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Title: ... or not to be? : ethical decisions in Alzheimer's disease : the usefulness of comparative judgements
Author: Unsworth Webb, J.
Awarding Body: University of Wales Swansea
Current Institution: Swansea University
Date of Award: 2001
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The concept of permanently insentient, though biologically alive human being and the associated legal precedence for the withdrawal of artificially delivered nutrition and hydration provides the basis for a number of ethical questions. Individuals in this state, for whom different disorders or circumstances have produced what is perceived to be the same effect, do not elicit the same responses either medically or legally. The question of whether this is a justified anomaly or an inadequacy in healthcare becomes the foundation for a review of the criteria on which treatment decisions are made, recognising that actions cannot be divorced from human values and an individual's worth. Moral regard in this respect is primarily expressed by the type of healthcare provided, and the current position which amounts to the abandonment of treatment is seen to be inadequate. Much of the claim for a withholding, withdrawal or cessation of treatment is based on a concept of personhood as distinct from humanness and which, it has been claimed, is fundamentally affected by the extent of disorder. The thesis examines and ultimately supports this concept distinction. Subsequently the question of what is appropriate moral regard and therefore what is appropriate healthcare is considered in detail and changes to current practice are proposed. Essentially, the position of individuals who are no longer persons is seen to alter life preserving care responses. This is on a number of counts: the difficulty in discerning interests, if indeed the individual can be said to have interests; the logical inconsistency in maintaining a person-centred approach where personhood has been lost, and the recognition of futile care. In addressing the need for a better response, the thesis explores an alternative care formulation. What is proposed is an extension of current provision by an acceptance of care towards an organised death.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available