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Of Meatballs, Autonomy, and Human Dignity: Neuroethics and the Boundaries of Decision Making Among Persons with Dementia (2018)

19 December 2022

Autonomy is considered a basic principle of the doctor-patient relationship: in general, people have the right to be treated according to their informed preferences and wishes. However, there are situations related to cognitive disorders in which it is no longer clear whether the patient is actually able to understand his or her prior preferences. In such cases, trying to respect the patient's autonomy can become highly problematic. An interesting real-life case of an Alzheimer's patient - reported in the literature - provides an opportunity to discuss the complex interplay of factors at stake in such cases: in different circumstances, some ethical considerations become more relevant and others are unclear. Respect for human dignity should always be a moot point, but with the caveat that this may apply to different things in different situations and at different stages. In particular, attention should be paid to the value and limits of respecting previous autonomy as a way of respecting human dignity. This shows that realising human dignity in the borderline areas of cognitive and decision-making capacity requires an increasingly sophisticated understanding of what happens in the patient's brain and how and when illness impairs the patient's capacity.

https://www.researchgate.net/profile/Patrick-Mcdonald-

5/publication/334618329_It_Is_Time_to_Expand_the_Scope_and_Reach_of_Neuroethics/lin ks/5d36544592851cd0467e2be8/It-Is-Time-to-Expand-the-Scope-and-Reach-of-Neuroethics.pdf