Viewing Alzheimer's disease through new lenses: Protecting personhood, combating stigma, and preserving decision-making capacity.

摘要

Alzheimer's disease (AD) is an incurable chronic neurodegenerative disorder. Since there is no cure for AD, the focus of the disease is negative and hopeless. A negative view of AD poses problems; it strips individuals with the disease of their personhood, perpetuates personal and societal stigma, and removes autonomous decision-making capacity from those with AD.;Some philosophers have included memory and cognition as criteria for personhood, placing persons with AD at risk for losing their status as persons. Further, our culture strongly values cognition, intellect, and independence, and fears anything that erodes those principles. Therefore, our society fears AD. As a consequence, society tends to discriminate against, stereotype, and devalue those suffering from the disease. When stigma and stereotyping occurs, this further reinforces the lack of personhood of those with the disease. Our culture also values autonomy. It is traditionally believed that when a person experiences cognitive deficits, he or she needs a third party to make legal and medical decisions. Persons with AD can exert previous autonomous wishes but problems arise when their previous wishes conflict with what is in their current best interests.;This dissertation examines the writings of philosophers throughout history to determine criteria for personhood, explores theories of stigma, and explores the narratives of persons with AD to gain an insight into how society treats them once they are diagnosed, and presents the bioethical standards for decision-making to apply them to persons with AD.;Disputing the belief that cognition and memory are sole criteria for personhood, this work explores cognitive capacities that remain in a person throughout the course of AD, identifies other criteria for personhood, and discusses how the loss of one's memory affects personal identity, but not one's status as a person. Finally, it proposes a model for decision-making that honors a person's current autonomy and considers his or her best interests, and offers a new way for our society to view AD, a view that brings hope rather than despair.