We haven't done the research ourselves. We rely on institutes like CIHI to help us with that kind of research. But certainly it bears doing research to see what the cost is. In individual emotional terms, it's quite obvious. There are both the perceived mistreatment and the real mistreatment. When there is a fear of mistreatment, that probably far exceeds the actual impact. So the neglect and the psychological trauma of feeling that your medical or physical needs are not being met exacerbate the problem.
We do get the concerns. We personally don't have the research showing what the impact of those is. We only have the anecdotes that cause us to point this issue out to the various policy-makers and administrators to make sure they are, first of all, judging whether or not they themselves are making differential choices based on a person's age and whether or not they are communicating their choices well so as to allay the person's fears. That has been our focus, rather than specific research as to whether or not treatment would actually have a negative clinical impact, but I think it stands to reason that it could. I'm not aware of research that has actually looked at that, but perhaps Dr. Joanette might know of some.