Dementia: ethical issues - Nuffield Council on Bioethics
Dementia: ethical issues - Nuffield Council on Bioethics
Dementia: ethical issues - Nuffield Council on Bioethics
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<str<strong>on</strong>g>Dementia</str<strong>on</strong>g>: <str<strong>on</strong>g>ethical</str<strong>on</strong>g> <str<strong>on</strong>g>issues</str<strong>on</strong>g><br />
a guide to the report<br />
11<br />
Proxy decisi<strong>on</strong>-making: welfare attorneys<br />
People who are still able to make their own decisi<strong>on</strong>s may choose<br />
some<strong>on</strong>e they trust to make decisi<strong>on</strong>s for them in the future. The<br />
pers<strong>on</strong> chosen is known as a ‘welfare attorney’. The welfare attorney<br />
must always act in the best interests of the pers<strong>on</strong> with dementia<br />
when making decisi<strong>on</strong>s.<br />
Welfare attorneys have many advantages over advance decisi<strong>on</strong>s, as<br />
they have up-to-date informati<strong>on</strong> about the decisi<strong>on</strong> to be made.<br />
However, there are c<strong>on</strong>cerns that some people may find it too<br />
expensive or complicated to nominate a welfare attorney.<br />
We c<strong>on</strong>clude…<br />
In principle, the process of appointing a welfare attorney should be<br />
free of charge for every<strong>on</strong>e, as they represent a ‘social good’. At the<br />
least, people with dementia should have support in nominating a<br />
welfare attorney if they wish to do so [paras 5.55–5.57].<br />
There will be times when doctors disagree with the welfare attorney<br />
over the best interests of the pers<strong>on</strong> with dementia. Such disputes can<br />
be referred to court. However, there is little guidance for doctors as<br />
to what level of c<strong>on</strong>cern should trigger this process.<br />
We c<strong>on</strong>clude…<br />
More guidance is needed about when it is appropriate for<br />
professi<strong>on</strong>als to challenge the decisi<strong>on</strong> of a welfare attorney in court.<br />
Significant weight should be placed <strong>on</strong> the fact that the welfare<br />
attorney was previously chosen and trusted by the pers<strong>on</strong> about<br />
whom the decisi<strong>on</strong> is being made [para 5.63].