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Well-Being, Time, and Dementia

Ethics 124 (3):507-542 (2014)

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  1. Caregiving and Moral Distress for Family Caregivers during Early-Stage Alzheimer’s Disease.Chris Weigel - 2019 - International Journal of Feminist Approaches to Bioethics 12 (2):74-91.
    As the global prevalence of Alzheimer’s disease increases, the need to understand family caregiving becomes increasingly pressing. I argue that there is an under-recognized form of caregiving for people with early to mid-stage Alzheimer’s disease. This type of caregiving involves, roughly, helping people reason through their values. It arises along with the loss of the capacity for executive functioning. Moreover, it is prone to give rise to moral distress, which is an under-recognized vulnerability in family caregiving. Categories of family caregiving (...)
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  • Clarifying the best interests standard: the elaborative and enumerative strategies in public policy-making.Chong Ming Lim, Michael C. Dunn & Jacqueline J. Chin - 2016 - Journal of Medical Ethics 42 (8):542-549.
    One recurring criticism of the best interests standard concerns its vagueness, and thus the inadequate guidance it offers to care providers. The lack of an agreed definition of ‘best interests’, together with the fact that several suggested considerations adopted in legislation or professional guidelines for doctors do not obviously apply across different groups of persons, result in decisions being made in murky waters. In response, bioethicists have attempted to specify the best interests standard, to reduce the indeterminacy surrounding medical decisions. (...)
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  • Commentary: On The Moral Bindingness of Advance Directives.Stephen Latham - 2020 - Cambridge Quarterly of Healthcare Ethics 29 (1):110-114.
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  • The time of one's life: views of aging and age group justice.Nancy S. Jecker - 2021 - History and Philosophy of the Life Sciences 43 (1):1-14.
    This paper argues that we can see our lives as a snapshot happening now or as a moving picture extending across time. These dual ways of seeing our lives inform how we conceive of the problem of age group justice. A snapshot view sees age group justice as an interpersonal problem between distinct age groups. A moving picture view sees age group justice as a first-person problem of prudential choice. This paper explores these different ways of thinking about age group (...)
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  • Well-being—more than health?Anna Hirsch - 2021 - Ethik in der Medizin 33 (1):71-88.
    Definition of the problem The medical-ethical principle of beneficence is directed towards the well-being of patients. In clinical practice, the focus is often on the relief of pain, the elimination of symptoms and the restoration of bodily functioning. However, the significance of these health-related aspects for the overall well-being of patients also depends on individual values, desires, and life plans. Argumentation An overemphasis on the subjective perspective of patients on their well-being would admittedly lead to a strong substantial convergence of (...)
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  • Theory Without Theories: Well-Being, Ethics, and Medicine.Jennifer Hawkins - 2021 - Journal of Medicine and Philosophy 46 (6):656-683.
    Medical ethics would be better if people were taught to think more clearly about well-being or the concept of what is good for a person. Yet for a variety of reasons, bioethicists have generally paid little attention to this concept. Here, I argue, first, that focusing on general theories of welfare is not useful for practical medical ethics. I argue, second, for what I call the “theory-without-theories approach” to welfare in practical contexts. The first element of this approach is a (...)
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  • Further Reflections: Surrogate Decisionmaking When Significant Mental Capacities are Retained.Jennifer Hawkins - 2021 - Cambridge Quarterly of Healthcare Ethics 30 (1):192-198.
    Mackenzie Graham has made an important contribution to the literature on decisionmaking for patients with disorders of consciousness. He argues, and I agree, that decisions for unresponsive patients who are known to retain some degree of covert awareness ought to focus on current interests, since such patients likely retain the kinds of mental capacities that in ordinary life command our current respect and attention. If he is right, then it is not appropriate to make decisions for such patients by appealing (...)
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  • A Fate Worse Than Death? The Well-Being of Patients Diagnosed as Vegetative With Covert Awareness.Mackenzie Graham - 2017 - Ethical Theory and Moral Practice 20 (5):1005-1020.
    Patients in the vegetative state are wholly unaware of themselves, or their surroundings. However, a minority of patients diagnosed as vegetative are actually aware. What is the well-being of these patients? How are their lives going, for them? It has been argued that on a reasonable conception of well-being, these patients are faring so poorly that it may be in their best interests not to continue existing. I argue against this claim. Standard conceptions of well-being do not clearly support the (...)
