Aging is a part of life that everyone has to go through at some point. It is absolutely painful to observe a love one going through the declination in health, both mentally and physically. With advancement in technology, the physical body is getting stronger and more long-lived; meanwhile, the brain may not able to be preserved in the same manner. Dementia could be the result of the brains living beyond what they were designed for. Therefore, as more people are living longer, dementia is becoming more common in the population as a whole. This phenomenon raises many issues on caregiver’s responsibility, human rights, medical ethics, and existential neuroscience.
People with abnormal aging often go through diminishing recognition as well as diminishing awareness of the loss of abilities. The big controversy-provoking question is that whether the loss of self-consciousness when the brain loses mental faculties means the end of the “self” and the moral status. What if the consciousness still exists even in the case of advanced dementia? If not, are we wasting the social and economical potentials on prolonging the life of those who have already gone? Is this ethical to withdraw life supporting means when people are in the advanced stage of dementia?
Dementia is an incurable and terminal disease. There is no effective treatments to halt or slow the progression of dementia nor medications for the behavioral and psychological symptoms that commonly accompany. Taking care of abnormally aging patients costs hundreds of billions dollars a year, yet all means still lead to the inevitable death of the patients sooner or later. For those reasons, in the case of advanced dementia and Alzheimer’s disease where the consciousness ends, I assume that it would not be unethical or immoral to withdraw life-saving measures if physicians have consent from the patients (before losing consciousness) and/or from family.
As whether dementia is a state, in which withholding life-support measures can be considered, is a debatable topic, my opinion rises arguments from the perspectives of ones who have dementia family members. From my viewpoint, this might only be the struggle between eros and agape types of love. Some of us might only want to prolong the life of our loved ones because our eros, the more selfish type of love, wants to keep them alive for the comfort of ourselves, not theirs; meanwhile, the altruistic love, agape, otherwise, would let go when in time even if it brings discomfort to ourselves.
Looking deeper into the scholarly discussion of this dilemma, I found myself standing in the middle, without any ability to neither disapprove nor stand for any side of this argument. On the one hand, it is true that medical ethics of non-maleficence and lack of family’s permission prevent physicians to retreat any means of life-support. On the other hand, medical ethics also include autonomy, the respect to the patient’s wishes, and beneficence, serving the best interests of patients. In my final reflection and analysis, I hold a belief that if the patients have understood all of their options and formally choose how their end-of-life care before the consciousness fades, physicians and caregivers should respect and honor that option. However, I don’t think I have enough knowledge and experience to determine whether I agree or disagree that dementia is a state in which lifesaving measure should not be taken.
When consciousness ceases is a practical and problematic dilemma as aging is a common process that we all have to go through at some point in our life. The righteousness of the opinion may not lie in common sense but largely defined by one’s point of view and by the unique situation of each individual cases. However, the dilemma definitely rises various questions as well as clues for future studies in brain science. How much neurological tools tell us about one’s moral status or state of consciousness? What can we learn about neural mechanism through the study of AD’s brain? What ways can we advance our mental health? Those are just some among thousands of trace for researches in this contemporary life.