Cognitive citizenship: access to hip surgery for people with dementia
Cognitive citizenship: access to hip surgery for people with dementia
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DOI：
10.1177/1363459304043466
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发表时间：
2004-07-01
期刊：
影响因子：
2.1
通讯作者：
Graham, R
中科院分区：
文献类型：
--
作者：
Graham, R
痴呆症和慢性髋关节疾病都随着年龄的增长而更加普遍。鉴于此，在英国这样的老龄化人口中，患有痴呆症和髋关节疾病的人数可能会增加。这篇文章提出了一些问题，关于痴呆症和慢性髋关节疾病患者如何在循证医学的背景下被概念化，以及这种概念化是否会不公平地限制他们获得手术服务。在髋关节疾病和痴呆症的接口发表的临床研究话语被视为“证据基础”，并在其是否适合告知专业决策的可行性手术方面进行评估。分析表明，用于确定患者生存能力的结果标准对痴呆症患者存在不公平的歧视。如果存在这种歧视，就必然不利于促进认知障碍者与健康有关的公民权利，从而形成一种以证据为基础的文化，鼓励一种有问题的认知公民模式。
Dementia and chronic hip disease are both more prevalent with advancing age. Given this, the number of people with both dementia and hip disease is likely to increase in an ageing population such as the UK. This article raises questions about how people with dementia and chronic hip disease are conceptualized in the context of evidence-based medicine, and whether this conceptualization may limit unfairly their access to surgical services. The published clinical research discourse at the interface of hip disease and dementia is taken as an 'evidence-base', and is evaluated in terms of its suitability for informing professional decisions about viability for surgery. The analysis suggests that the outcomes criteria used to determine patient viability serve to discriminate unfairly against people with dementia. If such discrimination exists, it necessarily militates against the promotion of health-related citizenship rights of the cognitively impaired, creating an evidence-based culture that encourages a problematic model of cognitive citizenship.