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  1. The capacity to designate a surrogate is distinct from decisional capacity: normative and empirical considerations.Mark Navin, Jason Adam Wasserman, Devan Stahl & Tom Tomlinson - forthcoming - Journal of Medical Ethics.
    The capacity to designate a surrogate is not simply another kind of medical decision-making capacity. A patient with DMC can express a preference, understand information relevant to that choice, appreciate the significance of that information for their clinical condition, and reason about their choice in light of their goals and values. In contrast, a patient can possess the CDS even if they cannot appreciate their condition or reason about the relative risks and benefits of their options. Patients who lack DMC (...)
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  2. The Relational Care Framework: Promoting Continuity or Maintenance of Selfhood in Person-Centred Care.Matthew Tieu & Steve Matthews - forthcoming - Journal of Medicine and Philosophy.
    We argue that contemporary conceptualizations of “persons” have failed to achieve the moral goals of “person-centred care” (PCC, a model of dementia care developed by Tom Kitwood) and that they are detrimental to those receiving care, their families, and practitioners of care. We draw a distinction between personhood and selfhood, pointing out that continuity or maintenance of the latter is what is really at stake in dementia care. We then demonstrate how our conceptualization, which is one that privileges the lived (...)
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  3. Complexity, Not Severity: Reinterpreting the Sliding Scale of Capacity.George Mellgard & Nada Gligorov - 2022 - Cambridge Quarterly of Healthcare Ethics 4 (31):506–517.
    In this article, we focus on the definition and application of the sliding scale of capacity. We show that the current interpretations of the sliding scale confound distinct features of the medical decision, such as its urgency, its severity, or its complexity, that do not always covary.We propose that the threshold for assessing capacity should be adjusted based solely on the cognitive complexity of the decision at hand. We further suggest that the complexity of a decision should be identified based (...)
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  4. Epistemic Injustice in Late-Stage Dementia: A Case for Non-Verbal Testimonial Injustice.Lucienne Spencer - 2022 - Social Epistemology 1 (1):62-79.
    The literature on epistemic injustice has thus far confined the concept of testimonial injustice to speech expressions such as inquiring, discussing, deliberating, and, above all, telling. I propose that it is time to broaden the horizons of testimonial injustice to include a wider range of expressions. Controversially, the form of communication I have in mind is non-verbal expression. Non-verbal expression is a vital, though often overlooked, form of communication, particularly for people who have certain neurocognitive disorders. Dependency upon non-verbal expression (...)
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  5. Dementia care, robot pets, and aliefs.Rhonda Martens & Christine Hildebrand - 2021 - Bioethics 35 (9):870-876.
  6. Truth and diversion: Self and other-regarding lies in dementia care.Matthew Tieu - 2021 - Bioethics 35 (9):857-863.
    When a person with dementia (PwD) makes a specific request or behaves in a particular way that is inappropriate or dangerous and based on a false understanding of reality, there is a particular technique that caregivers may use to try and manage the situation. The technique is known as ‘diversion’ and it works by affirming the false beliefs and behaviour of a PwD and creating the false impression that their specific request will be fulfilled. It may take the form of (...)
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  7. Advance Directives and Transformative Experience: Resilience in the Face of Change.Govind C. Persad - 2020 - American Journal of Bioethics 20 (8):69-71.
    In this commentary, I critique three aspects of Emily Walsh's proposal to reduce the moral and legal weight of advance directives: (1) the ambiguity of its initial thesis, (2) its views about the ethics and legality of clinical practice, and (3) its interpretation and application of Ronald Dworkin’s account of advance directives and L.A. Paul's view on transformative experience. I also consider what Walsh’s proposal would mean for people facing the prospect of dementia. I conclude that our reasons to honor (...)
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  8. Charité, mon amour.Andrej Poleev - 2020
    Wie jedes Krankenhaus hat Charité ihre Geschichte, die mit dem Erlaß des preußischen Königs Friedrich I. vom 14. November 1709 zur Gründung von Lazareth-Häusern anfing, um der Ausbreitung der Pest entgegenzuwirken, wozu es allerdings in Berlin nie gekommen ist. Am 9. Januar 1727 verfügte König Friedrich Wilhelm I. die Umwandlung des vor dem Spandowischen Tor errichteten Lazareth in ein Hospital und nannte es „das Haus die Charité“ nach dem Vorbild von Hôpital de la Charité in Paris. -/- Das Wort und (...)
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  9. The Irrelevance of Origins: Dementia, Advance Directives, and the Capacity for Preferences.Jason Adam Wasserman & Mark Christopher Navin - 2020 - American Journal of Bioethics 20 (8):98-100.
    We agree with Emily Walsh (2020) that the current preferences of patients with dementia should sometimes supersede those patients’ advance directives. We also agree that consensus clinical ethics guidance does a poor job of explaining the moral value of such patients’ preferences. Furthermore, Walsh correctly notes that clinicians are often averse to treating patients with dementia over their objections, and that this aversion reflects clinical wisdom that can inform revisions to clinical ethics guidance. But Walsh’s account of the moral value (...)
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  10. Consent’s dominion: Dementia and prior consent to sexual relations.Samuel Director - 2019 - Bioethics 33 (9):1065-1071.
    In this paper, I answer the following question: suppose that two individuals, C and D, have been in a long-term committed relationship, and D now has dementia, while C is competent; if D agrees to have sex with C, is it permissible for C to have sex with D? Ultimately, I defend the view that, under certain conditions, D can give valid consent to sex with C, rendering sex between them permissible. Specifically, I argue there is compelling reason to endorse (...)
