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Abstract Details

Dementia, valuing, and advance directives
Practice, Policy, and Ethics
P9 - Poster Session 9 (12:00 PM-1:00 PM)
7-003
N/A

New criteria for diagnosis of Alzheimer’s disease involves biomarker data rather than purely clinical findings. Our increasing understanding of this disease enables prodromal diagnosis. We therefore anticipate that advanced directives will become more prevalent as patients must make decisions about the planning of their medical care prior to becoming demented.

N/A
Advance directives made by patient can decline medical care for their future incompetent self. We examine the authority of advance directives in an important class of dementia cases: those in which patients’ current best interests appear to conflict with their past instructions. Our core claim is that the loss of competence does not entail the absence of valuing, caring, or exercise of the will that commands respect in treatment decisions. To elucidate this claim we conducted interviews with patients who had been cured of dementia in the via successful treatment for normal pressure hydrocephalus. These interviews reveal that patients retrospectively endorse the continuity of their values throughout their period of dementia. In addition, the quality of these values at the time of dementia seem to be of the appropriate sort to demand respect from the standpoint of autonomy.

We offer evidence that demented patients lacking capacity or competence can retain attitudes and values that imbue their decisions with some autonomy, thereby commanding a degree of moral respect for these decisions.

Authors/Disclosures
Benjamin Lin
PRESENTER
No disclosure on file
No disclosure on file