Le libre choix. De l'autonomie rêvée à l'attention aux capacités

Zielinski, Agata

doi:10.3917/gs.131.0011

Cited by 18 publications

(3 citation statements)

References 2 publications

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“…Therefore, between a conception of the autonomy of rationality (Kant) and autonomy as self-determination or absolute independence of the individual in J. S. Mill’s liberalism, it is necessary to point to a third way, that of attention to capabilities. Through this, respect for the dignity of the person goes beyond acquiescence to self-determination and beyond the consideration of reason alone, and includes taking into account their history, relationships, capacities and difficulties to plan and carry out their projects, in short, their capacities and their vulnerability [ 30 ] (pp. 23–24).…”

Section: Vulnerable With Dignity Towards a Paradoxical And Relatimentioning

confidence: 99%

Vulnerable Dignity, Dignified Vulnerability: Intertwining of Ethical Principles in End-of-Life Care

Terrón

2021

IJERPH

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The aim of this article is to analyze how dignity and vulnerability, as declared principles of bioethics, both can be seen in a new light when they are thought of together, in their intertwining, in order to outline a proposal for an analytical framework for end-of-life care. It is thus shown, on the one hand, that the demand for respect for the equal dignity of every person, linked by the different anthropological and ethical theories to their autonomy as a rational agent, also refers to their fragile, vulnerable, and interdependent character, as an embodied subjectivity, sustained by a complex web of care. On the other hand, the vulnerability of these selves as others, constituted by the radical appeal of everything that affects them socially, emotionally, sensitively, and by their need for recognition and attention, would be pathological if it did not include the impulse towards autonomy, which, although precarious and connotative, requires dignified and equitable treatment. This intertwining of both principles points to a phenomenological conception of the person as a corporeal social existence, from which a number of studies on the attention to dignity and vulnerability at the end of life are analyzed.

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Section: Vulnerable With Dignity Towards a Paradoxical And Relatimentioning

confidence: 99%

Vulnerable Dignity, Dignified Vulnerability: Intertwining of Ethical Principles in End-of-Life Care

Terrón

2021

IJERPH

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“…However, the tendency is to consider decision-making autonomy in a binary mode, where autonomy is preserved versus affected, while in reality it is more like a continuum. 6 Indeed, the decision-making autonomy of older people with cognitive impairment is relative and dependent on their neuropsychological disorders and previous experiences they remember, as well as on the ability of their relatives to support them. Considering that the older person, particularly with neurocognitive impairment, is no longer competent to decide the living place for himself or herself, has a major impact.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

“…Assessment of decision-making capacity (DMC) is essential in this respect. However, the tendency is to consider decision-making autonomy in a binary mode, where autonomy is preserved versus affected, while in reality it is more like a continuum 6. Indeed, the decision-making autonomy of older people with cognitive impairment is relative and dependent on their neuropsychological disorders and previous experiences they remember, as well as on the ability of their relatives to support them.…”

Section: Introductionmentioning

confidence: 99%

Added value of functional neuroimaging to assess decision-making capacity of older adults with neurocognitive disorders: protocol for a prospective, monocentric, single-arm study (IMAGISION)

et al. 2021

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IntroductionAssessment of decision-making capacity (DMC) is essential in daily life as well as for defining a person-centred care plan. Nevertheless, in ageing, especially if signs of dementia appear, it becomes difficult to assess decision-making ability and raises ethical questions. Currently, the assessment of DMC is based on the clinician’s evaluation, completed by neuropsychological tests. Functional MRI (fMRI) could bring added value to the diagnosis of DMC in difficult situations.Methods and analysisIMAGISION is a prospective, monocentric, single-arm study evaluating fMRI compared with clinical assessment of DMC. The study will begin during Fall 2021 and should be completed by Spring 2023. Participants will be recruited from a memory clinic where they will come for an assessment of their cognitive abilities due to decision-making needs to support ageing in place. They will be older people over 70 years of age, living at home, presenting with a diagnosis of mild dementia, and no exclusion criteria of MRI. They will be clinically assessed by a geriatrician on their DMC, based on the neuropsychological tests usually performed. Participants will then perform a behavioural task in fMRI (Balloon Analogue Risk Task) to analyse the activation areas. Additional semistructured interviews will be conducted to explore real life implications. The main analysis will study concordance/discordance between the clinical classification and the activation of fMRI regions of interest. Reclassification as ‘capable’, based on fMRI, of patients for whom clinical diagnosis is ‘questionable’ will be considered as a diagnostic gain.Ethics and disseminationIMAGISION has been authorised by a research ethics board (Comité de Protection des Personnes, Bordeaux, II) in France, in accordance with French legislation on interventional biomedical research, under the reference IDRCB number 2019-A00863-54, since 30 September 2020. Participants will sign an informed consent form. The results of the study will be presented in international peer-reviewed scientific journals, international scientific conferences and public lectures.Trial registration numberNCT03931148

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Impact sur la qualité de vie des patients de l’information sur la conduite automobile : étude prospective dans le cadre des tumeurs gliales

et al. 2016

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Le libre choix. De l'autonomie rêvée à l'attention aux capacités

Cited by 18 publications

References 2 publications

Vulnerable Dignity, Dignified Vulnerability: Intertwining of Ethical Principles in End-of-Life Care

Vulnerable Dignity, Dignified Vulnerability: Intertwining of Ethical Principles in End-of-Life Care

Added value of functional neuroimaging to assess decision-making capacity of older adults with neurocognitive disorders: protocol for a prospective, monocentric, single-arm study (IMAGISION)

Impact sur la qualité de vie des patients de l’information sur la conduite automobile : étude prospective dans le cadre des tumeurs gliales

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