Remaining True to Ourselves: Dementia, Value Change, and Enduring Interests

Abstract

It is common to think that, in making choices for others, we should consider their values. But do the current interests of people with dementia ever depend on what they used to value?  Or do their interests depend solely on what matters to them from now on?  Two approaches are especially prominent in the philosophical literature. Some believe that the capacity to value or significantly care about things bestows a certain standing on the person’s present perspective, making it inappropriate to appeal to her former values until the person no longer has this capacity. Others hold that a person’s past attitudes can never affect what is good for him now.  On the “Revision Model” I defend, we should ordinarily recognize a person’s current values as authoritative in defining a person’s interests, because these represent his most up-to-date revision of his earlier views. However, if a person has lost the ability to comprehend his former values, then we cannot treat his current perspective as a genuine revision, since he is not answerable for the fact that his values have changed. Having never truly revised those former values, we should recognize their enduring relevance in defining his interests, insofar as they remain relevant to his life.  This, however, is consistent with recognizing that the person’s interests may also depend on some of his current values and concerns as well.