email page print pageAll Topic Reviews
Anger and Forgiveness"Are You There Alone?"10 Good Questions about Life and DeathA Casebook of Ethical Challenges in NeuropsychologyA Companion to BioethicsA Companion to BioethicsA Companion to GenethicsA Companion to GenethicsA Companion to Muslim EthicsA Cooperative SpeciesA Critique of the Moral Defense of VegetarianismA Delicate BalanceA Fragile LifeA Life for a LifeA Life-Centered Approach to BioethicsA Matter of SecurityA Natural History of Human MoralityA Philosophical DiseaseA Practical Guide to Clinical Ethics ConsultingA Question of TrustA Sentimentalist Theory of the MindA Short Stay in SwitzerlandA Tapestry of ValuesA Very Bad WizardA World Without ValuesAction and ResponsibilityAction Theory, Rationality and CompulsionActs of ConscienceAddiction and ResponsibilityAddiction NeuroethicsAdvance Directives in Mental HealthAfter HarmAftermathAgainst AutonomyAgainst BioethicsAgainst HealthAgainst Moral ResponsibilityAgency and AnswerabilityAgency and ResponsibilityAgency, Freedom, and Moral ResponsibilityAging, Biotechnology, and the FutureAlbert Schweitzer's Reverence for LifeAlphavilleAltruismAltruismAmerican EugenicsAmerican PsychosisAn American SicknessAn Anthology of Psychiatric EthicsAn Introduction to EthicsAn Introduction to Evolutionary EthicsAn Introduction to Kant's Moral Philosophy And a Time to DieAnimal LessonsAnimal RightsAnimals Like UsApplied Ethics in Mental Health CareAre Women Human?Aristotle on Practical WisdomAristotle's Ethics and Moral ResponsibilityAssisted Suicide and the Right to DieAutonomyAutonomy and the Challenges to LiberalismAutonomy, Consent and the LawBabies by DesignBackslidingBad PharmaBad SoulsBasic Desert, Reactive Attitudes and Free WillBeauty JunkiesBefore ForgivingBeing AmoralBeing YourselfBending Over BackwardsBending ScienceBernard WilliamsBetter Humans?Better Than WellBeyond ChoiceBeyond GeneticsBeyond HatredBeyond Humanity?Beyond LossBeyond LossBeyond Moral JudgmentBeyond the DSM StoryBias in Psychiatric DiagnosisBioethicsBioethicsBioethics and the BrainBioethics at the MoviesBioethics Beyond the HeadlinesBioethics Critically ReconsideredBioethics in a Liberal SocietyBioethics in the ClinicBiomedical EthicsBiomedical EthicsBiomedical EthicsBiomedical EthicsBiomedical Research and BeyondBiosBioscience EthicsBipolar ChildrenBluebirdBodies out of BoundsBodies, Commodities, and BiotechnologiesBody BazaarBoundBoundaries and Boundary Violations in PsychoanalysisBraintrustBrandedBreaking the SilenceBuffy the Vampire Slayer and PhilosophyCapital PunishmentCase Studies in Biomedical Research EthicsChallenging the Stigma of Mental IllnessCharacter and Moral Psychology Character as Moral FictionChild Well-BeingChildrenChildren's RightsChoosing ChildrenChoosing Not to ChooseClinical Dilemmas in PsychotherapyClinical EthicsCloningClose toYouCoercion as CureCoercive Treatment in PsychiatryCognition of Value in Aristotle's EthicsCognitive Disability and Its Challenge to Moral Philosophy Comfortably NumbCommonsense RebellionCommunicative Action and Rational ChoiceCompetence, Condemnation, and CommitmentComprehending CareConducting Insanity EvaluationsConfidential RelationshipsConfidentiality and Mental HealthConflict of Interest in the ProfessionsConsuming KidsContemporary Debates In Applied EthicsContemporary Debates in Moral TheoryContemporary Debates in Social PhilosophyContentious IssuesContesting PsychiatryCrazy in AmericaCreating CapabilitiesCreatures Like Us?Crime and CulpabilityCrime, Punishment, and Mental IllnessCritical Perspectives in Public HealthCritical PsychiatryCrueltyCultural Assessment in Clinical PsychiatryCurrent Controversies in Values and ScienceCutting to the CoreCyborg CitizenDamaged IdentitiesDeaf Identities in the MakingDeath Is That Man Taking NamesDebating ProcreationDebating Same-Sex MarriageDecision