title: Justified paternalism: the nature of beneficence in the care of dementia patients.
abstract: The issue of patient autonomy in cases of permanent dementia has recently received a great deal of philosophical attention. Specifically, many have worried about ethical issues surrounding advance directives in which people specify how they shall be treated when they are no longer competent to make their own medical decisions. Ronald Dworkin has been a staunch defender of what he calls precedent autonomy in these cases, believing persons have a right to control, to some degree, how their lives will end, despite the common intuition that the principle of beneficence requires us to improve the experiential quality of patients' lives. Objections have been brought against Dworkin on a number of fronts, including worries about personal identity theory and informed consent. Here, I offer an objection to Dworkin's assessment of the nature of paternalism as it relates to cases of permanent dementia.
authors.affiliation: University of Washington, USA, kashinadawn@gmail.com
authors.forename: Kashina
authors.initials: K
authors.lastname: Groves
mesh_terms: D024362:Advance Directive Adherence / Q000941:ethics*; D016223:Advance Directives; D026686:Beneficence; D003657:Decision Making / Q000941:ethics; D003704:Dementia; D005066:Euthanasia, Passive; D006801:Humans; D008020:Life Support Care; D016743:Mental Competency; D026706:Paternalism / Q000941:ethics*; D026684:Personal Autonomy; D028723:Personhood; D011788:Quality of Life