Submitter Withdrawn Australasian Association of Bioethics & Health Law and New Zealand Bioethics Conference

Consent and inter-dependence in dementia care (1045)

Brent Hyslop 1
  1. Medicine, University of Otago, Dunedin, New Zealand

Despite being embedded in health law, challenges remains with informed consent. This is often due to uncertainty in determining what genuine consent consists of, or requires, and whether those requirements are met in a particular case.  This presentation, though, considers another possible hesitation with a standard conception of consent, particularly in dementia care.  Sometimes, one might feel doubtful about consent as solely individual consent, the assent or dissent of a single person to a certain course of healthcare intervention.  Our major life decisions involve and affect people we are close to and who support us.  In dementia, our autonomy and identity can even be seen as contingent upon these relationships.  On occasions, then, to treat consent as purely ‘individualistic’ could be to inappropriately remove our decision-making from this network of inter-dependence in which it resides.

                As well as respecting individual autonomy, our law and practice should remain sensitive to the inherently collective nature of some healthcare decisions.  In the consent process, this could include encouraging collaboration in decision-making, a principle of supported decision-making, and a reflection on criteria for capacity assessment.  This topic is particularly relevant with the increasing number of people with dementia and, consequently, spouse and family carers.