Making, Personhood and DementiaDecoding the Ethics CodeDefining DifferenceDefining Right and Wrong in Brain ScienceDefining the Beginning and End of LifeDelusions of GenderDementiaDemocracy in What State?Demons of the Modern WorldDescriptions and PrescriptionsDesert and VirtueDesire, Practical Reason, and the GoodDestructive Trends in Mental HealthDeveloping the VirtuesDid My Neurons Make Me Do It?Difference and IdentityDigital HemlockDigital SoulDignityDisability BioethicsDisability, Difference, DiscriminationDisordered Personalities and CrimeDisorders of VolitionDisorientation and Moral LifeDivided Minds and Successive SelvesDoes Feminism Discriminate against Men?Does Torture Work?Double Standards in Medical Research in Developing CountriesDrugs and JusticeDworkin and His CriticsDying in the Twenty-First CenturyEarly WarningEconomics and Youth ViolenceEmbodied RhetoricsEmerging Conceptual, Ethical and Policy Issues in BionanotechnologyEmotional ReasonEmotions in the Moral LifeEmotions in the Moral LifeEmpathyEmpathy and Moral DevelopmentEmpathy and MoralityEmpirical Ethics in PsychiatryEncountering NatureEncountering the Sacred in PsychotherapyEngendering International HealthEnhancing EvolutionEnhancing Human CapacitiesEnoughEros and the GoodErotic InnocenceErotic MoralityEssays on Derek Parfit's On What MattersEssays on Free Will and Moral ResponsibilityEthical Choices in Contemporary MedicineEthical Conflicts in PsychologyEthical Dilemmas in PediatricsEthical Issues in Behavioral ResearchEthical Issues in Dementia CareEthical Issues in Forensic Mental Health ResearchEthical Issues in the New GeneticsEthical LifeEthical Reasoning for Mental Health ProfessionalsEthical TheoryEthical WillsEthically Challenged ProfessionsEthicsEthicsEthicsEthics and AnimalsEthics and ScienceEthics and the A PrioriEthics and the Discovery of the UnconsciousEthics and the Metaphysics of MedicineEthics at the CinemaEthics Case Book of the American Psychoanalytic AssociationEthics Done RightEthics ExpertiseEthics for EveryoneEthics for PsychologistsEthics for the New MillenniumEthics in CyberspaceEthics in Health CareEthics In Health Services ManagementEthics in Mental Health ResearchEthics in PracticeEthics in PsychiatryEthics in PsychologyEthics in Psychotherapy and CounselingEthics of PsychiatryEthics without OntologyEthics, Culture, and PsychiatryEthics, Sexual Orientation, and Choices about ChildrenEvaluating the Science and Ethics of Research on HumansEvilEvil GenesEvil in Modern ThoughtEvil in Modern ThoughtEvolution, Gender, and RapeEvolutionary Ethics and Contemporary BiologyEvolutionary Psychology and ViolenceEvolved MoralityExperiments in EthicsExploding the Gene MythExploiting ChildhoodFacing Human SufferingFact and ValueFaking ItFalse-Memory Creation in Children and AdultsFat ShameFatal FreedomFellow-Feeling and the Moral LifeFeminism and Its DiscontentsFeminist Ethics and Social and Political PhilosophyFeminist TheoryFinal ExamFirst Do No HarmFirst, Do No HarmFlashpointFlesh WoundsForced to CareForgivenessForgivenessForgiveness and LoveForgiveness and ReconciliationForgiveness and RetributionFoucault and the Government of DisabilityFoundational Issues in Human Brain MappingFoundations of Forensic Mental Health AssessmentFree WillFree Will And Moral ResponsibilityFree Will and Reactive AttitudesFree Will, Agency, and Meaning in LifeFree?Freedom and ValueFreedom vs. InterventionFriendshipFrom Darwin to HitlerFrom Disgust to HumanityFrom Enlightenment to ReceptivityFrom Morality to Mental HealthFrom Silence to VoiceFrom Valuing to ValueFrontiers of JusticeGender in the MirrorGenetic PoliticsGenetic ProspectsGenetic ProspectsGenetics of Original SinGenetics of Original SinGenocide's AftermathGetting RealGluttonyGood WorkGoodness & AdviceGreedGroups in ConflictGrowing Up GirlGut FeminismHabilitation, Health, and AgencyHandbook for