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  11. An Aristotelian Naturalist Perspective on Artificial Nutrition and Hydration.Paolo Biondi - 2016 - Diametros 50:138-151.
    This polemical note looks at the ethical issue of providing artificial nutrition and hydration to patients with advanced dementia from the perspective of an Aristotelian and naturalist ethics. I argue that this issue may be considered in terms of the Aristotelian notion of eudaimonia, well-being. I present a number of facts about the conditions of human life that contribute to eudaimonia. In addition, I present a number of facts about advanced dementia as well as clarify the goals of medicine. From (...)
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  12. Solidarity in Healthcare – the Challenge of Dementia.Aleksandra Małgorzata Głos - 2016 - Diametros 49:1-26.
    Dementia will soon be ranked as the world’s largest economy. At present, it ranges from the 16th to 18th place, with countries such as Indonesia, the Netherlands, and Turkey. Dementia is not only a financial challenge, but also a philosophical one. It provokes a paradigm shift in the traditional view of healthcare and expands the classic concepts of human personhood and autonomy. A promising response to these challenges is the idea of cooperative solidarity. Cooperative solidarity, contrary to its ‘humanitarian’ version, (...)
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  13. Polemical Note: Can it Be Unethical to Provide Nutrition and Hydration to Patients with Advanced Dementia?Rachel Haliburton - 2016 - Diametros 50:152-160.
    Patients suffering from advanced dementia present ethicists and caregivers with a difficult issue: we do not know how they feel or how they want to be treated, and they have no way of telling us. We do not know, therefore, whether we ought to prolong their lives by providing them with nutrition and hydration, or whether we should not provide them with food and water and let them die. Since providing food and water to patients is considered to be basic (...)
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  14. Animals, advance directives, and prudence: Should we let the cheerfully demented die?David Limbaugh - 2016 - Ethics, Medicine and Public Health 2 (4):481-489.
    A high level of confidence in the identity of individuals is required to let them die as ordered by an advance directive. Thus, if we are animalists, then we should lack the confidence required to apply lethal advance directives to the cheerfully demented, or so I argue. In short, there is consensus among animalists that the best way to avoid serious objections to their account is to adopt an ontology that denies the existence of brains, hands, tables, chairs, iced-tea, and (...)
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  15. Ethical Issues related to End of Life Treatment in Patients with Advanced Dementia – The Case of Artificial Nutrition and Hydration.Esther-Lee Marcus, Ofra Golan & David Goodman - 2016 - Diametros 50:118-137.
    Patients with advanced dementia suffer from severe cognitive and functional impairment, including eating disorders. The focus of our research is on the issue of life-sustaining treatment, specifically on the social and ethical implications of tube feeding. The treatment decision, based on values of life and dignity, involves sustaining lives that many people consider not worth living. We explore the moral approach to caring for these patients and review the history of the debate on artificial nutrition and hydration showing the impact (...)
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  16. On the Existential Situation of a Person with Dementia: The Drama ofMankind is repeated in the Drama of Dementia.Björn Freter - 2015 - Journal of Health Science 2015:205-216.
    Man suffers from a very particular fate, namely that of being besieged by questions which he cannot answer and cannot ignore either. The ability to pose questions like these is a key characteristic of the fundamental existential situation of mankind. Every person must find his or her own particular method of coping with such questions. This makes up a significant part of the human maturing process. People with dementia, having already found their personal solution to cope with the problem of (...)
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  17. Well-Being, Time, and Dementia.Jennifer Hawkins - 2014 - Ethics 124 (3):507-542.
    Philosophers concerned with what would be good for a person sometimes consider a person’s past desires. Indeed, some theorists have argued by appeal to past desires that it is in the best interests of certain dementia patients to die. I reject this conclusion. I consider three different ways one might appeal to a person’s past desires in arguing for conclusions about the good of such patients, finding flaws with each. Of the views I reject, the most interesting one is the (...)
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  18. Quantifying the quiet epidemic: Diagnosing dementia in late 20th-century Britain.Duncan Wilson - 2014 - History of the Human Sciences 27 (5):126-146.
    During the late 20th century numerical rating scales became central to the diagnosis of dementia and helped transform attitudes about its causes and prevalence. Concentrating largely on the development and use of the Blessed Dementia Scale, I argue that rating scales served professional ends during the 1960s and 1970s. They helped old age psychiatrists establish jurisdiction over conditions such as dementia and present their field as a vital component of the welfare state, where they argued that ‘reliable modes of diagnosis’ (...)
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  19. Doing the Right Thing: A Geriatrician's Perspective on Medical Care for the Person with Advanced Dementia.Muriel R. Gillick - 2012 - Journal of Law, Medicine and Ethics 40 (1):51-56.
    America is aging. But even more striking than the rise in the proportion of the population over age 65 is the unprecedented number of individuals who are living into their eighties and nineties. While many people remain robust well into advanced age, the dramatic increase in the number of the oldest old has brought with it an epidemic of Alzheimer’s disease and other dementias. Dementia is a highly prevalent condition — currently 5.4 million Americans have Alzheimer’s disease, a number which (...)
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  20. Into the darkness: Losing identity with dementia.Jennifer Radden & Joan M. Fordyce - 2006 - In Julian C. Hughes, Stephen J. Louw & Steven R. Sabat (eds.), Dementia: Mind, Meaning, and the Person. Oxford University Press.