Dilemas y ética del cuidado: conservar y cuidar la autonomía de la persona con demencia

Abstract

IntroductionDementias constitute a group of diseases that notoriously affect people who suffer from them, especially in terms of their independence and decision-making, leading the caregiver to assume or make various decisions about the patient. However, in the past this was explained by the fact that there was a theoretical and narrative insufficiency around patients with dementia, which led us to ignore that they still conserved their decision-making capacity as well as their autonomy. ObjectiveThis text proposes to defend the existence of autonomy in these patients and a way about how we can take care of it and preserve it in the medical field, through an ethical position based on the care and recognition of vulnerability. MethodologyAn approach focused on the ethics of care and vulnerability by Ronald Dworkin, Emmanuel Levinas and Corine Pelluchon focused on the person with dementia. I introduced a scale that allows assessing autonomy and decision-making in people with dementia. Results and discussionTo guarantee the dignity of the person with dementia, it is necessary to understand how they are autonomous, in terms of self-governance and seeking to reduce asymmetries in relationships. In addition, always include caregivers and family members in decision-making. ConclusionsPeople with dementia are autonomous in an individual or personal sense and deserve respect. Although they are in a state of vulnerability, there are different mechanisms focused on their care.