Ethical issues in the care of people with dementia

Abstract

Dementia is a syndrome characterised by cognitive decline, memory loss and progressive functional impairment. It is increasingly common, and is largely managed in the community. The nature of dementia leads to many deep philosophical problems that bear on the various ethical issues that arise for clinicians caring for these patients. This article explores these ethical issues with a focus on promoting autonomy and making best interests decisions. Everyday ethical issues including truth telling, restraint and limitations of freedom, abuse and vulnerability are considered. Ethical issues generated by the use of assistive technologies and finally confidentiality are also, briefly, considered. Although this article cannot give specific ‘right answers’ to the myriad ethical issues confronting GPs working with people with dementia, it does aim to highlight productive lines of thought in navigating such issues.