AGENCY AND MORAL RELATIONSHIP IN DEMENTIA

This essay examines the goals of care and the exercise of guardianship authority in the long-term care of persons with Alzheimer's disease and other forms of chronic, progressive dementia. It counters philosophical views that deny both agency and personhood to individuals with Alzheimer's on definitional or analytic conceptual grounds. It develops a specific conception of the quality of life and offers a critique of hedonic conceptions of quality of life and models of guardianship that are based on a hedonic legal standard of "best interests." As an alternative, it proposes a conception of quality of life based on the notions of "semantic agency" and "memorial personhood.".