On the ethics of specific medical practices.
Yes Folks, once more I delve into ethical dilemmas to look at Chocolat.
In the novel, Armande refuses to listen to Doctors or her daughter because she doesn’t want to go to a home. She doesn’t want to have to ask to go to the toilet and she doesn’t want to lose her independence. I get that I do, only, I work at an Aged Care Facility.
I work in the Dementia ward and every time I go there I tell people that the trains aren’t working and that there was a storm and their family isn’t coming to pick them up until tomorrow, but it’s okay we’ve got you a room. And we need to do that to keep them safe. If we told them that they were in the dementia wing of Generic Aged Care Facility they’d probably be worse off. And they wouldn’t believe me.
So where do the ethics come in?
At what point do people become unable to make their own decisions. In a lot of cases, they wouldn’t be able to tell you. I can assure you that probably well over half the people in the dementia wing I work in – if asked – would tell me that they are fit to make their own decisions. Their own life choices. But they’re put in the secure area because someone else is making the decisions for them. They probably wouldn’t know half the medications they’re on or off at any given moment. They aren’t the ones deciding. The family is.
And what I want to ask you and discuss is: “Is that right?” How much agency should Armande Voizin have over the rest of her life? She’s refusing to take her medicine and constantly eats things that are unhealthy for her. There are cases either way.
On the one hand she presents as mentally stable (and there’s no way to know more, this is a book, but let’s pretend she is). She knows what she’s doing is unhealthy for her. And by the end she actively refuses to take insulin, instead of forgetting or being unable. On the one hand she is fit to make her own decisions.
But on the other, she was found one day almost passing out because she couldn’t get to the medicine she wanted. She is making bad life choices for herself almost seemingly because of her tumultuous relationship with her daughter. She knowing does things that endanger her life which could indicate some mental problems and by the end she actively refuses to take her insulin, not from a non-desire to get well, but because she doesn’t want to take it any more. That to me sounds like someone who I would consider placing in an aged care facility.
I would like to say one more thing before I depart today:
Aged Care Facilities are about promoting independence and wellbeing. Over the course of working at Generic Aged Care Facility never have I seen anyone not achieving to the best of their abilities at the time. From the novel Armande appears well enough to take herself to the toilet and to the shower even. She would be able to do what she wants when she wants in a dignified manor. She would be able to make decisions about what she eats, even if she is advised against it. Going in a home does not mean the end of independence in the slightest. Instead it allows you to be cared for in the the way that you need. You are able to make you own decisions unless proved mentally unfit for it. Everyone I’ve seen at work has been happy with the facility. Armande didn’t give herself the chance to be.
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