Senility--Is It Immoral?

Question: What is the Objectivist position on dementia? I understand that Ayn Rand treated her husband, Frank O’Connor, in the following way when he suffered from dementia:

Nowadays this comes across as downright cruelty (as well as downright stupidity), but I understand that this treatment of him was derived from her overvaluation of supposed intellectual consistency in the conduct of daily life. For Rand, there was no ambiguity in the world:  if it is true that man has free will and is responsible for his conduct, it cannot also be that there is a condition such as dementia that robs a man of his capacity for choice. Hence her husband’s lapses were wilful and deliberate.  At least they were to her. Do modern day Objectivists believe this is the correct and proper way to deal with those suffering from dementia? Answer: Ayn Rand ’s treatment of Frank O’Connor as it’s described in Anne Heller’s biography is an anecdote about her personal life with her husband. It’s an insight into aspects of her personality and a portrait of two people struggling with a situation which was probably painful and confusing for both of them. But it’s not a template for a philosophically consistent Objectivist position on mental illness.Objectivism takes the individual as a primary unit. The individual’s faculty of reason is a fact about human nature that is a basis for its ethics and other conclusions—the same way you assume a given person has arms and legs, and that because of this he will behave in certain ways. But none of our faculties always function in good health, and age-related dementia is a case in point.  Objectivism is also a philosophy with a high degree of respect for science and medicine, which reveal the body and especially the brain to be extremely complex. As neurologists and other professionals study the brain, they might find things about brain processes, mental illness, and the ability to make decisions that will give philosophers insight into the boundaries of rationality and volitional control, the experience and development of the rational faculty, and ways in which the faculty might be damaged or non-functioning altogether.I hope that anyone suffering from Alzheimer’s or mental disease of any kind will seek out treatment in order to be as comfortable and healthy as possible.A somewhat related essay on our website is James Lee Brooks’ 2001 review of  PC, M.D.: How Political Correctness is Corrupting Medicine By Sally Satel . Brooks’ essay points out a potential pitfall that I’d like to avoid: while medicine might refine our ideas about rationality and free will, and offer insight to Objectivist philosophers, the presence of mental illness would not contradict the axioms that we began with—that rationality (and its obstacles) exist in reality, and that it is consciousness we use in identifying and classifying them. Without mental functioning, i.e., consciousness, we would not have an understanding of mental illness in first place.