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Conceptual issues in ‘cognitive impairment

Hughes, Julian C.

Current Opinion in Psychiatry: March 2015 - Volume 28 - Issue 2 - p 188–193
doi: 10.1097/YCO.0000000000000145
Edited by KWM (Bill) Fulford, John Z. Sadler, and Paul Hoff

Purpose of review This review aims to set out the recent writings relevant to acquired cognitive impairment in an attempt to reveal some of the underlying conceptual issues.

Recent findings The huge strides being taken to diagnose Alzheimer's and other dementias early, including pre-symptomatically, raise important ethical issues. But there are broader conceptual issues too, around the notion of normal ageing. New techniques, such as deep brain stimulation, raise further ethical concerns, but may be relevant to deeper philosophical issues. Meanwhile, capacity continues to be of interest to researchers in the field of cognitive impairment, but the ‘United Nations Convention on the Rights of Persons with Disabilities’ is raising questions about our understanding of the nature of capacity. These new ideas reflect shifts in our understanding of personhood. How we think about the person is relevant to how we think about dilemmas over artificial nutrition and is also pertinent to debates about rational suicide in response to a diagnosis of dementia. A person-centred view allows us to think more broadly about cognitive impairment.

Summary Cognitive impairment challenges us to think broadly, to see such impairment as something to be dealt with in the context of our multifaceted life-worlds.

Northumbria Healthcare NHS Foundation Trust and Policy, Ethics and Life Sciences (PEALS) Research Centre, Newcastle University, Newcastle, UK

Corresponding to Professor Julian C. Hughes, Psychiatry of Old Age Service, Ash Court, North Tyneside General Hospital, Rake Lane, North Shields, Tyne and Wear NE29 8NH, UK. Tel: +44 191 293 4057; e-mail:

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