If Alex's wife can convincingly show (I don't know how) that through Alex's life, he placed extreme value on his marriage, family values, and fidelity in general, would this effect the decision? My thought is that maybe the wife could argue that, absent the dementia, Alex's current behavior is actually counter to his values and beliefs. I assume that there is some sort of mechanism for honoring the pre-dementia wishes of dementia patients; for example, if a devoutly religious person has a request related to their body after death, I assume this request doesn't get discarded if the patient develops dementia and loses their religious identity. Is it possible for a SDM to claim that someone's current actions are in conflict with the goals and values they had prior to their condition?
Great question. This is the source of the tension. I get cases pretty often where a person with dementia is acting in ways that are strongly opposed to her previous values: vegetarians who become meat eaters, religious people who become atheists, sexually conservative people who become sexually outgoing (and vice versa for all of them). Families will say, "You have to stop this; this isn't who she is" and they're right! Then the question becomes what we can do about it and the risks and benefits of doing so. In one case, a man was had been a rancher stopped eating meat. His family was understandably surprised, so they tried to get him to eat it, but he was totally opposed. In this case, any means of getting him to eat it-e.g., force feeding-would be much worse for him, so it isn't ethically justified. The same is often true of sex. Families want patients to be drugged or restrained, which is hard to justify.
Let me know if there's another ethics issue you'd like me to discuss!
If Alex's wife can convincingly show (I don't know how) that through Alex's life, he placed extreme value on his marriage, family values, and fidelity in general, would this effect the decision?
My thought is that maybe the wife could argue that, absent the dementia, Alex's current behavior is actually counter to his values and beliefs. I assume that there is some sort of mechanism for honoring the pre-dementia wishes of dementia patients; for example, if a devoutly religious person has a request related to their body after death, I assume this request doesn't get discarded if the patient develops dementia and loses their religious identity.
Is it possible for a SDM to claim that someone's current actions are in conflict with the goals and values they had prior to their condition?
Great question. This is the source of the tension. I get cases pretty often where a person with dementia is acting in ways that are strongly opposed to her previous values: vegetarians who become meat eaters, religious people who become atheists, sexually conservative people who become sexually outgoing (and vice versa for all of them). Families will say, "You have to stop this; this isn't who she is" and they're right!
Then the question becomes what we can do about it and the risks and benefits of doing so. In one case, a man was had been a rancher stopped eating meat. His family was understandably surprised, so they tried to get him to eat it, but he was totally opposed. In this case, any means of getting him to eat it-e.g., force feeding-would be much worse for him, so it isn't ethically justified. The same is often true of sex. Families want patients to be drugged or restrained, which is hard to justify.
@@ValueJudgments Thanks a lot, I really appreciate the time you put into your responses. Best wishes for this channel
@@blacktimhoward4322 Thanks for watching!