Self, Identity and the Philosophy of Person-Centred Care

Author: Matthew Tieu

Tieu, Matthew, 2019 Self, Identity and the Philosophy of Person-Centred Care, Flinders University, College of Humanities, Arts and Social Sciences

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“Person-centred care” is a model of care that is widely regarded as best practice in aged care, particularly in dementia care. The impetus for person-centred care is typically grounded in both ethical and egoistic considerations. Firstly, there is the idea that people with dementia are still persons and it is in virtue of their personhood that they are worthy of a particular standard of treatment that is delivered through person-centred care. Secondly, there is also the idea that it is in one’s own interests to maintain quality of life and well-being in older age by receiving person-centred care, and this idea constitutes the egoistic impetus for person-centred care.

Though our understanding of person-centred care remains somewhat contentious, there is a general definition emerging from the literature, which defines person-centred care as primarily concerned with promoting or maintaining continuity of selfhood. However, because there are so many theories, models and frameworks that describe selfhood, it remains unclear what selfhood is and what it means to promote or maintain its continuity. As a result, person-centred care lacks a proper philosophical and ethical foundation, and this can lead to uncertainty about what best practice in aged care consists of.

The aim of my thesis is to clarify some of these issues. I begin by introducing a variety of discussions and debates about selfhood and then argue that human beings possess a unique form of selfhood that no other species possesses. This paves the way for me to develop a theoretical framework that describes human selfhood and its development across the lifespan, which I refer to as “narrative constructivism”. It captures the idea that human selfhood is constituted by a first-person subjective sense of personal identity that takes the form of autobiographical narratives, which we as agents construct to make sense of our lives and our place in the world. This framework will draw on concepts, theories, empirical evidence, and other frameworks from disciplines such as analytic philosophy, continental philosophy, cognitive neuroscience, developmental psychology, social psychology, lifespan development, and sociology. I then conclude by discussing what it means to promote or maintain continuity of human selfhood in the context of person-centred care, with specific reference to how this translates to situations where a person with dementia has either retained or lost a substantive amount of their selfhood.

Keywords: Self, Selfhood, Selves, Identity, Personal Identity, First-Person, Second-Person, Third-Person, Subjective, Subjectivity, Personhood, Persons, Agent, Agency, Diachronic, Temporal, Egoism, Egoistic, Ethics, Moral Imperative, Person-centred care, Dementia, Dementia Care, Cognitive Aging, Memory, Alzheimers, Phenomenology, Hermeneutics, Neuroscience, Cognitive Neuroscience, Philosophy, Philosophical, Narrative, Narrative Selfhood, Narrative Selves, Narrative Self, Narrative Gravity, Narrative Identity, Narrative Constructivism, Narrativeity, Autobiographical, Constructivism, Radical Constructivism, Self-concept, Sense of Identity, Who am I, Social Constructionism, Hume, Locke, Parfit, Dennett, Schechtman, Korsgaard, Velleman, Zahavi, Damasio, Gallagher, Ricoeur, Metzinger, Suddendorf, Povinelli, Gerrans, Kennett, Stanovich, Tulving, Kitwood, Brooker, Nay, Edvardsson, Baumeister, Husserl, Heidegger, Derrida, Foucault, Chomsky, Gergen, Mead, Blumer, Cooley, Berger, Luckman, Burr, von Glasersfeld, Piaget, Vygostky, Baltes, Lazaridis, Rochat, Westerman, Mareschal, Quartz, Sirois, Bruner, Taylor, Harre,

Subject: Philosophy thesis

Thesis type: Doctor of Philosophy
Completed: 2019
School: College of Humanities, Arts and Social Sciences
Supervisor: Ian Ravenscroft