Dementia and self-determination

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Published: 24 April 2012

Some 1.2 million people with moderate to severe dementia are currently living in Germany – trending upwards. In view of the health-political challenges accompanying these numbers, it is important to respect and encourage the self-determination of persons with dementia. The resources still existing in these people are coming into view only if the equating of human beings with their cognitive performance is overcome by a perspective which recognises the sentient, emotional and social nature of human beings.

In order to reinforce these views, the German Ethics Council draws up a total of 16 recommendations. It supports the Federal Government's aim of developing a National Action Plan for dementia. The need for care of people with dementia should be reviewed by taking adequate account of their potential of self-determination. Outpatient communal housing and residential communities for persons with dementia should be expanded and the effort of caring family members more widely recognized and – also financially – supported. The principles of the UN Convention on the Rights of Persons with Disabilities, which also includes persons with dementia, should be consistently applied to support their possibilities of self-determination. Finally, when considering the applicability of an advance directive expressions of a patient’s will to live should be taken into account even if his or her competence is lacking or at least questionable.