Challenging questions and ethical obligations: the ethics of everyday practice > 21 January 2015

Kate Harvey


People with dementia and their families, as well as healthcare staff and care workers, face difficult ethical dilemmas – decisions about what is ‘the right thing to do’ – on a day-to-day basis. The Nuffield Council on Bioethics set up an expert Working Party in 2007 to examine the ethical issues raised by dementia. Following a public consultation, a deliberative workshop with members of the public, and meetings with stakeholders including people with dementia, carers, health professionals and other members of the public, a report was published in 2009.

This report presents a 6-part ethical framework to help those who face ethical dilemmas in connection with the everyday care of a person with dementia, for example around:

  • deciding when and how to communicate a diagnosis;
  • balancing a person’s safety with their need for independence and freedom;
  • deciding what is in the best interests of the person with dementia, for example when making decisions about their care and treatment; and
  • balancing the sometimes conflicting needs of the person with dementia with the needs of others, especially carers.

This talk will explain the rationale behind this framework and set out a case-by-case approach to decision making in which components of the framework will be used to work through everyday care scenarios.



Kate Harvey is Senior Research Officer at the Nuffield Council on Bioethics, and was part of the team leading the Council’s work on the ethical issues arising out of dementia, published in 2009.


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