Volume 2, 2022
Frances Bottenberg
Pages 185-208
Epistemic Arrogance, Moral Harm, and Dementia
When it comes to supporting the well-being of a person living with dementia, remaining sensitive to that person’s interests can be challenging, given the impairments that typically define the condition particularly in its later stages. Epistemic arrogance, an attitude regularly adopted by people not living with dementia towards those who are, further impedes this task. In this case, epistemic arrogance amounts to the assumption that one sufficiently knows or can imagine what it is like to live with dementia to make decisions in matters concerning the care and well-being of someone with dementia, without appropriately consulting their views and preferences. Drawing on three fictional scenarios, I describe common pathways for epistemic arrogance in dementia-support contexts and the ways in which these cause moral harm, linking them to central issues in dementia studies and medical ethics, including person-centered care, the “best interests” principle and the prescriptive reach of advance directives.