Philosopher Challenges Dementia View, Argues for Patient's Evolving Preferences
A philosopher challenges the prevalent view in philosophical literature on dementia, arguing it's out of touch with clinical practice. The author contends that preferences expressed by patients with dementia after the condition's onset should hold more sway in medical decisions.
The author criticises the 'received view' in philosophical literature, which gives decisive moral weight to preferences expressed at the onset of dementia, often through advance directives. They argue this approach is inadequate and fails to reflect real-world clinical practice.
Clinical practice, the author notes, often favours considering preferences expressed by patients with dementia even after the condition has progressed. This is because having dementia can be a 'cognitive transformative experience', leading to legitimate preference changes. These changes, the author insists, should be given moral weight in medical decision-making.
The author suggests reducing confidence in the moral weight of advance directives for patients with dementia. They encourage a more nuanced approach that acknowledges the evolving nature of preferences in patients with dementia, especially those in the moderate-late stage who may express preferences different from those at the onset of their condition.
The philosopher argues for a shift in the philosophical literature's view on dementia, aligning it more closely with clinical practice. They advocate for giving moral weight to preferences expressed by patients with dementia even after the condition's onset, acknowledging the transformative nature of the condition and the evolution of patient preferences.
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