The report suggests that there are approximately 700,000 people in the UK who currently have dementia and they predict that this figure is likely to rise to 1.7 million by 2051, potentially costing the UK around £17 Billion a year. They argue the importance of understanding dementia in ethical terms, looking at issues such as balancing safety with freedom, deciding what is in the best interest of the person with dementia and considering the needs of others involved. In response to these they offer an ‘ethical framework’ to give help and guidance to those facing ethical decisions.
Their ethical framework is made up of the six components briefly outlined below:
- Using a ‘case-based’ approach, whereby decisions are made by looking at the facts, applying ethical values to them and then comparing similar situations.
- Having a belief about the nature of dementia.
- Having a belief about an individual’s quality of life with dementia.
- Promoting both the interests of the person with dementia and those who care for them.
- Acknowledging a responsibility to support people with dementia.
- Ensuring the personhood and identity of a person with dementia remains equally valued.
A key argument in their report is the belief that how services are carried out can be much more important than the ‘particular structure or format of services’ themselves. They offer a number of recommendations to improve care for people with dementia, some of which are outlined below:
- More research should be carried out to determine why there is variation between different cultures with respect to readiness to come forward for diagnosis.
- There should be clear guidance on the role of those close to the person with dementia, including guidance on confidentiality at the point of diagnosis.
- The legal duties of all “service providers” under the Disability Discrimination Act 1995 should be publicised to address the discrimination experienced by people with dementia.
- Specific attention should be put on providing support for those who care for dementia sufferers.
- They highlight the importance of using social research to provide evidence on better ways to support people with dementia and their carers and criticise that preventative strategies appear to have a low priority.
To read the report visit the Nuffield Council on Bioethics website