Truthfulness and sense-making: two modes of respect for agency

Jeanette Kennett (Macquarie University)

People with dementia often have a self-image that is frozen in the past. They may, for example, believe that they still occupy a former role and act out that role in care home settings. Carers then face a dilemma between going along with the person, and even assisting them to act out their role, or being truthful. On the one hand allowing the person to fulfil their ‘role’ appears a good thing – it keeps them happy and busy – on the other hand, doing so is deceitful. It may seem disrespectful, even patronizing, to withhold the truth from the person. This dilemma, as it arises in aged care, is pervasive and vexing.

Contrary to the usual couching of this dilemma as a conflict between the deontological requirement of respect for persons and beneficent utilitarian concern for well-being, we think it highlights the existence of two distinct modes of respect for persons: on the one hand this manifests as the requirement for truthfulness in our interactions with others, and on the other as the requirement to assist in the fundamental project all agents have of making sense of themselves and their circumstances. While truthfulness is widely held to be fundamental to respect, we argue that respect also requires support for the sense-making capacities of agents.

To illuminate this, we will consider a range of cases that point to the importance of sense-making for agency and consider how truthfulness interacts with the requirements of sense-making. We argue that truthfulness and sense-making are both modes of respect for agency. We show how undermining sense-making is a serious violation of the respect we owe to each other. We then trace the importance of truthfulness for the sense-making project, and, through a series of cases, explore why and when divergences from being wholly truthful might be morally justified on grounds of respect for agency.

Professor Jeanette Kennett is based in the Centre for Agency, Values and Ethics (CAVE) at Macquarie University

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