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Beyond the Dementia Dyad: Rethinking Capacity in a Distributed Mind.

The article focuses on the clinical application of the Extended Mind Concept to dementia care, particularly through the "dementia dyad" model, where a primary caregiver supplements the cognitive deficits of a patient with dementia. This model supports a novel approach called supported decision-makin...

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Published in:American Journal of Bioethics Vol. 26; no. 4; pp. 67 - 70
Main Author: Weiss, Anthony P.
Format: commentary Journal Article
Published: Taylor & Francis Ltd Apr2026
Online Access:View this record in EBSCOhost
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      dt: Apr2026
      vid: 26
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      pub: Taylor & Francis Ltd
      place: Philadelphia, Pennsylvania
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        10.1080/15265161.2026.2637096
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      tig:
        atl: Beyond the Dementia Dyad: Rethinking Capacity in a Distributed Mind.
      aug:
        au: Weiss, Anthony P.
        affil: Harvard Medical School
      sug:
        subj:
          Dementia Therapy
          Morals
          Decision Making, Clinical
          Physician-Patient Relations
          Caregivers Psychosocial Factors
          Patient Participation
          Caregiver Attitudes
          Mental Health
          Support, Social
          Artificial Intelligence Ethical Issues
          Brain-Computer Interfaces
          Autonomy
          Social Cognition
      ab: The article focuses on the clinical application of the Extended Mind Concept to dementia care, particularly through the "dementia dyad" model, where a primary caregiver supplements the cognitive deficits of a patient with dementia. This model supports a novel approach called supported decision-making (SDM), which involves joint decision-making between patient and caregiver, respecting individual autonomy while acknowledging distributed cognition. The article argues for revising traditional capacity assessments to incorporate this extended cognition, including social and technological supports such as AI and brain-computer interfaces, reflecting how decision-making increasingly relies on external resources. It also highlights ethical and practical challenges in balancing support with potential manipulation, suggesting that expanding the dyad model could benefit other vulnerable populations and reduce confrontational capacity evaluations.
      pubtype: Academic Journal
      doctype:
        commentary
        Journal Article
      ougenre: Article
    language: English
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