The ethics of dementia care - with Vince Mitchell

What ethical challenges are presented by caring for people with dementia? How should we understand - and respect - the personhood of those experiencing cognitive decline? And what can virtue ethics and care ethics contribute to the development of an alternative ethical model for dementia care?

These are some of the questions we explore in this episode, in conversation with Vince Mitchell. Vince is a Lecturer in Health and Social Care, specialising in mental health, at The Open University (UK). He is a qualified mental health nurse with experience of nursing people in a wide variety of clinical settings. Having graduated with a Bachelor of Science in Health Care Practice and a Master of Arts in Applied Ethics from the University of York, Vince undertook doctoral research at the University of Surrey, where he was awarded a PhD in 2016 for his thesis examining ethical frameworks for dementia care. Since then, he has published a number of articles and book chapters on the ethics of mental health nursing and on ethical practice in dementia care.

We discuss the following topics in this episode:

Vince's journey into nursing (02:15)

Working as a mental health nurse (04:50)

Bridging the worlds of philosophy and care practice (07:00)

The challenges that dementia presents for care providers (10:40)

The inadequacy of existing ethical models (13:15)

Some of the key ethical issues in dementia care (15:35)

Personhood and autonomy (19:08)

The personal identity challenge to advance directives (23:50)

Thomas Kitwood's model of person-centred care (30:10)

Julian Hughes' Situated Embodied Agent approach (34:13)

Personal dignity and human flourishing (36:19)

Introducing virtue ethics (39:55)

Vulnerability, interdependence and trust (43:05)

Care ethics, justice and the socio-political context of dementia care (47:55)

An alternative ethical model for dementia care (51:10)

Implementing the model in practice (55:35)

Vince's plans for future work in care ethics (58:50)

A selection of Vince's publications

'Ethics and mental health nursing' (2017)

'Ethical practice in dementia care' (2019)

Some of the writers and thinkers mentioned in the episode

Rebecca Dresser

Ronald Dworkin

Derek Parfit

Thomas Kitwood

Julian Hughes

Maurice Merleau-Ponty

Martin Buber

Martha Nussbaum

Emmanel Levinas