Department of Philosophy, Virginia Tech, Blacksburg, Virginia.
Bioethics. 2021 Nov;35(9):877-883. doi: 10.1111/bioe.12964. Epub 2021 Oct 8.
Caring for loved ones with dementia can sometimes necessitate a loose relationship with the truth. Some might view such deception as categorically immoral, and a violation of our general truth-telling obligations. I argue that this view is mistaken. This is because truth-telling obligations may be limited by the particular relationships in which they feature. Specifically, within caregiving relationships, we are often permitted (and sometimes obligated) to deceive the people with whom we share them. Our standing to deceive follows from certain features of caregiving relationships. Specifically, they are relationships that involve obligations to promote a person's interests and values (and not simply their autonomy), that often permit us to assume the hypothetical consent of the person with whom we share them, and in which we are often entitled to act out of self-interest. Once we appreciate these features, we will be able to recognize that the truth-telling norms governing our relationships with loved ones with dementia do not represent a radical departure from our general truth-telling obligations, but are instead consistent with truth-telling norms that feature in other caregiving relationships. In addition, we will be able to understand why we may feel conflicted about lying to loved ones with dementia, even when lying is permissible.
照顾患有痴呆症的亲人有时可能需要与真相保持一定的距离。有些人可能会认为这种欺骗行为是绝对不道德的,违反了我们一般的诚实义务。我认为这种观点是错误的。这是因为诚实义务可能会受到他们所涉及的特定关系的限制。具体来说,在护理关系中,我们通常被允许(有时甚至有义务)欺骗与我们分享这些关系的人。我们有欺骗的资格,这源于护理关系的某些特征。具体来说,它们是涉及促进一个人的利益和价值观(而不仅仅是自主)的义务的关系,通常允许我们假设我们与之分享关系的人的假设同意,并且我们通常有权出于自身利益行事。一旦我们认识到这些特征,我们将能够认识到,我们与患有痴呆症的亲人的关系中的诚实规范并没有背离我们一般的诚实义务,而是与其他护理关系中的诚实规范一致。此外,我们将能够理解为什么我们即使在允许撒谎的情况下,也可能对向患有痴呆症的亲人撒谎感到矛盾。