Introduction
An agreed definition of dementia is a syndrome caused in most cases by an array of illness which affects memory, reasoning, ability to carry out daily duties and communication skills. Ethical concerns not only on issues of dementia but throughout nursing practice are a pivotal point for the practice. The condition of dementia raises some ethical issues during treatment as the diseases affects a person’s ability to make sound decisions by themselves without assistance. Ethical issues in caregiving to patients with dementia come in different shape and sizes. For example, questions arise on whether a nurse should give food to a woman suffering from dysphagia or whether a man sick suffering from sexual disinhibition should be put under anti-androgen. These mentioned examples are questions of moral or ethical values as they raise issues about right or wrong. Even though clinical decisions on their own are moral stands, some pertinent questions arise when it comes to treatment of dementia and other related conditions.
There are numerous advantages associated with ethical practice in the treatment of dementia as a lot of the victims face stigmatization and discrimination. The result is the social exclusion of people with the condition. Nurses in their practice are urged not to discriminate against individuals living with the condition to uphold the highest ethical standards through the following practices; one is in relation with patients’ self-determination. Even though a patient might not be in a position of making a sound decision, if it is deciding on their behalf then the practitioner must first assume the position of the sick. Secondly, caregivers must respect the right of the sick to confidentiality regardless of the condition. Nurses should not go about announcing the status of the sick just because they have dementia. Lastly, patients with any form of dementia must be involved in daily activities regardless of their conditions. It would be unethical to assume the need for engagement in everyday activities like reading, conversing, visiting and jogging among others due to the status of the sick.
Theories of ethical practice
Ethics exist in different types and forms and find their basis on the assumptions in place. In most cases ethical practice in medical practices involve issues of wellbeing and matters of life and death while in the event of dementia, the primary moral concern is related to limiting some fundamental freedoms of the sick (Edelman, Mandle & Kudzma, 2013). There are different theories used to guide the practitioners in making ethical decision making as discussed in the paper.
Virtue Ethics Theory
The focus of the theory is the character of the moral agent as opposed to following the stipulated rules or the consequence as the only ethical decision-making elements. In other words, the theory assumes that a suitable virtuous agent would make the right decision. A worthy nurse should exhibit the following professional characteristics, compassion, trustworthiness, discernment, consciousness and integrity. When it comes to making a decision on behalf of a patient with dementia, the best thing to do as a nurse is what a person considered virtuous would undertake (Hughes & Common, 2015). Nurses and caregivers should also conduct some ethical practices related to caregiving which include trust, responsibility, fidelity and sensitivity as far as the patient nurses relationship is concerned.
Deontological Theory
The theory considers whether the nature of an action is right or wrong regardless of the outcome. Medical practice, in this case, is believed to be ethical if it feels if it is in line with the societal moral rules and principles. The theory as advanced by Kant states that as a man is a moral agent, he is responsible for all that he undertakes, actions considered either as right or wrong. In addition to this, Hughes and Common (2015) argue that deontology theory is a feature of an act in addition to consequences make such an undertaking good or bad. However, critiques of the theory have come up with arms pointing out that the result of an action should not be ignored for the societal moral stand. A set of social standards exists under the theory which deontologists believe they should not go against regardless of the condition. Deontologists believe in rational thinking when it comes to arriving at a medical decision (Carter, 2014).
Consequentialism
Under consequentialism, the right thing to do is what maximizes a patients’ happiness, pleasure, or social welfare. The theory states that the outcome of an action determines if it is good or bad. This means that the result determines whether an action is ethical or not. An example of the theory is the utilitarianism which is the greatest happiness for the greatest number of the society. Ethical issues in dementia require the caregivers to consider the outcome of the treatment not the process; this means that the process determines the consequence of the treatment.
In summation, there are numerous ethical issues surrounding treatment dementia as supported by the theories discussed above. Different caregivers take a different approach in treating the condition depending on the belief. The best outcome is what is considered in most cases as the best result.
Reference
Hughes, J., & Common, J. (2015). Ethical issues in caring for patients with dementia. Nursing Standard, 29(49), 42-47.
Daly, L., & Fahey-McCarthy, E. (2014). Re-examining the basis for ethical dementia care practice. British Journal of Nursing, 23(2).
Edelman, C. L., Mandle, C. L., & Kudzma, E. C. (2013). Health promotion throughout the life span. Elsevier Health Sciences.
Hughes, J., & Common, J. (2015). Ethical issues in caring for patients with dementia. Nursing Standard (2014+), 29(49), 42.
Carter, S. M. (2014). Health promotion: an ethical analysis. Health Promotion Journal of Australia, 25(1), 19-24.
