Exploring Compassion & Choices’ approach to dementia, Part 2

In its new "Dementia Values & Priorities Tool," Compassion and Choices (C&C) helps people clarify their wishes if they acquire dementia.  They offer a satisfactory, though limited, list of dementia-related symptoms (discussed in Part 1).  In Part 2, I have identified a few other (or slightly different) symptoms that are important to me in the event that I lose the ability to hasten my own death because of dementia or some unexpected reason, such as a stroke or other event that renders me incapable of carrying out a hastened death. Part 2 concludes an analysis of C&C's approach to dementia. (Continue reading ...)

Is a “good death” a viable option

Two weeks ago, I spoke to about twenty people at the regular weekly meeting of the Ethical Society of Austin (Texas).  The topic was the seven choices available to a person who becomes afflicted with dementia.  I began by asking what, for them, are the characteristics of a "good death."  In about ten minutes, the group offered ideas that suggest a "good death" is a viable option, with some universal characteristics, in spite of some voices to the contrary. (Continue reading ...)

Choices and dilemmas in dementia care

Larissa MacFarquhar discusses treatment approaches for people in the late stages of dementia in the October 8, 2018, issue of The New Yorker–The Comforting Fictions of Dementia Care.  It is not unusual for late-stage dementia patients to have delusions (the belief in something that is not real) or hallucinations (false sensory perceptions of objects or events). How caregivers might respond to these and related dementia problems is the subject of MacFarquhar's article. (Continue reading ...)

Whose Life is it Anyway?

Since the 1970s there have been debates about whether “patients” have the right to refuse various forms of life-saving or life-sustaining medical treatment, ranging from blood transfusions to ventilators and feeding tubes.  More recently the debate has moved into the area of dementia and which, if any, kinds of treatment may be refused under the terms of a directive written in advance of loss of decision-making capacity.  The issue of forced feeding is addressed by several articles in the July/August issue (48:4) of the Hastings Center Report, one of the nation’s preeminent bioethics publications. (Continue reading ...)

Advance care planning for dementia: a case study–Part 1

Rebecca Dresser is a law professor and recognized expert in biomedical ethics. She argues that "people usually live for many years after a dementia diagnosis, years in which meaningful and satisfying life can continue. People can’t be sure how they will fare as dementia patients . . ."  She suggests that because dementia patients can adapt to their new circumstances, they must, therefore, be allowed to accept this new life.. Lamar Hankins analyses her ideas in a two-part post. (Continue reading ...)
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