Decision-making management in patients with advanced dementia and dysphagia in Costa Rica: A Clinical And Philosophical Analysis
DOI:
https://doi.org/10.15359/praxis.83.1Keywords:
end-of-life care, ethic, feeding tube, decision-making, modus ponens, autonomy, principle of humanity, logic reasoning, bioethics, moralAbstract
The use of feeding tubes in patients with advanced dementia suggests several ethical concerns not only for healthcare professionals but also for the patient’s family. One point explored in this research deals with the symbolism associated with food and the idea of a good life and vitality (as seen in Costa Rica and in other Latin American countries). Subsequently, the request from families to use a feeding tube in a person with advanced dementia may be explained in terms of this association. Another point discussed in this research is the decision-making process between the family, the healthcare workers, and the patients themselves. Such discussions are examined in terms of the principle of autonomy and the principle of humanity to understand the desires and beliefs in the end-of-life decision. In the same manner, this research aims to investigate the reasoning process involved in the decision itself in terms of the modus ponens as a strong logical reasoning that leads to the decision. Yet, such a decision may be compromised when the modus ponens diverts into a fallacy by denying the consequences. Subsequently, this can derive into a chain of deductions that may undermine the consideration of the autonomy principle and the principle of humanity in deciding whether to use the feeding tube. This research also suggests the need for an extensive educative process to encourage the early decision of terminating a person’s life. Finally, this research makes an appeal for the evaluation of the laws governing end-of-life decision-making in Costa Rica, including medical and judicial policies.
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La revista trabaja bajo la Licencia Creative Commons Atribución-NoComercial-CompartirIgual 4.0 Internacional; apartir de la publicación número 79 (2019); en publicaciones anteriores se trabajaba bajo una Licencia Atribución- No Comercial- Sin Derivadas 4.0 Internacional.
