This paper explores the syndrome of dementia and the way in which it affects a person's capacity to make a medical decision. The symptoms of dementia exist along a continuum, meaning that a patient will begin with a mild form of dementia and then progress to a more severe form of this syndrome. This paper argues that although demented patients generally do not have the capacity to make medical decisions, some demented patients, because of the continuum nature of the syndrome, can participate in the planning of their care and, in some cases, participate in the informed consent process. It maintains that the principles of respect for autonomy and dignity, beneficence, and justice provide ethical reasons for involving demented patients in the care when they are capable to do so. Moreover, this paper contends that ageism, sexism, and hypercognitivism are biases that likely affect the way in which physicians view their demented patients, and consequently, the intersectionality of these three biases may play a role in a physician's disregard for an elderly demented patient's involvement in the planning of their care. Finally, the way in which physicians' interpret the idea of "involvement" provides further reasons to explain why physicians sometimes exclude demented patients in participating in decisionmaking. This paper concludes by providing some suggestions for positively involving demented patients in care planning
