-
Future Scoping: Ethical Issues In Aging And DementiaIn Judy Illes & Barbara J. Sahakian (eds.), Oxford Handbook of Neuroethics, Oxford University Press. 2011.This article highlights some pathophysiological facts in terms of aging and dementia. It considers potential biomedical advances and how they relate to well-being. It focuses on mild cognitive impairment, which brings together the themes of aging and dementia. Consideration of MCI throws us back to the social context of aging and dementia, where values are to the fore and judgments have to be made. The point at issue in this discussion is the role of the normative in aging and dementia. The arti…Read more
-
Seeing wholeIn Julian C. Hughes, Stephen J. Louw & Steven R. Sabat (eds.), Dementia: Mind, Meaning, and the Person, Oxford University Press. 2005.
-
Patterns of Practice: A Useful Notion in Medical Ethics?Journal of Ethics in Mental Health 1 (1): 1. 2009.This paper introduces the notion of patterns of practice and shows the extent to which it is useful at the level of practice and at a profound philosophical level. The notion makes deep connections with ideas in the realm of the philosophy of language and thought and, in addition, it connects to virtue ethics. Using the example of whether or not to admit someone using compulsory powers or whether to treat them in the community, the notion of patterns of practice can be used to demonstrate the in…Read more
-
Case Study-" Hey Bill, smoking is bad for you..."Journal of Ethics in Mental Health 2 (2): 11. 2009.
-
28How are we to understand dementia? The main argument involves an analysis (in Chapter 2) of intentional mental states, using Wittgenstein's discussion of rule-following, which suggests that such states demonstrate an irreducible, transcendental normativity. This externalist account of intentional mental states highlights the worldly embedding of practices. In Chapters 3,4 and 5, this analysis is applied respectively to the disease, cognitive neuropsychology and social constructionist models of d…Read more
-
Seeing wholeIn Julian C. Hughes, Stephen J. Louw & Steven R. Sabat (eds.), Dementia: Mind, Meaning, and the Person, Oxford University Press. 2005.
-
37The return of the living dead: Agency lost and found?In Julian C. Hughes, Stephen J. Louw & Steven R. Sabat (eds.), Dementia: Mind, Meaning, and the Person, Oxford University Press. pp. 143--161. 2005.
-
Dementia is Dead, Long Live AgeingIn K. W. M. Fulford, Martin Davies, Richard Gipps, George Graham, John Sadler, Giovanni Stanghellini & Tim Thornton (eds.), The Oxford handbook of philosophy and psychiatry, Oxford University Press. 2013.Dementia is dead, long live aging! This chapter sets out the philosophical sources for understanding working with "dementia." The concept, "dementia," serves no useful purpose. Even "Alzheimer's disease" turns out to be problematic. This is because there is a lack of precision around the boundaries of these notions. The messiness that surrounds these notions, in terms of facts and values, is made obvious when we consider mild cognitive impairment, which is said to be a pre-dementia state. It mak…Read more
-
19The advance directive conjuring trick and the person with dementiaIn Guy Widdershoven (ed.), Empirical ethics in psychiatry, Oxford University Press. pp. 123--40. 2008.
-
The use of new technologies in managing dementia patientsIn Charles Foster, Jonathan Herring & Israel Doron (eds.), The law and ethics of dementia, Hart Publishing. 2014.
-
16Alzheimer's and other DementiasOxford University Press. 2011.With more people in the world living into older age, Alzheimer's and other Dementias: The Facts takes a comprehensive look at the spread of dementia, and provides authoritative information and practical advice for sufferers, their families, and the medical professionals who care for them. Written by a consultant in old age psychiatry, the book provides an overview of all the different types of dementia (including younger-onset dementias), from the most-recognized - Alzheimer's - to the less-freq…Read more
-
28Thinking Through DementiaOxford University Press. 2011.Dementia affects millions of people throughout the world. Thinking through Dementia offers a critique of the main models used to understand dementia-the biomedical, neuropsychological, and social constructionist. It discusses clinical issues and cases, together with philosophical work that might help us to better understand and treat this illness.
-
8Este artículo discute los problemas relacionados con la toma de decisiones en la demencia (y otras deficiencias cognitivas progresivas). Presenta cinco de estos temas; a saber, los relacionados con el lugar de residencia, la atención forzada, la medicación encubierta (en relación con la cual también mencionaré la verdad), la sexualidad, la comida y la bebida, que incluye cierta consideración de suspender y retirar el tratamiento en general. Después reflexionará sobre cómo se trata la toma de dec…Read more
-
27Resuscitation decisions at the end of life: medical views and the juridification of practiceJournal of Medical Ethics 44 (6): 376-383. 2018.BackgroundConcerns about decision making related to resuscitation have led to two important challenges in the courts resulting in new legal precedents for decision-making practice. Systematic research investigating the experiences of doctors involved in decisions about resuscitation in light of the recent changes in law remains lacking.AimTo analyse the practice of resuscitation decision making on hospital wards from the perspectives of doctors.DesignThe data presented in this paper were collect…Read more
-
21Introduction: The Heat of Mild Cognitive ImpairmentPhilosophy, Psychiatry, and Psychology 13 (1): 1-2. 2006.In lieu of an abstract, here is a brief excerpt of the content:Introduction:The Heat of Mild Cognitive ImpairmentJulian C. Hughes (bio)Keywordsaging, explanation, mild cognitive impairment, understanding, valuesDebates about mild cognitive impairment (MCI) are generating heat, albeit civilized heat. But under the surface, as I think the papers in this special issue demonstrate, the civilized heat comes from a good deal of passion. One way in which philosophy can contribute to the debate is by ma…Read more
-
23Nudging the Older Person Into Care: An End to the Dilemma?American Journal of Bioethics 13 (6): 34-36. 2013.
