The Ethics of Life and Death: Advance Directives and End-of-Life Decision Making in Persons with Dementia

Abstract

This article explores the ethics of end-of-life decision making for persons who competently execute advance directives and then suffer from dementia. This exploration is informed by a review of the relevant empirical and case law literature and current debate among legal scholars in this area. The analysis emphasizes the importance of (re)examining how moral normative ethical approaches (i.e., deontological, consequentialist, virtue-based) could better inform end-of-life decision making for all parties. Implications are considered that further individual needs and also honor societal demands. Recommendations are proposed that are designed to better integrate and utilize medical, legal, clinical, and public policy professional practice efforts.

Keywords:

• dementia
• advance directives
• normative ethics
• autonomy
• authenticity