title: Addressing the ethical, legal, and social issues raised by voting by persons with dementia.
abstract: This article addresses an emerging policy problem in the United States participation in the electoral process by citizens with dementia. At present, health care professionals, family caregivers, and long-term care staff lack adequate guidance to decide whether individuals with dementia should be precluded from or assisted in casting a ballot. Voting by persons with dementia raises a series of important questions about the autonomy of individuals with dementia, the integrity of the electoral process, and the prevention of fraud. Three subsidiary issues warrant special attention: development of a method to assess capacity to vote; identification of appropriate kinds of assistance to enable persons with cognitive impairment to vote; and formulation of uniform and workable policies for voting in long-term care settings. In some instances, extrapolation from existing policies and research permits reasonable recommendations to guide policy and practice. However, in other instances, additional research is necessary.
authors.affiliation: Department of Medicine, Center for Bioethics, Institute on Aging, University of Pennsylvania, Philadelphia 19104, USA. jasonkar@mail.med.upenn.edu
authors.forename: Jason H
authors.initials: JH
authors.lastname: Karlawish
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Bonnie
authors.forename: Paul S
authors.initials: PS
authors.lastname: Appelbaum
authors.forename: Constantine
authors.initials: C
authors.lastname: Lyketsos
authors.forename: Bryan
authors.initials: B
authors.lastname: James
authors.forename: David
authors.initials: D
authors.lastname: Knopman
authors.forename: Christopher
authors.initials: C
authors.lastname: Patusky
authors.forename: Rosalie A
authors.initials: RA
authors.lastname: Kane
authors.forename: Pamela S
authors.initials: PS
authors.lastname: Karlan
mesh_terms: D002961:Civil Rights / Q000941:ethics / Q000331:legislation & jurisprudence; D003704:Dementia / Q000523:psychology*; D006801:Humans; D008134:Long-Term Care; D016743:Mental Competency / Q000331:legislation & jurisprudence / Q000592:standards; D011050:Policy Making; D011057:Politics; D014481:United States