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  • Against Contextualism about Prudential Discourse.Guy Fletcher - 2019 - Philosophical Quarterly 69 (277):699-720.
    In recent times, there has been a surge of interest in, and enthusiasm for, contextualist views about prudential discourse — thought and talk about what has prudential value or contributes to someone’s well-being. In this paper I examine and reject two cases for radical forms of prudential contextualism, proposed by Anna Alexandrova and Steve Campbell. Alexandrova holds that the semantic content of terms like ‘well-being’ and ‘doing well’ varies across contexts. Campbell proposes that there are plural prudential concepts at play (...)
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  • Primum Non Nocere Mortuis: Bioethics and the Lives of the Dead.Richard H. Dees - 2019 - Journal of Medicine and Philosophy 44 (6):732-755.
    advanced directivesend-of-life decisionsharming the deadposthumous reproductiontransplant ethics.
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  • First Do No Harm: Euthanasia of Patients with Dementia in Belgium.Raphael Cohen-Almagor - 2016 - Journal of Medicine and Philosophy 41 (1):74-89.
    In Memory of Ed PellegrinoEuthanasia in Belgium is not limited to terminally ill patients. It may be applied to patients with chronic degenerative diseases. Currently, people in Belgium wish to make it possible to euthanize incompetent patients who suffer from dementia. This article explains the Belgian law and then explores arguments for and against euthanasia of patients with dementia. It probes the dementia paradox by elucidating Dworkin’s distinction between critical and experiential interests, arguing that at the end-of-life this distinction is (...)
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  • First Do No Harm: Euthanasia of Patients with Dementia in Belgium: Table 1.Raphael Cohen-Almagor - 2015 - Journal of Medicine and Philosophy:jhv031.
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  • When the Shape of a Life Matters.Stephen M. Campbell - 2015 - Ethical Theory and Moral Practice 18 (3): 565-75.
    It seems better to have a life that begins poorly and ends well than a life that begins well and ends poorly. One possible explanation is that the very shape of a life can be good or bad for us. If so, this raises a tough question: when can the shape of our lives be good or bad for us? In this essay, I present and critique an argument that the shape of a life is a non-synchronic prudential value—that is, (...)
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  • Eudaimonia and well-being: questioning the moral authority of advance directives in dementia.Philippa Byers - 2020 - Theoretical Medicine and Bioethics 41 (1):23-37.
    This paper revisits Ronald Dworkin’s influential position that a person’s advance directive for future health care and medical treatment retains its moral authority beyond the onset of dementia, even when respecting this authority involves foreshortening the life of someone who is happy and content and who no longer remembers or identifies with instructions included within the advance directive. The analysis distils a eudaimonist perspective from Dworkin’s argument and traces variations of this perspective in further arguments for the moral authority of (...)
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  • Substituted decision making and the dispositional choice account.Anna-Karin Margareta Andersson & Kjell Arne Johansson - 2018 - Journal of Medical Ethics 44 (10):703.1-709.
    There are two main ways of understanding the function of surrogate decision making in a legal context: the Best Interests Standard and the Substituted Judgment Standard. First, we will argue that the Best Interests Standard is difficult to apply to unconscious patients. Application is difficult regardless of whether they have ever been conscious. Second, we will argue that if we accept the least problematic explanation of how unconscious patients can have interests, we are also obliged to accept that the Substituted (...)
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  • Happiness.Dan Haybron - forthcoming - Stanford Encyclopedia of Philosophy.
    There are roughly two philosophical literatures on “happiness,” each corresponding to a different sense of the term. One uses ‘happiness’ as a value term, roughly synonymous with well-being or flourishing. The other body of work uses the word as a purely descriptive psychological term, akin to ‘depression’ or ‘tranquility’. An important project in the philosophy of happiness is simply getting clear on what various writers are talking about: what are the important meanings of the term and how do they connect? (...)
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  • Medicine & Well-Being.Daniel Groll - 2015 - In Guy Fletcher (ed.), The Routledge Handbook of Philosophy of Well-Being. Routledge.
    The connections between medicine and well-being are myriad. This paper focuses on the place of well-being in clinical medicine. It is here that different views of well-being, and their connection to concepts like “autonomy” and “authenticity”, both illuminate and are illuminated by looking closely at the kinds of interactions that routinely take place between clinicians, patients, and family members. -/- In the first part of the paper, I explore the place of well-being in a paradigmatic clinical encounter, one where a (...)
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