-
9Emotions and Personhood. Exploring Fragility — Making Sense of Vulnerability by Giovanni Stanghellini & René Rosfort, 2013 Oxford, Oxford University Press xii + 340 pp, £44.99 (pb) (review)Journal of Applied Philosophy 31 (1): 106-108. 2014.
-
55Views of the person with dementiaJournal of Medical Ethics 27 (2): 86-91. 2001.In this paper I consider, in connection with dementia, two views of the person. One view of the person is derived from Locke and Parfit. This tends to regard the person solely in terms of psychological states and his/her connections. The second view of the person is derived from a variety of thinkers. I have called it the situated-embodied-agent view of the person. This view, I suggest, more readily squares with the reality of clinical experience. It regards the person as embedded in a history a…Read more
-
37Dependence and autonomy in old age: an ethical framework for long term careJournal of Medical Ethics 31 (1). 2005.Perhaps the change of title says it all. This is the revised edition of Agich’s Autonomy and Long Term Care, which was itself a seminal work. The new title gives us the main drift: if autonomy is important in old age, so too is dependence. Indeed, in the actual world in which Agich is keen to locate his study, autonomy and dependence intermingle as inescapable features of old age for real people. As he says: “Maintaining a sense of autonomous wellbeing is consistent with dependencies on medicati…Read more
-
48Types of centredness in health care: themes and concepts (review)Medicine, Health Care and Philosophy 11 (4): 455-463. 2008.Background For a variety of sociological reasons, different types of centredness have become important in health and social care. In trying to characterize one type of centredness, we were led to consider, at a conceptual level, the importance of the notion of centredness in general and the reasons for there being different types of centeredness. Method We searched the literature for papers on client-, family-, patient-, person- and relationship- centred care. We identified reviews or papers tha…Read more
-
14"More Things in Heaven and Earth": The Worldly Situated Human Person PerspectivePhilosophy, Psychiatry, and Psychology 29 (2): 107-109. 2022.It might seem too obvious to start with this quotation:O day and night, but this is wondrous strange!And therefore as a stranger give it welcome.There are more things in heaven and earth, Horatio,Than are dreamt of in your philosophy.But then, I think it is obviously correct, as Professor Waterman suggests, that "There are more things in heaven and earth" than simply the application of the scientific method to medical practice. Perhaps there are two quick comments to make about the quotation. Fi…Read more
-
1Gesundheitsbegriffe in der PsychiatrieIn Philip Eijk, Detlev Ganten & Roman Marek (eds.), Was Ist Gesundheit?: Interdisziplinäre Perspektiven Aus Medizin, Geschichte Und Kultur, De Gruyter. pp. 322-338. 2021.
-
30Going Against the Stream: Ethical Aspects of Ageing and Care: P Jeffery. Gracewing, 2001, 14.99 (pb), pp xxi + 282. ISBN 0 85244 541 (review)Journal of Medical Ethics 29 (4): 15-15. 2003.This book is challenging and sets itself up as “going against the stream”. But which stream? Perhaps there is a distinction between the stream in medical ethics and the stream in clinical practice. One impressive feature of the book is the detail of the references and footnotes. This gives me the impression that Jeffery is swimming in the stream of academic medical ethics. It is also true that he has first hand experience of clinical practice, but I suspect it is the flow towards euthanasia in t…Read more
-
18From the Subjective Brain to the Situated PersonAmerican Journal of Bioethics 9 (9): 29-30. 2009.Reading Grant Gillett (2009) is a bit like watching a supreme tightrope artist: his balance is always impeccable and his footing sure; and yet one cannot help occasionally holding one's breath. Ove...
-
97Value judgements and conceptual tensions: decision-making in relation to hospital discharge for people with dementiaClinical Ethics 7 (4): 166-174. 2012.We reflect, using a vignette, on conceptual tensions and the value judgements that lie behind difficult decisions about whether or not the older person with dementia should return home or move into long-term care following hospital admission. The paper seeks, first, to expose some of the difficulties arising from the assessment of residence capacity, particularly around the nature of evaluative judgements and conceptual tensions inherent in the legal approach to capacity. Secondly, we consider t…Read more
-
19Challenges faced by patients, relatives and clinicians in end-stage dementia decision-making: a qualitative study of swallowing problemsJournal of Medical Ethics 47 (12). 2021.BackgroundDecision-making in end-stage dementia is a complex process involving medical, social, legal and ethical issues. In ESD, the person suffers from severe cognitive problems leading to a loss of capacity to decide matters regarding health and end-of-life issues. The decisional responsibility is usually passed to clinicians and relatives who can face significant difficulty in making moral decisions, particularly in the presence of life-threatening swallowing problems.AimThis study aimed to …Read more
-
9Truthfulness and the person living with dementia: Embedded intentions, speech acts and conforming to the realityBioethics 35 (9): 842-849. 2021.Highly reputable bodies have said that lying is to be avoided when speaking with people living with dementia, unless it cannot be. And yet, the evidence is that many professionals looking after people who live with dementia have been lying to them. I wish to consider an underlying philosophical justification for the moral position that allows lying under some circumstances whilst still condemning it generally. It can seem difficult to ignore the immorality of lying, but thinkers have developed a…Read more
-
20The ethics of forced care in dementia: Perspectives of care home staffClinical Ethics 19 (1): 80-87. 2024.Some care home residents with dementia have the capacity, some do not. Staff may need to make decisions about administering care interventions to someone whom they believe lacks the capacity to consent to it, but also resists the intervention. Such intervention can be termed forced care. The literature on forced care (especially reflecting empirical work) is scant. This study aims to investigate how the ethics of forced care is navigated in practice, through ten semi-structured interviews with s…Read more