Episode 24

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Published on:

8th Sep 2025

The ethics of dementia care - with Vince Mitchell

What ethical challenges are presented by caring for people with dementia? How should we understand - and respect - the personhood of those experiencing cognitive decline? And what can virtue ethics and care ethics contribute to the development of an alternative ethical model for dementia care?

These are some of the questions we explore in this episode, in conversation with Vince Mitchell. Vince is a Lecturer in Health and Social Care, specialising in mental health, at The Open University (UK). He is a qualified mental health nurse with experience of nursing people in a wide variety of clinical settings. Having graduated with a Bachelor of Science in Health Care Practice and a Master of Arts in Applied Ethics from the University of York, Vince undertook doctoral research at the University of Surrey, where he was awarded a PhD in 2016 for his thesis examining ethical frameworks for dementia care. Since then, he has published a number of articles and book chapters on the ethics of mental health nursing and on ethical practice in dementia care.

We discuss the following topics in this episode:

Vince's journey into nursing (02:15)

Working as a mental health nurse (04:50)

Bridging the worlds of philosophy and care practice (07:00)

The challenges that dementia presents for care providers (10:40)

The inadequacy of existing ethical models (13:15)

Some of the key ethical issues in dementia care (15:35)

Personhood and autonomy (19:08)

The personal identity challenge to advance directives (23:50)

Thomas Kitwood's model of person-centred care (30:10)

Julian Hughes' Situated Embodied Agent approach (34:13)

Personal dignity and human flourishing (36:19)

Introducing virtue ethics (39:55)

Vulnerability, interdependence and trust (43:05)

Care ethics, justice and the socio-political context of dementia care (47:55)

An alternative ethical model for dementia care (51:10)

Implementing the model in practice (55:35)

Vince's plans for future work in care ethics (58:50)

A selection of Vince's publications

'Ethics and mental health nursing' (2017)

'Ethical practice in dementia care' (2019)

Some of the writers and thinkers mentioned in the episode

Rebecca Dresser

Ronald Dworkin

Derek Parfit

Thomas Kitwood

Julian Hughes

Maurice Merleau-Ponty

Martin Buber

Martha Nussbaum

Emmanel Levinas

Aristotle

Immanuel Kant

Elizabeth Anscombe

Philippa Foot

Alasdair MacIntyre

Rosalind Hursthouse

Eva Kittay

James Thompson

Onora O'Neill

Carol Gilligan

Joan Tronto

Virginia Held

Michael Slote

You can download a transcript of the episode by following this link to the Careful Thinking Substack.

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About the Podcast

Careful Thinking
Exploring ideas about care
At some point in our lives, we will all have the experience of caring for another person - or of being cared for ourselves. But what exactly is ‘care’, and what do we mean by ‘good’ care? How do our beliefs, identities, and the social, cultural and political contexts in which we live, shape our experience of caring or being cared for? And how can ideas, theories, and the findings from research, help us to think more care-fully – and to care more thoughtfully?

Careful Thinking explores these and similar questions, inspired by a belief that thinking critically about care can both deepen our understanding and improve the everyday practice of care. In each episode of the podcast, you'll hear an in-depth conversation with a researcher, writer or practitioner at the cutting edge of current thinking about care.

If you would like to give us your feedback, or suggest a guest or a topic for a future episode, you can get in touch at carefulthinkingpodcast@gmail.com. And you can leave comments on episodes and join in the discussion at https://carefulthinking.substack.com.

About your host

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Martin Robb

Martin Robb is Professor of Care Ethics and Culture at The Open University (UK), where his research has focused on questions of identity, relationships, and care. He is the author of 'Men, Masculinities and the Care of Children: Images, Ideas and Identities' (2020) and the co-editor of 'Men and Loss: New Perspectives on Bereavement, Grief and Masculinity' (2025).