Health Care Ethics CommitteesHandbook of BioethicsHandbook of Children's RightsHandbook of PsychopathyHappinessHappiness and the Good LifeHappiness Is OverratedHard FeelingsHard LuckHardwired BehaviorHarmful ThoughtsHeal & ForgiveHealing PsychiatryHealth Care Ethics for PsychologistsHeterosyncraciesHistorical and Philosophical Perspectives on Biomedical EthicsHoly WarHookedHookedHow Can I Be Trusted?How Propaganda WorksHow to Do Things with Pornography How to Make Opportunity EqualHow Universities Can Help Create a Wiser WorldHow We HopeHow We Think About DementiaHuman BondingHuman EnhancementHuman GoodnessHuman Identity and BioethicsHuman TrialsHumanism, What's That?Humanitarian ReasonHumanityHumanizing MadnessI am Not Sick I Don't Need Help!I Was WrongIdentifying Hyperactive ChildrenIf That Ever Happens to MeImproving Nature?In Defense of FloggingIn Defense of SinIn Love With LifeIn Our Own ImageIn the FamilyIn the Land of the DeafIn the Name of IdentityIn the Wake of 9/11In Two MindsInclusive EthicsInclusive EthicsInformed Consent in Medical ResearchInnovation in Medical TechnologyInside Assisted LivingInside EthicsIntelligence, Race, and GeneticsIntensive CareInto the Gray ZoneIs Human Nature Obsolete?Is Long-Term Therapy Unethical?Is There a Duty to Die?Is There an Ethicist in the House?Issues in Philosophical CounselingJudging Children As ChildrenJust a DogJust BabiesJust CareJustice for ChildrenJustice for HedgehogsJustice in RobesJustice, Luck, and KnowledgeJustifiable ConductKant on Moral AutonomyKant's Theory of VirtueKids of CharacterKilling McVeighLack of CharacterLack of CharacterLaw and the BrainLearning About School ViolenceLearning from Baby PLeaving YouLectures on the History of Political PhilosophyLegal and Ethical Aspects of HealthcareLegal Aspects of Mental CapacityLegal ConceptionsLegal InsanityLegalizing ProstitutionLet Them Eat ProzacLevelling the Playing FieldLiberal Education in a Knowledge SocietyLiberal EugenicsLife After FaithLife at the BottomLife, Sex, and IdeasListening to the WhispersLiving ProfessionalismLosing Matt ShepardLostLuckyMad in AmericaMad PrideMadhouseMaking Another World PossibleMaking Babies, Making FamiliesMaking Genes, Making WavesMaking Sense of Freedom and ResponsibilityMalignantMasculinity Studies and Feminist TheoryMeaning and Moral OrderMeaning in LifeMeaning in Life and Why It MattersMeans, Ends, and PersonsMeans, Ends, and PersonsMedical Enhancement and PosthumanityMedical Research for HireMedicalized MasculinitiesMedically Assisted DeathMeditations for the HumanistMelancholia and MoralismMental Health Professionals, Minorities and the PoorMental Illness, Medicine and LawMerit, Meaning, and Human BondageMetaethical SubjectivismMill's UtilitarianismMind FieldsMind WarsMind WarsModern Theories of JusticeModernity and TechnologyMoney ShotMonsterMoral Acquaintances and Moral DecisionsMoral BrainsMoral ClarityMoral CultivationMoral Development and RealityMoral Dilemmas in Real LifeMoral DimensionsMoral EntanglementsMoral FailureMoral LiteracyMoral MachinesMoral MindsMoral OriginsMoral Panics, Sex PanicsMoral ParticularismMoral PerceptionMoral PsychologyMoral Psychology: Volume IVMoral RealismMoral RelativismMoral RepairMoral Responsibility and Alternative PossibilitiesMoral Status and Human LifeMoral StealthMoral Theory at the MoviesMoral TribesMoral Value and Human DiversityMoral, Immoral, AmoralMoralismMorality and Self-InterestMorality in a Natural WorldMorality, Moral Luck and ResponsibilityMorals, Rights and Practice in the Human ServicesMorals, Rights and Practice in the Human ServicesMore Than HumanMotive and RightnessMovies and the Moral Adventure of LifeMurder in the InnMy Body PoliticMy Brain Made Me Do ItMy Sister's KeeperMy Sister's KeeperMy WayNano-Bio-EthicsNarrative MedicineNarrative ProsthesisNatural Ethical FactsNatural-Born CybogsNaturalized