Ethical issues in Dementia care
pp. 445-468
in: Geoffrey Scarre (ed), The Palgrave handbook of the philosophy of aging, Berlin, Springer, 2016Abstract
This chapter addresses some of the key ethical dilemmas posed during the course of dementia, from diagnosis through to end-of-life care. These dilemmas present a variety of different but related issues concerning autonomy and agency, care, consideration and dignity. While many of these are shared by other conditions associated with neuro-cognitive impairments, what is difficult is the temporal instability of those impairments and especially their progressive nature that changes the conditions upon which clinical and personal decisions are to be made, from those confronting the person faced with an early diagnosis to those with responsibility for caring at the limits of life. We have tried to cover most of these dilemmas – of choice, dignity and responsibility throughout the course of dementia – in a way that we hope will be helpful to clinicians, researchers and those more personally interested in the condition, recognising that during this process considerations of agency and autonomy are inevitably overshadowed by care and the concerns of others.