title: Why is dementia different? Medical students' views about deceiving people with dementia.
abstract: OBJECTIVE
  Care of patients with dementia raises challenging ethical issues, including the use of deception in clinical practice. This study aimed to determine the extent to which medical students agree that ethical arguments for and against deceiving patients in general apply to patients with dementia.
  
  
  METHODS
  Qualitative study using six focus groups (n = 21) and 10 interviews (n = 10) with undergraduate students in years 1, 3 and 5 at a UK medical school. Analysis using initial coding followed by comparison of data with a pre-existing framework concerning deception in clinical practice.
  
  
  RESULTS
  Arguments for and against deceiving patients with dementia overlapped with those previously described in relation to clinical practice in general. However, the majority of participants highlighted issues unique to dementia care that warranted additional consideration. Three key dementia-specific considerations identified were capacity (understanding, retaining and emotional processing), perceived vulnerability and family dynamics. Students expressed uncertainty as to their ability to make judgements about honest communication with patients with dementia and their families.
  
  
  CONCLUSIONS
  Dementia adds additional complexity to clinical judgements about the acceptability of deception in practice. Medical students have a number of unmet learning needs with regard to communicating with patients with dementia and their families. Existing ethical frameworks may provide a helpful starting point for education about dementia care.
authors.affiliation: a Institute for Ageing and Health, Biomedical Research Building, Campus for Ageing and Vitality , Newcastle University , Newcastle-upon-Tyne , UK.
authors.forename: Ellen StClair
authors.initials: ES
authors.lastname: Tullo
authors.forename: Richard Philip
authors.initials: RP
authors.lastname: Lee
authors.forename: Louise
authors.initials: L
authors.lastname: Robinson
authors.forename: Louise
authors.initials: L
authors.lastname: Allan
mesh_terms: D000328:Adult; D008192:Deception; D003704:Dementia / Q000523:psychology / Q000628:therapy*; D004992:Ethics, Medical / Q000193:education; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D036301:Qualitative Research; D013337:Students, Medical / Q000523:psychology*; D055815:Young Adult
keywords: dementia and cognitive disorders; ethics and law; policy; qualitative methods