BioethicsNeither Bad nor MadNeoconservatismNeonatal BioethicsNeurobiology and the Development of Human MoralityNeuroethicsNeuroethicsNeuroethicsNew Takes in Film-PhilosophyNew Waves in EthicsNew Waves in MetaethicsNietzsche on Ethics and PoliticsNo Child Left DifferentNo Impact ManNormative EthicsNormativityNothing about us, without us!Oath BetrayedOf War and LawOn ApologyOn Being AuthenticOn EvilOn Human RightsOn The Stigma Of Mental IllnessOn the TakeOn Virtue EthicsOn What MattersOn What We Owe to Each OtherOne ChildOne Nation Under TherapyOne World NowOne World NowOur Bodies, Whose Property?Our Bodies, Whose Property?Our Daily MedsOur Faithfulness to the PastOur Posthuman FutureOut of EdenOut of Its MindOut of the ShadowsOverdosed AmericaOxford Handbook of Psychiatric EthicsOxford Textbook of Philosophy of PsychiatryPassionate DeliberationPatient Autonomy and the Ethics of ResponsibilityPC, M.D.Perfecting VirtuePersonal AutonomyPersonal Autonomy in SocietyPersonal Identity and EthicsPersonalities on the PlatePersonhood and Health CarePersons, Humanity, and the Definition of DeathPerspectives On Health And Human RightsPharmacracyPharmageddonPhilosophy and This Actual WorldPhilosophy of BiologyPhilosophy of Technology: The Technological ConditionPhysician-Assisted DyingPicturing DisabilityPilgrim at Tinker CreekPlaying God?Playing God?Political EmotionsPornlandPowerful MedicinesPractical Autonomy and BioethicsPractical EthicsPractical Ethics for PsychologistsPractical RulesPragmatic BioethicsPragmatic BioethicsPragmatic NeuroethicsPraise and BlamePreferences and Well-BeingPrimates and PhilosophersPro-Life, Pro-ChoiceProcreation and ParenthoodProfits Before People?Progress in BioethicsProperty in the BodyProzac As a Way of LifeProzac on the CouchPsychiatric Aspects of Justification, Excuse and Mitigation in Anglo-American Criminal Law Psychiatric EthicsPsychiatry and EmpirePsychological Concepts and Biological PsychiatryPsychology and Consumer CulturePsychology and LawPsychotropic Drug Prescriber's Survival GuidePublic Health LawPublic Health Law and EthicsPublic PhilosophyPunishing the Mentally IllPunishmentPursuits of WisdomPutting Morality Back Into PoliticsPutting on VirtueQuality of Life and Human DifferenceRaceRadical HopeRadical VirtuesRape Is RapeRe-creating MedicineRe-Engineering Philosophy for Limited BeingsReason's GriefReasonably ViciousReckoning With HomelessnessReconceiving Medical EthicsRecovery from SchizophreniaRedefining RapeRedesigning HumansReducing the Stigma of Mental IllnessReflections On How We LiveReframing Disease ContextuallyRefusing CareRefuting Peter Singer's Ethical TheoryRelative JusticeRelativism and Human RightsReligion ExplainedReprogeneticsRescuing JeffreyResponsibilityResponsibility and PsychopathyResponsibility and PunishmentResponsibility and PunishmentResponsibility from the MarginsResponsible GeneticsRethinking CommodificationRethinking Informed Consent in BioethicsRethinking Mental Health and DisorderRethinking RapeReturn to ReasonRevolution in PsychologyRightsRights, Democracy, and Fulfillment in the Era of Identity PoliticsRisk and Luck in Medical EthicsRobert NozickRousseau and the Dilemmas of Modernity Rule of Law, Misrule of MenRun, Spot, RunRunning on RitalinSatisficing and MaximizingSchizophrenia, Culture, and SubjectivityScience and EthicsScience in the Private InterestScience, Policy, and the Value-Free IdealScience, Seeds and CyborgsScratching the Surface of BioethicsSecular Philosophy and the Religious TemperamentSeeing the LightSelf-ConstitutionSelf-Made MadnessSelf-Trust and Reproductive AutonomySentimental RulesSex Fiends, Perverts, and PedophilesSex OffendersSex, Family, and the Culture WarsSexual DevianceSexual EthicsSexual PredatorsSexualized BrainsShaping Our SelvesShock TherapyShould I Medicate My Child?ShunnedSick to Death and Not Going to Take It AnymoreSickoSide