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Milbank Q. 1986;64(Suppl. 2):4-16.

Autonomy and the demented self.


A person who becomes demented can be considered as he presently is, a demented person, or in light of his entire life, of which dementia is but the final stage. These two perspectives can provide conflicting determinations of the person's interests and preferences, since what is best for a demented person at the time may not make his life better overall and may be directly contrary to preferences expressed while competent. Reflection on the concept of autonomy--what faculties it requires, what its point is--provides a clear understanding of the rights of the demented patient.

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