Solidarity in Healthcare – the Challenge of Dementia

Głos, Aleksandra

doi:10.13153/diam.49.2016.918

Cited by 1 publication

(2 citation statements)

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“…When decision-making capacity is compromised to some degree, assistance from their loved ones is helpful to evaluate whether the decisions patients make align with what they genuinely value (Tonelli and Misak 2010 ). This is particularly the case with people with dementia (Głos 2016 ).…”

Section: The Concept Of Relational Autonomymentioning

confidence: 99%

“…Even though rationality and memory are impaired in patients with dementia, they display their preferences and crude rationality hidden in and tangled with emotions. Close relationships with family and friends can help them express themselves and maintain their sense of self by constituting part of their identity, shaped and restored through relationships (Głos 2016 ). For this reason, in my opinion, discussions between patients, family, and medical professionals facilitate relational autonomy, and doctors can take wishes of patients with dementia as authoritative as long as these are discernible from their previous interactions and lifestyles, believing families as witnesses.…”

Section: The Concept Of Relational Autonomymentioning

confidence: 99%

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Relational Autonomy, the Right to Reject Treatment, and Advance Directives in Japan

Asagumo

2021

ABR

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Although the patient’s right to decide what they want for themselves, which is encompassed in the notion of ‘patient-centred medicine’ and ‘informed consent’, is widely recognised and emphasised in Japan, there remain grave problems when it comes to respecting the wishes of the no-longer-competent when death is imminent. In general, it is believed that the concepts above do not include the right to refuse treatment when treatment withdrawal inevitably results in death, even when the patient previously expressed the wish to exercise this right when competent. In this paper, I first explain the current social and legal situation in Japan, where the lack of legal clarity regarding the right to reject treatment tends to result in doctors adopting the interpretation of patients’ words that is least conducive to treatment withdrawal. I then argue that the right to refuse treatment should be taken seriously, even when the patient is no longer competent, or the treatment refusal will result in death. I suggest that the concept of relational autonomy might have some practical and valuable implications in a country where individual autonomy is considered incompatible with societal values. Finally, I answer possible objections to relational autonomy and address the widespread societal concern about sliding down the slippery slope from allowing the right to refuse treatment to the obligation to die.

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Section: The Concept Of Relational Autonomymentioning

confidence: 99%

Section: The Concept Of Relational Autonomymentioning

confidence: 99%