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Refined Discourse Ethics and the Social Inclusion of People with Dementia

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Living with Dementia

Part of the book series: Advances in Neuroethics ((AIN))

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Abstract

This chapter examines whether and how refined discourse ethics can promote the social inclusion of people with dementia. The starting point is the fact that people with dementia are often barred from participating in social discourse because they may not share the normalized form of rationality. In order to tackle such discrimination and stigma, this chapter considers discourse ethics as a means to achieve greater inclusion of persons with dementia. First, I argue that the concepts of communicative rationality and of the ideal speech situation offer promising starting points for a general strengthening of participation rights, but are still too narrowly defined to include people with dementia as members of the discourse. I then refine discourse ethics approaches by refining these underlying concepts. After that, current scientific findings about the communication methods of people with dementia are presented, emphasizing their competence to contribute important claims. Based on these findings, I suggest ways to include persons with dementia in discourse, thus strengthening them as rightful participants in shared decision-making processes. Ultimately, (renewed) discourse ethics theories are identified as important tools to empower people with dementia.

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Notes

  1. 1.

    The survey was conducted in English, Spanish, Chinese and Greek. The participants with dementia generally were in early stages of the disease, as the nature of the survey would prevent the participation of people in later stages. However, some responses were collected from service providers who interviewed people with dementia individually. Diagnoses reported in the English survey included mild cognitive impairment (MCI) (10%), Alzheimer’s disease (55%), vascular dementia (12%) and fronto-temporal dementia (FTD) (7%).

  2. 2.

    The information was obtained from semi-structured interviews with 24 participants who had been diagnosed with dementia, but the participants were required “to demonstrate their understanding of study participation after this was explained, by re-articulating the study’s purpose and describing how they would be able to contribute” [6, p. 428]. This requirement means that the results cannot be extended unreservedly to people with severe dementia; it also illustrates that people with severe dementia are often excluded as participants in scientific studies due to various access criteria.

  3. 3.

    The town hall meetings took place between July 2007 and May 2008. A total of 301 persons with early-stage Alzheimer’s or dementia participated in the meetings.

  4. 4.

    The Concept of validity claims (Geltungsanspruch in German) is central to Habermas’ work and includes claims to truth, normative rightness and sincerity. Therefore, normative rightness claims are a specific type of validity claim that are particularly important for practical discourses. According to Habermas, validity claims are inherent in every speech act used for social coordination and can be criticized or justified by others [22].

  5. 5.

    Most research on advocatory ethics focuses on people with disabilities or unborn future generations in the context of future responsibility. Although the experience of people with dementia is not identical to the situation of these other groups, there are significant parallels with regard to the challenge of surrogate decision making.

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Authors and Affiliations

  1. Mercator Institute for Literacy and Language Education, University of Cologne, Cologne, Germany

    Petr Frantik

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  1. Department of Philosophy and Religious Studies, and Science Technology and Society (STS) Program, North Carolina State University, Raleigh, NC, USA

    Veljko Dubljević

  2. Department of Philosophy, University of North Carolina, Greensboro, NC, USA

    Frances Bottenberg

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Frantik, P. (2021). Refined Discourse Ethics and the Social Inclusion of People with Dementia. In: Dubljević, V., Bottenberg, F. (eds) Living with Dementia. Advances in Neuroethics. Springer, Cham. https://doi.org/10.1007/978-3-030-62073-8_2

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  • DOI: https://doi.org/10.1007/978-3-030-62073-8_2

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