Centre for Policy on Ageing


Social work and people with dementia
 — putting principles into practice
Author(s)Esther Rachel Polden
Journal titleInternational Journal of Geriatric Psychiatry, vol 4, no 3, May-June 1989
Pagespp 173 - 181
KeywordsDementia ; Social work.
AnnotationThe Kantian principle of respect for persons has traditionally held a central place in social work theory and practice. It is argued here, however, that the language of respect for persons falls short of giving a full account of the complex nature of social work intervention in relation to elderly persons who have dementia, and so ultimately of having practical application. An alternative framework based on the theory of consent is proposed. The aim is to put into practice the principle that all persons have the right to make decisions about their own lives no matter how disabled they may be. This involves assessing the competence of individuals to give informed consent. There is also the need to offer alternative strategies to assist persons who, because of the severity of their dementia, are not deemed competent to make a particular decision. Three options are considered: justified paternalism, consent by proxy and citizen advocacy. But a fourth option is preferred in what Paul Ramsey, in his book The Patient as Person: Explorations in Medical Ethics (see Faulder, 1985), has termed constructive consent, where the decision to give consent is based on the knowledge that the individual concerned would certainly have consented if competent to do so. In this way, the language of consent gives shape and content to Immanuel Kant's formulation of respect for persons, providing a theoretical and practical framework which promotes morally and professionally proper practice. (KJ).
Accession NumberCPA-891011010
ClassmarkEA: IG

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