V for Life

3. Exploring ethical dilemmas in dementia #DementiaActionWeek

Posted by Tom on 14/05/24 in Articles, Life After Retirement

In part two of this series, we introduced an ethical quandary, in which the Swedish Ethics Committee opted to serve meat to Oscar, a dedicated vegan grappling with Alzheimer’s, deeming it the optimal solution.

However, an academic paper delves deeper into the complexities surrounding this decision. Exploring various ethical and philosophical angles, the paper offers insights into alternative viewpoints on serving meatballs to Oscar. We caught up with the authors to discuss their research.


Navigating this ethical quandary, Drs. Lavazza and Reichlin explore various philosophical perspectives, including those of Dresser, Dworkin, and Jaworska.

Dr Lavazza said: “We know that there are some classical philosophical views, for example, brought about by Dresser. In this perspective, we must follow the patient’s perspective, the way they manifest at the time being, given that the previous values are no longer applicable. So in this case, if we need to translate this general proviso, we need to serve meatballs.

“On the contrary, we can have another very influential view in this case, for example, advocated by Dworkin. He believed that only desires expressed in full autonomy have ethical relevance, and in this case one should this not serve meatballs to Oscar because his current desire to have meat is not related to his full endorsed desires, so to say.”

Another thinker, Jaworska, suggests a different view based on neuroscience. She says that even if people with dementia lose some mental abilities, they can still develop new interests.

Research indicates that in Alzheimer's disease, the hippocampus, a key part of the brain, is one of the first areas to be affected. This affects recent memories more than older ones, though it doesn't happen the same way for everyone.

Even when memory fades, some parts of the brain keep working, letting emotional bonds stay strong. Jaworska thinks this means that people with Alzheimer's can still make decisions and decide what's important for quite some time.

“[Jaworska] maintains that it is legitimate to refer to a different conception of autonomy. This is one for which [people living with] dementia… continue to possess mental functions on the basis of which they are able to generate new genuine interests,” Lavazza said.

Jaworska's perspective challenges the idea proposed by Dworkin that only interests held before the disease should be considered valid. This introduces a new angle to the discussion.

We continue our discussions in part 4, tomorrow.


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