Despite the aging of the population and demands for empowerment of the
physically and mentally disabled, the issue of whether to let everyone living in
geriatric or psychiatric institutions vote there – whatever his or her state of
mental capacity – has not been discussed.
Patients in such institutions
for chronic illness have, for nearly 20 years, been able to go, or be taken, to
the ballot box by a relative or friend or party representative. But they may not
be taken by a boss or employee of the institution where they live.
The
Central Elections Committee website states that anyone who is hospitalized on
Election Day is entitled to vote in the institution if there are 50 beds or
more. But it does not say anything about limitations on patients suffering from
severe Alzheimer’s disease or other dementias, psychoses or other psychiatric
conditions.
Haredi parties have been seen in previous elections taking to
the polling booth inpatients staring into space and seemingly unaware of what
was happening.
“I am sure there is manipulation, especially by the
well-organized parties, to get everybody to the polls, but it’s very difficult to
know who is severely demented or psychotic or ill but still able to vote
competently, Prof. Shimon Glick, emeritus professor of medical ethics at
Ben-Gurion University of the Negev told The Jerusalem Post when asked to comment
on Sunday.
“It should be raised as an issue with the Central Elections
Committee when there is time after this election. It would be ideal if, instead
of party representatives, patients could be accompanied by absolutely
independent duty officers at the polls who would help them vote as they
wish.”
But one could never prevent relatives from picking the little
piece of paper representing the party of choice and placing it into the
envelope, Glick said.
He suggested that senior experts on psychiatry and
psychogeriatrics be asked by the Elections Committee to prepare a position paper
on the matter.
EMDA, a voluntary organization that assists Alzheimer’s
patients and their families, announced on Sunday that it had launched for the
first time a telephone hotline to help patients and their families about going
to vote, whether they lived at home or in institutions.
The number is
03-534- 1274.
The organization noted that there are over 100,000 Israelis
in various stages of Alzheimer’s disease or other dementias, and that from age
80 the progressive, incurable disease affects one out of every two.
Dr.
Yehezkel Caine, director-general of the geriatric and psychiatric Herzog Hospital
in the capital, said that by law no one is permitted to intervene in the voting
process there, even if patients are being manipulated.
He added that it
would be very difficult to determine patients’ competency or capacity to vote.
Patients’ conditions change, and assessment can take hours. The financial cost
would be huge, he said.
Many research papers on voting by people with
serious dementias or psychiatric illness have been written abroad.
One
article published eight years ago in the American Journal of Psychiatry reported
that having Alzheimer’s patients fill out a short questionnaire called the Doe
Standard quickly assessed mental capacity for voting when compared to the longer
Mini-Mental State Examination.
“This approach can ensure retention of
voting rights by capable persons and exclusion of clearly impaired persons from
the voting booth,” the authors wrote. “Some legal experts are concerned about
the implications of helping someone with dementia during the voting process.
With concern about coercion, they believe a person should be assisted only with
mechanical impediments such as filling out a ballot or other necessary election
form.”
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