EffectsSidewalk StoriesSister CitizenSkeptical FeminismSocial Inclusion of People with Mental IllnessSocial JusticeSociological Perspectives on the New GeneticsSome We Love, Some We Hate, Some We EatSovereign VirtueSpeech MattersSpiral of EntrapmentSplit DecisionsSticks and StonesStories MatterSubjectivity and Being SomebodySuffering, Death, and IdentitySuicide ProhibitionSurgery JunkiesSurgically Shaping ChildrenTaking Morality SeriouslyTaming the Troublesome ChildTechnology and the Good Life?TestimonyText and Materials on International Human RightsThe Aims of Higher EducationThe Almost MoonThe Altruistic BrainThe American Psychiatric Publishing Textbook of Forensic PsychiatryThe Animal ManifestoThe Animals' AgendaThe Art of LivingThe Autonomy of MoralityThe Beloved SelfThe Best Things in LifeThe Big FixThe Bioethics ReaderThe Biology and Psychology of Moral AgencyThe Blackwell Guide to Medical EthicsThe Body SilentThe BondThe Book of LifeThe Burden of SympathyThe Cambridge Companion to Virtue EthicsThe Cambridge Companion to Virtue EthicsThe Cambridge Textbook of BioethicsThe Case against Assisted SuicideThe Case Against PerfectionThe Case Against PunishmentThe Case for PerfectionThe Case of Terri SchiavoThe Challenge of Human RightsThe Code for Global EthicsThe Colonization Of Psychic SpaceThe Commercialization of Intimate LifeThe Common ThreadThe Connected SelfThe Constitution of AgencyThe Creation of PsychopharmacologyThe Criminal BrainThe Decency WarsThe Difficult-to-Treat Psychiatric PatientThe Disability PendulumThe Disability Rights Movement: From Charity to ConfrontationThe Domain of ReasonsThe Double-Edged HelixThe Duty to ProtectThe Emotional Construction of MoralsThe End of Ethics in a Technological SocietyThe End of Stigma?The Essentials of New York Mental Health LawThe Ethical BrainThe Ethical Dimensions of the Biological and Health SciencesThe Ethics of BioethicsThe Ethics of Human EnhancementThe Ethics of ParenthoodThe Ethics of SightseeingThe Ethics of the FamilyThe Ethics of the Family in SenecaThe Ethics of the LieThe Ethics of TransplantsThe Ethics of WarThe Ethics ToolkitThe Evolution of Mental Health LawThe Evolution of MoralityThe FamilyThe Fat Studies ReaderThe Forgiveness ProjectThe Form of Practical KnowledgeThe Fountain of YouthThe Freedom ParadoxThe Future of Assisted Suicide and EuthanasiaThe Future of Human NatureThe Good BookThe Good LifeThe Great BetrayalThe Handbook of Disability StudiesThe Healing VirtuesThe High Price of MaterialismThe History of Human RightsThe HorizonThe Idea of JusticeThe Ideal of NatureThe Illusion of Freedom and EqualityThe Immortal Life of Henrietta LacksThe Importance of Being UnderstoodThe Insanity OffenseThe Joy of SecularismThe Language PoliceThe Last Normal ChildThe Last UtopiaThe Limits of MedicineThe LobotomistThe Love CureThe Lucifer EffectThe Manual of EpictetusThe Mark of ShameThe Meaning of NiceThe Medicalization of SocietyThe Merck DruggernautThe Mind Has MountainsThe Modern Art of DyingThe Modern SavageThe Moral ArcThe Moral BrainThe Moral Demands of MemoryThe Moral FoolThe Moral MindThe Moral Psychology HandbookThe Moral, Social, and Commercial Imperatives of Genetic Testing and ScreeningThe Most Good You Can DoThe Myth of ChoiceThe Myth of the Moral BrainThe Nature of NormativityThe New Disability HistoryThe New Genetic MedicineThe New Religious IntoleranceThe Offensive InternetThe Origins of FairnessThe Oxford Handbook of Animal EthicsThe Oxford Handbook of Ethics at the End of LifeThe Perfect BabyThe Philosophy of NeedThe Philosophy of PornographyThe Philosophy of PsychiatryThe Politics Of LustThe Portable Ethicist for Mental Health Professionals The Power of Religion in the Public SphereThe Price of PerfectionThe Price of TruthThe Problem of PunishmentThe Prosthetic ImpulseThe Psychology of Good and EvilThe Psychology of Good and