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Personhood as projection: the value of multiple conceptions of personhood for understanding the dehumanisation of people living with dementia

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Abstract

We examine the concept of personhood in relation to people living with dementia and implications for the humanity of care, drawing on a body of ethnographic work. Much debate has searched for an adequate account of the person for these purposes. Broad contrasts can be made between accounts focusing on cognition and mental faculties, and accounts focusing on embodied and relational aspects of the person. Some have suggested the concept of the person is critical for good care; others suggest the vexed debates mean that the concept should be abandoned. We argue instead that the competing accounts illuminate the very tensions in personhood which are manifest for all of us, but especially for people living with dementia, and argue that our account has explanatory power in shedding light on how precisely dehumanisation and constraints on agency may arise for people living with dementia, and for staff, within an institutional context.

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Notes

  1. We leave aside here the question of whether such a view of the place of cognition in relation to the person is indeed distinctively or uniquely ‘Western’ while noting that it is commonly seen within strands of Western philosophy at least since Plato and, as noted, is firmly present within what can broadly be called Western analytical philosophy. One may note that very fact of a considerable body of work attempts to combat such allegedly ‘hypercognitive’ views of the person suggests that multiple attitudes towards the person already exist.

  2. The importance and priority of basic bodily care work in recognising and enabling embodied personhood contrasts starkly with a view of the body as somehow the mere substrate of an autonomous rational agent. We will have more to say on basic bodily care and personhood in future papers.

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Acknowledgements and funding

This work was funded by the National Institute for Health Research, Health Services and Delivery Research Programme (projects 13/10/80, 15/136/37, 132,903). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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Authors and Affiliations

  1. Geller Institute of Aging and Memory, University of West London, St Mary’s Road Ealing, London, SW5 5RF, UK

    Paula Boddington, Andy Northcott & Katie Featherstone

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  1. Paula Boddington
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  3. Katie Featherstone
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Contributions

All authors contributed to the study concept and design for the empirical work on which this paper draws and on the analysis of data. Kate Featherstone was Chief Investigator for the underlying research projects, and with Andy Northcott collected the ethnographic data. Paula Boddington and Andy Northcott were responsible for the analysis leading to the drafting the paper and commented on subsequent drafts. All authors approved the final draft of this paper.

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Correspondence to Paula Boddington.

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The empirical research work referred to in this paper was given ethics approval by the NHS Research Ethics Service and approved by the Health Research Authority.

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Boddington, P., Northcott, A. & Featherstone, K. Personhood as projection: the value of multiple conceptions of personhood for understanding the dehumanisation of people living with dementia. Med Health Care and Philos 27, 93–106 (2024). https://doi.org/10.1007/s11019-023-10187-3

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