4.3 Article

'Self-care without a self': Alzheimer's disease and the concept of personal responsibility for health

期刊

MEDICINE HEALTH CARE AND PHILOSOPHY
卷 11, 期 3, 页码 315-324

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SPRINGER
DOI: 10.1007/s11019-008-9125-3

关键词

Alzheimer's disease; Aspects of self/personhood; Autonomy and rationality; Empowerment and the self-care concept; Normality; Personal responsibility for health; Power relations; Public health policies; Self-care; Technologies of the self

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The article focuses on the impact of the concept of self-care on persons who are understood as incapable of self-care due to their physical and/or mental 'incapacity'. The article challenges the idea of this health care concept as empowerment and highlights the difficulties for persons who do not fit into this concept. To exemplify this, the self-care concept is discussed with regard to persons with Alzheimer's disease (AD). In the case of persons with AD, self-care is interpreted in many different ways-depending on the point of view, for instance as an affected person or a carer. To prevent a marginalisation of the growing group of elderly persons with dementia, the article argues that concepts such as those of personhood, wellbeing, autonomy, rationality and normality have to be re-thought with regard to an increasingly ageing population. Taking into account that AD as a socio-medical construct has to be understood in the context of power relations, the article focuses on the mutual influence between the concepts of self-care and of AD and its possible impact on governing dementia and AD in particular. Michel Foucault's considerations on 'technologies of the self' provide the basis for the discussion of the self-care concept within existing societal power relations.

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