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Personhood, Dementia and the Integrity of a Life*

Published online by Cambridge University Press:  29 November 2010

Christine Harrison
Christine Harrison
Affiliation:
McMaster University
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Abstract

Dementing illnesses, such as Alzheimer's disease, cause great changes in individuals – sometimes even leading us to say that they are “different persons”. Professional caregivers to these individuals may better understand them and their suffering (and thus provide more compassionate care), if they look at the illness in the context of the individual's life. Although their personhood has been threatened by dementia, appreciating the gestalt, or integrity of their lives may help preserve it. The clinical focus, which currently looks only at problems, should also assess the individual's remaining strengths, positive functions and characteristics. A case scenario helps to illustrate these suggestions. Some recommendations to researchers, clinicians and bioethicists for further study in this area are included.

Résumé

Les maladies mentales, comme la maladie d'Alzheimer, causent des changements substantiels chez les personnes qui en sont atteintes, ce qui nous porte parfois à dire qu'elles sont devenues des « personnes différentes ». Les professionnels qui prodiguent des soins à ces personnes peuvent mieux les comprendre, de même que leur souffrance (et ainsi faire preuve de plus de compassion à leur endroit) lorsqu'ils envisagent la maladie dans le contexte de la vie quotidienne. Bien que l'identité de ces personnes soit menacée par la maladie, l'étude de la gestalt, ou l'intégrité de leur vie, peut les aider à préserver leur santé mentale. L'intervention clinique, qui à l'heure actuelle traite uniquement les problèmes, devrait également évaluer les forces, les fonctions et les caractéristiques positives des personnes atteintes. Une étude de cas vient illustrer ces suggestions. Quelques recommandations destinées aux chercheurs, aux cliniciens et aux spécialistes de la bioéthique désirant effectuer des études plus approfondies dans ce domaine sont également incluses.

Keywords

DementiaAlzheimer's DiseaseEthicsPersonal IdentityPersonhood.Démencemaladie d'Alzheimeréthiqueidentité personnelleidentité.
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 12 , Issue 4: The Humanities in Gerontology Numéro spécial: Les sciences humaines en gérontologie , Winter/hiver 1993 , pp. 428 - 440
Copyright
Copyright © Canadian Association on Gerontology 1993

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References

1.Warren, MA. On the moral and legal status of abortion. In: Mappes, TA & Zembaty, JS eds., Social ethics: Morality and social policy (2nd. ed.) (pp. 17–23). New York: McGraw-Hill, 1982.Google Scholar
2.Fletcher, JF. Indicators of humanhood: A tentative profile of man. Hastings Center Report 1972; 2: 1–4.CrossRefGoogle Scholar
3.Fletcher, JF. Four indicators of humanhood — the enquiry matures. Hastings Center Report 1974; 4: 4–7.CrossRefGoogle ScholarPubMed
4.Tooley, M. Abortion and Infanticide. Oxford: Clarendon, 1983.Google Scholar
5.Fletcher, JF. Humanhood: Essays in Biomedical Ethics. Buffalo: Prometheus, 1979.Google Scholar
6.Harrison, CE. “Person” in Medical Ethics. Unpublished doctoral dissertation, McMaster University, Hamilton, 1990.Google Scholar
7.Downie, RS, Telfer, E. Respect for Persons. London: Allen and Unwin, 1969.Google Scholar
8.Cassell, EJ. The Nature of Suffering. New York: Oxford, 1991.CrossRefGoogle Scholar
9.Frankena, WK. The ethics of respect for persons. Philosophical Topics 1986; 14: 149–67.CrossRefGoogle Scholar
10.Kant, I. Fundamental Principles of the Metaphysic of Morals. Indianapolis: Bobbs-Merrill, 1949.Google Scholar
11.Agich, GJ. Reassessing autonomy in long-term care. Hastings Center Report 1990; 20: 12–17.CrossRefGoogle ScholarPubMed
12.Lidz, CW, Fisher, L, Arnold, RM. The Erosion of Autonomy in Long-Term Care. New York: Oxford University Press, 1992.CrossRefGoogle Scholar
13.Dworkin, R. Autonomy and the demented self. Milbank Quarterly 1986; 64: 4–16, Supplement 2.CrossRefGoogle ScholarPubMed
14.Cassell, EJ. The nature of suffering and the goals of medicine. New England Journal of Medicine 1982; 306: 639–45.CrossRefGoogle Scholar
15.Tobin, SS. Personhood in Advanced Old Age. New York: Springer, 1991.Google Scholar
16.Semple, S, Smith, CM, Swash, M. The Alzheimer disease syndrome. In: Corkin, S. ed., Aging: Vol. 19. Alzheimer's Disease: A Report of Progress in Research (pp. 93–107). New York: Raven, 1982.Google Scholar
17.Stead, H. Day Centre at St. Joseph's helps cope with Alzheimers. The Guelph Mercury, July 9, 1992; p. Dl.Google Scholar
18.Doernberg, M. Stolen Mind: The Slow Disappearance of Ray Doernberg. Chapel Hill: Algonquin Books, 1986.Google Scholar
19.Maclntyre, A. After Virtue. Notre Dame: University of Notre Dame, 1981.Google Scholar
20.Harvey, W, Landry, L, Pepper-Smith, R. Competence, Guardianship and Social Justice. A paper presented at the 4th Annual Meeting, Canadian Bioethics Society, Toronto, Ontario, October 29, 1992.Google Scholar
21.Hamlyn, DW. Psychological explanation and the gestalt hypothesis. Mind 1951; 60: 506–20 (see note i).CrossRefGoogle Scholar
22.Arnheim, R. Gestalt psychology. Encyclopedia of Psychology. New York: John Wiley & Sons, 1984.Google Scholar
23.Meissner, WW. Theories of personality. In: Nicholi, A.M. Jr, ed., The Harvard Guide to Modern Psychiatry (pp. 115–46). Cambridge: Belknap, 1978.Google Scholar
24.Wertheimer, M. Gestalt theory. Social Research 1944; 11: 78–99.Google Scholar
25.Koehler, W. Some gestalt problems. In: Ellis, W.D. ed., A Source Book of Gestalt Psychology (pp. 55–70). New York: Humanities Press, 1967.Google Scholar
26.Frondizi, R. The Nature of the Self. New Haven: Yale, 1953 (see note ii).Google Scholar
27.Allport, GW. Personality: A Psychological Interpretation. New York: Henry Holt & Co., 1937.Google Scholar
28.Enelow, AJ, Swisher, SN. Interviewing and Patient Care. New York: Oxford, 1979.Google Scholar
29.Buzzell, EM. Sleuthing for abilities. A paper presented at the Pre-Conference Session, National Alzheimer's Society Conference, Hamilton, Ontario, April 19, 1990.Google Scholar
30.Kane, R. Who is in nursing homes – an ethnography. A paper presented at the American Society of Law Medicine & Ethics Conference, Ethics Committees and the Elderly: Hospitals and Nursing Homes, Baltimore, Maryland, March 19–20, 1993.Google Scholar