title: The full spectrum of ethical issues in dementia care: systematic qualitative review.
abstract: BACKGROUND
  Integrating ethical issues in dementia-specific training material, clinical guidelines and national strategy plans requires an unbiased awareness of all the relevant ethical issues.
  
  
  OBJECTIVE
  To determine systematically and transparently the full spectrum of ethical issues in clinical dementia care.
  
  
  METHODS
  We conducted a systematic review in Medline (restricted to English and German literature published between 2000 and 2011) and Google books (with no restrictions). We applied qualitative text analysis and normative analysis to categorise the spectrum of ethical issues in clinical dementia care.
  
  
  RESULTS
  The literature review retrieved 92 references that together mentioned a spectrum of 56 ethical issues in clinical dementia care. The spectrum was structured into seven major categories that consist of first- and second-order categories for ethical issues.
  
  
  CONCLUSIONS
  The systematically derived spectrum of ethical issues in clinical dementia care presented in this paper can be used as training material for healthcare professionals, students and the public for raising awareness and understanding of the complexity of ethical issues in dementia care. It can also be used to identify ethical issues that should be addressed in dementia-specific training programmes, national strategy plans and clinical practice guidelines. Further research should evaluate whether this new genre of systematic reviews can be applied to the identification of ethical issues in other cognitive and somatic diseases. Also, the practical challenges in addressing ethical issues in training material, guidelines and policies need to be evaluated.
authors.affiliation: Hannover Medical School, Institute for History, Ethics and Philosophy in Medicine, CELLS-Centre for Ethics and Law in the Life Sciences, Carl-Neuberg Straße 1, 30625 Hanover, Germany. strech.daniel@mh-hannover.de
authors.forename: Daniel
authors.initials: D
authors.lastname: Strech
authors.forename: Marcel
authors.initials: M
authors.lastname: Mertz
authors.forename: Hannes
authors.initials: H
authors.lastname: Knüppel
authors.forename: Gerald
authors.initials: G
authors.lastname: Neitzke
authors.forename: Martina
authors.initials: M
authors.lastname: Schmidhuber
mesh_terms: D003695:Delivery of Health Care / Q000941:ethics*; D003704:Dementia / Q000175:diagnosis / Q000628:therapy*; D004992:Ethics, Medical; D006801:Humans; D008605:Mental Health Services / Q000941:ethics*