The Value Given and Presupposed in Person-Centred Dementia Care

Abstract

Thirty years ago, Tom Kitwood proposed a change in the care of people with dementia, from ‘warehousing’ to ‘person-centred care’. The change had noticeable benefits for those with dementia. Kitwood set out his presuppositions for this change. For example, Kitwood understood personhood as the standing or status bestowed on one human being by others in the context of relationships and social being and held that respect for the absolute value of each person is a key theme in Western ethical discourse. He was clear this respect needs no theological grounding but is the only assumption on which our lives as social beings make sense. This paper discusses various contradictions within Kitwood’s presuppositions and offers a diagnosis. My alternative proposal is to keep the theme of the absolute or unconditional value of human persons but take this as an objective fact about each person, whether always recognised or not. I argue that this proposal is intelligible (contra J. Mackie) and that there is evidence in support (a critical discussion of S. Darwall, who also rejects any theological interpretation of his second personal standpoint). The paper concludes with a question about the power at work in person-centred care and considers an example from Peter Singer.