"10","year":"1996","journal-title":"Alzheimer Disease and Associated Disorders"},{"key":"2024052311130962000_26.2.114.2","unstructured":"Cools HJM. 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