RT Journal Article
SR Electronic
T1 Limits of advance directives in decision-making around food and nutrition in patients with dementia
JF Journal of Medical Ethics
JO J Med Ethics
FD BMJ Publishing Group Ltd and Institute of Medical Ethics
SP 762
OP 765
DO 10.1136/jme-2023-109652
VO 50
IS 11
A1 Shelton, Wayne
A1 Geppert, Cynthia
YR 2024
UL http://jme.bmj.com/content/50/11/762.abstract
AB Advance directives are critically important for capable individuals who wish to avoid the burdens of life-prolonging interventions in the advanced stages of dementia. However, this paper will argue that advance directives should have less application to questions about feeding patients during the clinical course of dementia than often has been presumed. The argument will be framed within the debate between Ronald Dworkin and Rebecca Dresser regarding the moral authority of precedent autonomy to determine an individual’s future end-of-life care plan. We will use a brief analysis of the positions taken in two important papers that come out of the Dworkin/Dresser debate and a hypothetical patient, John, who will be followed from diagnosis of dementia to death, to show how advance directives should apply to key points in the progression of his disease, particularly in relation to food and nutrition.Data sharing not applicable as no datasets generated and/or analysed for this study.