The legal position of vulnerable people in the future: improving or going backwards?

Two vulnerable groups in our society are children with psychiatric problems and people with intellectual disabilities. The demand for care is growing every year in both groups. The current (Dutch) legal status of people with intellectual disabilities and children with psychiatric problems is one in which too much attention is devoted to the right to self-determination. An important question is whether this central feature is enough to support clients in both groups in such a way that they can develop their abilities. The Dutch government is currently preparing new legislation to replace the Psychiatric Hospitals Act. We recommend that this legislation should also take account of the right to development and the right to good care in order to deal with the dilemmas that will arise in the near future. © 2012 Koninklijke Brill NV, Leiden

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The ideal application of surveillance technology in residential care for people with dementia

As our society is ageing, nursing homes are finding it increasingly difficult to deal with an expanding population of patients with dementia and a decreasing workforce. A potential answer to this problem might lie in the use of technology. However, the use and application of surveillance technology in dementia care has led to considerable ethical debate among healthcare professionals and ethicists, with no clear consensus to date. To explore how surveillance technology is viewed by care professionals and ethicists working in the field, by investigating the ideal application of surveillance technology in the residential care of people with dementia. Use was made of the concept mapping method, a computer-assisted procedure consisting of five steps: brainstorming, prioritizing, clustering, processing by the computer and analysis. Various participants (ranging from ethicists to physicians and nurses) were invited on the basis of their professional background. The views generated are grouped into six categories ranging from the need for a right balance between freedom and security, to be beneficial and tailored to the resident, and clearly defined procedures to competent and caring personnel, active monitoring and clear normative guidance. The results are presented in the form of a graphic chart. There appears to be an inherent duality in the views on using surveillance technology which is rooted in the moral conflict between safety and freedom. Elaboration of this ethical issue has proved to be very difficul