ABSTRACT
Neurodegenerative disorders are an increasing phenomenon in western society, commonly referred to collectively as dementia. Dementia has a long, variable and complex trajectory where a person’s capacity to exercise autonomy may fluctuate over an extended period of time. This challenges traditional approaches to the understanding of the autonomy required for persons to exercise a capacity for decision-making. In liberal philosophy, the cognitive ability for rational thought and reflection is the traditional basis for such self-government, and this ability underpins approaches to decision-making capacity. People perceived as being limited in or without this ability are not considered capable of self-determining. Although influential, this approach has been critiqued for its artificial legal construction, in which autonomy is conceptualised as absolute, and humans are viewed as operating separately from each other.
