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Respect for People with (Permanently) Imperfect Cognitions


This post is by Oliver Sensen (pictured above), Associate Professor in Philosophy at Tulane University in New Orleans. Oliver is interested in the question of how one should treat others, and, more particularly, in the notion of respect for persons. Much of his work is on Kant – since he is the one who thought most deeply about these issues – including his notions of dignity, autonomy, and respect. In this post Oliver summarises his recent article 'Respect Towards Elderly Demented Patients', published in Diametros.

As part of a more systematic project on respect, I have started to think about the regard that is owed to people with imperfect cognitions. The paper I summarise in this post focuses on respect for elderly demented patients. Imagine that you are a caregiver for a patient who does not remember what happened yesterday. If, for instance, her husband died years ago, she still might ask you when he will come back to see her. Telling her the truth might deeply upset her. Would you be disrespectful in withholding the husband’s death, because in that case you are not treating her as a normal human adult, or would you be disrespecting her condition by telling the truth (see also Lisa Bortolotti's post on Dementia and the Truth).

My broader project is to develop a more wholesome and inclusive account of respect. We believe that animals and the environment more generally deserve respect, but this creates a problem for third-personal views (which ground respect in a feature the other possesses, such as rationality or sentience), and second-personal views (which regard respect as a mutual recognition of equals). A first-personal account (according to which respect is a general attitude one should have regardless), on the other hand, has the advantage that it can justify a universal scope of respect; furthermore, it can explain more easily why one is motivated and obligated to respect others. Finally, there is no shortage of justification for such an account, since it can be supported by reasons from virtue ethicists, consequentialists, and deontologists alike.

In addition, a first-personal justification of respect can capture our intuition that one should respect the other for who she is. Should one hold open the door for a disabled person? It depends. If she wants to show that she can do it herself, it might be disrespectful to help. If, on the other hand, she is not able to open the door herself, it might be disrespectful not to assist. Furthermore, it matters what my specific relationship to the other is. If a demented patient speaks to her doctor or banker, we do not believe that they are allowed to lie – depending on the patient’s legal status – in order to avoid distress. However, the primary task of a caregiver is to make the patient safe and comfortable. This does not condone lying, but there does not seem to be a duty to tell harsh truths ('your husband will never come back'). There can be reasons to respect imperfect cognitions.
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