By Varshini Chellapilla
Clinicians and philosophers struggle to answer an ethically charged question: Are advance directives for people living with dementia useful? A recent essay suggests an entirely new way approach to answering this question. The authors include Penn Memory Center Co-Director Jason Karlawish, MD, and his colleague David Lyreskog, PhD.
Advance directives are documents prepared to guide care for someone who is unable to make their own health care decisions. They contain information about the person’s preferences for care. They’re also called “a living will.” They have an obvious appeal to guide the care of persons living with dementia, a condition that stereotypically impairs decision-making abilities.
Drs. Karlawish and Lyreskog, along with Saskia Nagel, PhD, of RWTH Aachen University, argue for an entirely new way of thinking about autonomy in persons living with dementia. Their argument was published in the August 6 issue of The American Journal of Bioethics under the title, “Where Do You End, and I Begin? How Relationships Confound Advance Directives in the Care of Persons Living with Dementia.”