EvilThe PsychopathThe Purity MythThe Pursuit of PerfectionThe Relevance of Philosophy to LifeThe Right Road to Radical FreedomThe Right to Be ParentsThe Righteous MindThe Root of All EvilThe Rules of InsanityThe Second SexismThe Second-Person StandpointThe Silent World of Doctor and PatientThe Sleep of ReasonThe Social Psychology of Good and EvilThe Social Psychology of MoralityThe Social Psychology of MoralityThe Speed of DarkThe Stem Cell ControversyThe Stem Cell ControversyThe Story of Cruel and UnusualThe Story WithinThe Stubborn System of Moral ResponsibilityThe Suicide TouristThe Terrible GiftThe Theory of OptionsThe Therapy of DesireThe Trauma of Psychological TortureThe Trauma of Psychological TortureThe Triple HelixThe Trolley Problem MysteriesThe Trouble with DiversityThe Truth About the Drug CompaniesThe Ugly LawsThe Varieties of Religious ExperienceThe Virtue of Defiance and Psychiatric EngagementThe Virtues of FreedomThe Virtues of HappinessThe Virtuous Life in Greek EthicsThe Virtuous PsychiatristThe Voice of Breast Cancer in Medicine and BioethicsThe War Against BoysThe War for Children's MindsThe Whole ChildThe Woman RacketThe Worldwide Practice of TortureTherapy with ChildrenThieves of VirtueThree Generations, No ImbecilesTimes of Triumph, Times of DoubtTolerance Among The VirtuesTolerance and the Ethical LifeTolerationToxic PsychiatryTrauma, Truth and ReconciliationTreatment Kind and FairTrusting on the EdgeTry to RememberUltimate JudgementUnborn in the USA: Inside the War on AbortionUndermining ScienceUnderstanding AbortionUnderstanding CloningUnderstanding EmotionsUnderstanding EvilUnderstanding Kant's EthicsUnderstanding Moral ObligationUnderstanding Physician-Pharmaceutical Industry InteractionsUnderstanding TerrorismUnderstanding the GenomeUnderstanding the Stigma of Mental IllnessUnderstanding Treatment Without ConsentUnhingedUnprincipled VirtueUnsanctifying Human Life: Essays on EthicsUnspeakable Acts, Ordinary PeopleUp in FlamesUpheavals of ThoughtUsers and Abusers of PsychiatryValue-Free Science?Values and Psychiatric DiagnosisValues in ConflictVegetarianismViolence and Mental DisorderVirtue EthicsVirtue, Rules, and JusticeVirtue, Vice, and PersonalityVirtues and Their VicesVulnerability, Autonomy, and Applied EthicsWar Against the WeakWar, Torture and TerrorismWarrior's DishonourWeaknessWelfare and Rational CareWhat Genes Can't DoWhat Have We DoneWhat Is a Human?What Is Good and WhyWhat Is Good and WhyWhat Is the Good Life?What Price Better Health?What Should I Do?What We Owe to Each OtherWhat Would Aristotle Do?What's Good on TVWhat's Normal?What's Wrong with Children's RightsWhat's Wrong with Homosexuality?What's Wrong With Morality?When Is Discrimination Wrong?Who Holds the Moral High Ground?Who Owns YouWho Qualifies for Rights?Whose America?Whose View of Life?Why Animals MatterWhy Animals MatterWhy I Burned My Book and Other Essays on DisabilityWhy Not Kill Them All?Why Punish? How Much?Why Some Things Should Not Be for SaleWisdom, Intuition and EthicsWithout ConscienceWomen and Borderline Personality DisorderWomen and MadnessWondergenesWould You Kill the Fat Man?Wrestling with Behavioral GeneticsWriting About PatientsYou Must Be DreamingYour Genetic DestinyYour Inner FishYouth Offending and Youth Justice Yuck!
How We Think About Dementia is a book directed at professionals or people who are familiar with research and medical terminology. The language is fairly technical and likely needs a bit of translation for the layperson/non-professional. There are, however, areas of the book that make sense for any person with even minor experience with dementia or other health conditions. I particularly like Hughes’ focus on compassionate care and the suggestion that dementia be called “acquired diffuse neurocognitive dysfunction” (2014, p. 11). This encompasses the many causes of dementia.
