Deciding on genetic testing for familial dementia: Perspectives of patients and families.

Introduction: We explored patients' and families' interest in, predictors of, and considerations regarding genetic testing for monogenic causes of dementia in a diagnostic setting.

Methods: This mixed-methods study evaluated 519 consecutive Alzheimer Center Amsterdam patients for monogenic testing eligibility. Among those qualifying, differences between testers and non-testers were analyzed.

No (true) right to die: barriers in access to physician-assisted death in case of psychiatric disease, advanced dementia or multiple geriatric syndromes in the Netherlands.

Even in the Netherlands, where the practice of physician-assisted death (PAD) has been legalized for over 20 years, there is no such thing as a 'right to die'. Especially patients with extraordinary requests, such as a wish for PAD based on psychiatric suffering, advanced dementia, or (a limited number of) multiple geriatric syndromes, encounter barriers in access to PAD. In this paper, we discuss whether these barriers can be justified in the context of the Dutch situation where PAD is legally permitted for those who suffer unbearably and hopelessly as a result of medical conditions.

Good health checks according to the general public; expectations and criteria: a focus group study.

Background: Health checks or health screenings identify (risk factors for) disease in people without a specific medical indication. So far, the perspective of (potential) health check users has remained underexposed in discussions about the ethics and regulation of health checks.

Methods: In 2017, we conducted a qualitative study with lay people from the Netherlands (four focus groups).

What is a good health check? An interview study of health check providers' views and practices.

Background: Health checks identify (risk factors for) disease in people without symptoms. They may be offered by the government through population screenings and by other providers to individual users as 'personal health checks'. Health check providers' perspective of 'good' health checks may further the debate on the ethical evaluation and possible regulation of these personal health checks.

[Wish-fulfilling medicine in Dutch practice. Have physicians become salesmen?].

Wish-fulfilling medicine - the use of medical technology for the prima facie non-medical wish of the patient - occurs in practice, both in and outside the Netherlands. In a recent study both GPs and plastic surgeons recalled occasions when they had fulfilled patient's non-medical wish, sometimes against their own better judgement. The question is whether this is turning physicians into salesmen? The central values of medical professional ethics, namely autonomy, non-maleficence, beneficence, and justice still appear to play a central role.

Wish-fulfilling medicine in practice: the opinions and arguments of lay people.

Background: Wish-fulfilling medicine appears to be on the rise. It can be defined as 'doctors and other health professionals using medical means (medical technology, drugs, and so on) in a medical setting to fulfil the explicitly stated, prima facie non-medical wish of a patient'. Some instances of wish fulfilling medicine can be understood as 'human enhancements'.

Wish-fulfilling medicine in practice: a qualitative study of physician arguments.

There has been a move in medicine towards patient-centred care, leading to more demands from patients for particular therapies and treatments, and for wish-fulfilling medicine: the use of medical services according to the patient's wishes to enhance their subjective functioning, appearance or health. In contrast to conventional medicine, this use of medical services is not needed from a medical point of view. Boundaries in wish-fulfilling medicine are partly set by a physician's decision to fulfil or decline a patient's wish in practice.