Abstract

Alzheimer's disease is poised to become a major health crisis in the coming years with a rapidly aging population and limited healthcare resources. This crisis is occurring in the contemporary cultural era of postmodernity, marked by ethical relativism, subjective individualism, and skepticism about ultimate meanings. Competing modern and postmodern worldviews intersect in postmodernity with differing interpretations of perennial philosophical themes of truth, freedom, and fulfillment. This creates a "coincidence of maladies" that predisposes AD patients and their caregivers to potential harms just as a coherent social response is difficult to offer. Chapter One reviews the practical context of both AD and postmodern culture and proposes an analogy between them organized around truth, freedom, and fulfillment. Chapter Two develops an ethical framework for responding to these coincident maladies through an ethic of reverence. After reviewing various discussions of reverence to identify its key characteristics, it argues that Dietrich von Hildebrand's account of reverence, developed from his value ethics, best represents these features. The methodology of reverent observation, reverent affirmation, and reverent response is then applied to related issues in postmodernity and AD, beginning with theoretical concerns in Chapter Three and moving to practical responses to AD in the postmodern context in Chapter Four. Chapter Three contrasts strong versions of postmodern ethical relativism, individualism, and the crisis of meaning with reverent observation, reverent response, and reverent affirmation. Chapter Four uses reverence to explore retained capacities in AD patients in a hypercognitive culture; the burdens on family caregivers aggravated by postmodern individualism, and the possibility of euthanasia as a management strategy for the "meaningless" lives of AD patients. Growth in reverence makes both individual and social transformation possible. While an ethic of reverence has theoretical strength, von Hildebrand's insight that the greatest ethical challenges we face are generally not theoretical but in the choice of being motivated by values or by the merely subjectively satisfying allows an ethic of reverence to have particular practical importance in addressing the ethical challenges raised by AD in the contemporary postmodern context