Letter to the Ethicist
My 78-year-old mother has been diagnosed with moderate dementia, and alongside this condition, she grapples with mood swings, depression, anxiety, agitation, and disturbed sleep patterns. One of her healthcare providers suggested that she try a low-dosage CBD/THC gummy to help manage these issues. Since she began taking one daily, combined with other therapeutic interventions, I’ve observed a noteworthy improvement in her mood stability and sleep quality.
However, there’s a significant hurdle: my mother holds a strong belief that marijuana is associated solely with drug addicts and criminals. This belief persists despite the fact that medical marijuana is legal in our state. In fact, she was so adamant against marijuana that she disapproved of my dying sister’s decision to use it for pain relief from inflammatory breast cancer years ago. Consequently, I find myself misleading her about the gummy ingredients, referring to them as “multivitamins” instead. Is it ethically justifiable to administer a substance to my mother that she would never have willingly accepted on her own?
— Name Withheld
From the Ethicist:
You perceive your mother’s stance on cannabis as irrational, and I concur. It’s likely that decades of governmental propaganda have deeply influenced this perspective. Nevertheless, her intense aversion to marijuana does not resolve the ethical dilemma at hand.
Consider two critical factors. First, her level of dementia is significant, impacting her ability to comprehend the information you share about the gummies. Based on your description, she seems capable of understanding that these gummies contain compounds derived from cannabis plants, including one responsible for the psychoactive effects she disapproves of. Historically, you’ve struggled to communicate the potential medical benefits of THC to her, even before her cognitive decline. In general, honesty about the medications we provide is essential, and your mother deserves to know what she is consuming. While mild dementia might cloud her understanding, it wouldn’t justify withholding this information. However, if her dementia has advanced to a more severe stage, you may need to act more as her caretaker than as a communicator of rational thoughts.
This leads us to the second consideration. When we are responsible for someone who can no longer make sound decisions, we must take into account not only what we believe is best for them but also what we know their own preferences would have been. For instance, an individual who adhered to kosher dietary laws prior to developing dementia should not be unknowingly fed bacon, simply because their caregiver does not practice those beliefs. Even if you’ve determined that your mother is beyond the point of making decisions for herself, you will still need to consider how integral her longstanding opposition to cannabis is to her identity. Balancing this against the potential benefits these gummies could provide for her well-being is crucial. A thorough understanding of your mother’s personal history and values is essential in navigating this complex situation; I hope this exploration of the issues aids you in your decision-making.
A Bonus Question
I am a liberal woman, slightly older than middle age, residing in a predominantly conservative community in New Jersey. Recently, I found myself paired for a round of golf with a woman I have known casually for a few years, whose company I genuinely enjoy. While we’ve had numerous conversations, we had never ventured into political territory. To my dismay, on this occasion, she wore a striking, sequin-encrusted TRUMP pin on her collar. This pin was, quite frankly, deeply offensive to me. Would it have been appropriate for me to request that she remove it while we played together?
— Nancy
