Matthews Steve
Bioethics. 2015 Oct;29(8):573-9. doi: 10.1111/bioe.12148. Epub 2015 Feb 6.
Dementia is now a leading cause of both mortality and morbidity, particularly in western nations, and current projections for rates of dementia suggest this will worsen. More than ever, cost effective and creative non-pharmacological therapies are needed to ensure we have an adequate system of care and supervision. Music therapy is one such measure, yet to date statements of what music therapy is supposed to bring about in ethical terms have been limited to fairly vague and under-developed claims about an improvement in well-being. This article identifies the relevant sense of wellbeing at stake in the question of dementia therapies of this type. In broad terms the idea is that this kind of therapy has a restorative effect on social agency. To the extent that music arouses a person through its rhythms and memory-inducing effects, particularly in communal settings, it may give rise to the recovery of one's narrative agency, and in turn allow for both carer and patient to participate in a more meaningful and mutually engaging social connection.
痴呆症如今是导致死亡和发病的主要原因之一,尤其是在西方国家,而且目前对痴呆症发病率的预测表明这种情况将会恶化。我们比以往任何时候都更需要具有成本效益且富有创造性的非药物疗法,以确保我们拥有完善的护理和监督体系。音乐疗法就是这样一种措施,然而迄今为止,关于音乐疗法在伦理层面应该带来何种效果的阐述,一直局限于对幸福感改善的相当模糊且欠成熟的说法。本文确定了在这类痴呆症治疗问题中所涉及的幸福感的相关意义。从广义上讲,这种疗法对社会能动性具有恢复作用。音乐通过其节奏和引发记忆的效果唤起一个人,尤其是在集体环境中,这可能会促使其叙事能动性的恢复,进而使护理人员和患者能够参与到更有意义且相互互动的社会联系中。