Chapter 17: Does Dementia Change the Equation? Advance Directives and Dementia

Charles A. Corr, Karen M. Corr, and Susan M. Ramsey discuss the ethical dilemmas that arise when a patient has dementia. In a carefully drawn chapter, the authors urge that when writing advance directives, adults clearly consider the possibility of future dementia. Yet, this raises an interesting ethical issue. Are such advance directives still determinative or does the very fact of dementia so dramatically alter prior persona of the person that such earlier choices now have limited meaning? The value of an agent who can speak for the values and wishes of a person who can no longer speak for himself or herself is clear in this case example, as are the challenges that confront such an agent.

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