, Volume 17, Issue 3, pp 377-387
Date: 22 Jan 2014

Eternal sunshine of the spotless mind? An anthropological-ethical framework for understanding and dealing with sexuality in dementia care

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Contemporary bioethics pays considerable attention to the ethical aspects of dementia care. However, ethical issues of sexuality especially as experienced by institutionalized persons with dementia are often overlooked. The relevant existing ethics literature generally applies an implicit philosophical anthropology that favors the principle of respect for autonomy and the concomitant notion of informed consent. In this article we will illustrate how this way of handling the issue fails in its duty to people with dementia. Our thesis is that a more inclusive philosophical anthropology is needed that also heeds the fate of this growing population. Drawing on the tradition of phenomenology, we will chalk out an anthropological framework that rests on four fundamental characteristics of human existence: the decentered self, human embodiment, being-in-the-world and being-with-others. Our aim in this article is thus to tentatively put forward a broader perspective for looking at aged sexuality in institutionalized people with dementia. Hopefully the developed framework will mark the beginning of a new and refreshed ethical reflection on the topic at hand.

“Eternal sunshine of the spotless mind” is taken from the ‘Eloise to Abelard’ poem written by Alexander Pope in the eighteenth century. The same line was borrowed in 2004 as title for a romantic science fiction film about a couple that (voluntarily) erased each other from their memories when their relationship went wrong. The story told raises questions as to whether (in)voluntary loss of memory pertaining to the realm of broken relationships and former partners is truly liberating or not? This liberating power is exactly what the original poem alludes to. Both the poem and the movie explore the complex relationship between love—the joy and perhaps also the pain it entails—, memory and identity. In doing so it makes you think about the impact dementia or involuntary loss of memory might have on love and relationships.