Dementia and Personal Identity

Dementia raises deeply troubling issues about our obligations to care for people whose identity might have changed in the most disturbing ways. In turn, those changes challenge us to confront our philosophical and ethical assumptions about what makes up that identity in the first place. Everyone touched by the disease goes through a crash-course in the philosophy of mind.

A philosophy of the self which roots identity in memory and the internal workings of the brain (‘I think, therefore I am’) raises troubling issues for those with dementia. If a person cannot interact with their memory, and therefore their surroundings, are they the same person? Does society view them as having the same worth? New advances in technology which provide patients with brain implants may only create deep social divisions – those with a firm grasp on the recent past holding power over those without.

The continental philosophical tradition which defines the self in relation to the outside world holds more promise. We are not simply our internal monologue, we are ‘beings-in-the-world’, connected to society through our relationships. Care for people with dementia should be based on this aspect of identity; should be a process of finding new ways to communicate without taking knowledge for granted. We need to make ourselves available to the physical, expressive and relational aspects of our own identities. Our bodies and our feelings count in our identity as much as our thoughts. Our identities are anchored in the world outside us as well as in our heads.   


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