Alcohol and cognitive impairment: considerations with the older client
This chapter addresses the ethical issues associated with alcohol-related brain damage (ARBD). Both the ethics of cognitive impairment and those of substance dependence are relevant when working with people with this condition. Autonomy is the state of having self-directing freedom and moral independence. Most legal jurisdictions assume that people are autonomous and thus have the capacity to make decisions unless proven otherwise. Individual autonomy is not always part of a person's cultural or ethnic beliefs. Beneficence is about active goodness, kindness or charity. "Morality requires not only that we treat persons autonomously and refrain from harming them, but that we contribute to their welfare". Non-maleficence is about doing no harm by our actions or, at the very least, minimizing harm done to individuals entrusted to the clinician's care. Justice is about fairness and the equitable sharing of resources: the equal and fair access to services that individuals have a right to.