People with dementia require multiple forms of care: “bodily care, psychological [care], emotional [care] and spiritual care” (Hughes, 2014, p. 32). I would include psychosocial care in that list due to the alienation of friendships when a person has dementia. Friends and family members may not know how to interact or react to the changes in memory and behaviors and, thus, keep their distance. This also isolates the caregiver.
All of life has significance, regardless of a person’s abilities or inabilities. Each person has the right to care provided with respect, kindness, and comassion, though it is often not given in that manner. As Hughes states “what might we really want given our changing expectations of life?....the experience of authentic love” (2014, p. 34). In the earliest stage of dementia, it is common to dismiss the symptoms as of little significance. Misplacing keys or losing words – being unable to recall the word needed in a sentence – is a common occurrence as we age and are due to a variety of normal environmental conditions, such as dietary intake, alcohol consumption, exposure to pollutions, and trauma, to name a few. Sadly, many doctors perpetuate the dismissal of symptoms. “This attitude can reasonably be called ageist inasmuch as it denies help to people simply on the basis of their age where they would receive help if they were younger. It may also reflect therapeutic nihilism, that is, the belief that nothing can be done and therefore nothing should be attempted and the person should be encouraged to just accept the facts of life, which in this case are the facts of aging” (Hughes, 2014, p. 39).
Hughes discusses personhood in terms of who the person is before the onset of dementia and that many of the roles we have in life and behaviors continue; a person does not stop being a parent even if they cannot recall they have children, they do not stop being a wife or husband even if they do not recognize their spouse. Those connections follow a person throughout the condition. Further, just because the person no longer communicates in the way he or she previously did, this does not mean his or her thought processes, feelings, understanding of your communication, etcetera, have stopped. Quite the opposite. The brain is still working, just not in the same way as it did before.
Determining capacity is described well in Chapter 6. As much as possible, the person with dementia should be allowed to make their own decisions. It becomes concerning when the person cannot make a reasonable decision based on all of the facts. If they believe they are safe on their own, but in reality are not, this must initiate a review of the person’s capacity. Once the review is done, caregivers or human service organizations may be relied upon for identifying next best steps.
Hughes identifies ethical concerns through the use of case studies. Within these case studies, circumstances are shared that bring to light challenges that may be encountered by caregivers. Not only are the case studies a review of ethical considerations for a person, they also incorporate the considerations of capacity. As discussed in Chapter 6 of the book, it is necessary to give the person input and control of their medical treatment decisions if possible. It is discussed that the decisions made by caregivers (professional or personal/family) should be done in the best interest of the person with dementia. However, this process can take considerable time. The time can be a good thing, meaning the decision is well-reviewed by a team of people. On the other hand, it can be a bad thing, such as when a person’s health is declining and a slow decision process allows further decline.
Towards the end of the book, Hughes writes about the arts and looking for joy along the journey. This does not mean dementia is a joyful process, but there are moments in the journey that can be joyful, and joy can be intentionally created through activities such as artwork and interactions with others. It is these moments that sustain the person with dementia and their loved ones through more difficult times, in my opinion.
I chose to review this book due to my mother’s passing from dementia. While I learned a great deal about dementia through my mother’s dementia journey, I know there is far more to learn, far more to share with others in the hopes of making a difference in the lives of those who will take this journey in the future. Once a caregiver is on the path of providing for a person with dementia, there is little time to do research and seek out support opportunities. This means the professionals must offer the support through human service agencies. A great challenge is often seen in the primary caregiver: the caregiver is unwilling to accept help or share in the caring because he or she knows the habits and expectations of the person with dementia. There is fear that another person won’t do something correctly, causing great upheaval and difficult behaviors in the person with dementia. Even though the caregiver is exhausted and need rest to rejuvenate, he or she cannot give up control. By understanding early on in the journey what opportunities are available and when services can and should be sought, this caregiver burden can be reduced.
It takes a team of services to provide quality care, and by quality I mean meeting a person’s basic needs of safety, shelter, food, activity, regular bathing, regular healthcare, and social interactions. Services, ethical considerations, methods and barriers to care are covered well in the book from a professional perspective. Portions of the book are related to the laws and provisions in England; none-the-less, the majority of the book provides a sense of direction for professionals (medical doctors, psychologists, psychiatric nurses, occupational therapists, etcetera) in caring for a patient with dementia.
© 2015 Lynne Trevisan
Lynne Trevisan, D. C., Assistant Professor, College of Health, Human Services, and Sciences, Ashford University