If a woman asks for her husband, having forgotten that he is dead, should you tell her the truth and cause her terrible grief, knowing that this fresh bereavement will likely repeat itself, over and over, day after day? Or should you just tell her that he is at the office? And is direct lying different from various forms of passive lying—encouraging delusions, or allowing existing delusions to persist? What is more important—dignity or happiness?
This is not a dignity or happiness question, this is an agency question: who is charge of this person's life? It gets directly to the definition of consciousness (but not sentience, which is a different animal entirely). My working definition of consciousness is the ability to receive stimulus in such a way that your internal mental model is changed.
If you cannot understand your husband has died in such a way that prevents you from keeping that thought in your head tomorrow and continuing with your grief, you are not conscious in the same way the rest of us are. You certainly may be able to speak and move around, but you are not fully awake. You may never be.
In this case, and this case only, you have lost agency. That is, others must make decisions for you based on their ability to receive new data and adjust their mental models. That's not the nursing home's job. That's probably a close family member, somebody you trust with your life.
It's an evil thing when other people take away your agency. The elevator button appears to make the elevator speed up, but it doesn't. The doctor uses meds as chemical restraints because that's easier for the staff. The emergency responder tells you that you're doing fine when in fact he knows you only have minutes to live. It's evil. There's no getting around it. Somebody is purposefully taking away your ability to make choices by creating a fake universe for you to live in so that their life is better. (Same goes for online forums that give you voting buttons that do nothing, or ghost you, but I digress)
But it's not an evil thing when you do it to yourself, when you select somebody to create a wistful fantasy for you to live in for your final days. It's probably the most humane thing we have going for these folks.
This is not a dignity or happiness question, this is an agency question: who is charge of this person's life? It gets directly to the definition of consciousness (but not sentience, which is a different animal entirely). My working definition of consciousness is the ability to receive stimulus in such a way that your internal mental model is changed.
If you cannot understand your husband has died in such a way that prevents you from keeping that thought in your head tomorrow and continuing with your grief, you are not conscious in the same way the rest of us are. You certainly may be able to speak and move around, but you are not fully awake. You may never be.
In this case, and this case only, you have lost agency. That is, others must make decisions for you based on their ability to receive new data and adjust their mental models. That's not the nursing home's job. That's probably a close family member, somebody you trust with your life.
It's an evil thing when other people take away your agency. The elevator button appears to make the elevator speed up, but it doesn't. The doctor uses meds as chemical restraints because that's easier for the staff. The emergency responder tells you that you're doing fine when in fact he knows you only have minutes to live. It's evil. There's no getting around it. Somebody is purposefully taking away your ability to make choices by creating a fake universe for you to live in so that their life is better. (Same goes for online forums that give you voting buttons that do nothing, or ghost you, but I digress)
But it's not an evil thing when you do it to yourself, when you select somebody to create a wistful fantasy for you to live in for your final days. It's probably the most humane thing we have going for these folks.