Deception is common in dementia care, although its moral legitimacy is questionable. This paper conceptually clarifies when does dementia care involve deception and argues that care ethics is an appropriate ethical framework to guide dementia care compared with the mainstream ethical theories that emphasize abilities. From a perspective of care ethics, this paper claims that morally defensible deception is context-specific, embodied as a caring process that needs to be identified through instant, creative and interactive care procedures. According to this argument, it further analyses and concludes the moral rationality of deception in five common cases. While deception is morally justified in many situations, another concern is that it is usually not the last resort but a means of convenience. As the ability to interact, autonomy and dignity of persons with dementia (PWDs) are generally ignored; nurses need more training and education to master the essential procedures to ensure that the value of authenticity and autonomy is maintained and considered throughout dementia care.

Kantian ethics provides one possible theoretical basis for moral legitimacy regarding issues of right to life and death in bioethics. A prevailing view is that suffering caused by an incurable disease cannot be an orthodox Kantian moral reason for hastening a rational patient's death by physician-assisted suicide or voluntary active euthanasia. 1 This position derives from an indisputable consensus that a rational being has a Kantian duty to preserve his/her life, and it is morally wrong for a person to commit suicide out of self-love (to avoid suffering), for committing suicide to avoid suffering cannot be a universal law of nature 2 and violates one's 'necessary duty to one-self'. 3 However, this position does not comprise an absolute moral principle. In Kantian theory, the motives and reasons for one's actions are the basis for identifying one's morality.In recent years, Kant's discussion of a person's duty to die has attracted increasing attention. Dennis Cooley's argument regarding the Kantian duty for people with pre-dementia 4 to commit suicide is an essential starting point in elaborating these arguments. 5 Cooley 1 See, for example, Kerstein, S. (2019). Hastening death and respect for dignity:

Accumulating evidence has revealed many clues that regular aerobic exercise benefits brain health and behaviors. The aims of this study were to explore the effect of aerobic exercise on ejaculatory behaviors, as well as to make a preliminary assessment of aerobic exercise as a complementary strategy to dapoxetine treatment in rapid ejaculators. Copulatory tests of rats and a treadmill training protocol were performed in this study. In total, 12 rapid ejaculators were selected on the basis of ejaculation distribution theory and randomly assigned to 4 groups: control (Ctrol) group, aerobic exercise (Ex) group, dapoxetine (Dapo) group, and Ex+Dapo group. We evaluated the changes in ejaculatory parameters in the 4 groups. Variations in biological markers, including serum corticosterone, serotonin (5-HT), and brain-derived neurotrophic factor (BDNF) of the raphe nucleus, were determined by enzyme-linked immunosorbent assay (ELISA). The primary finding of our study was that both aerobic exercise and acute dapoxetine could enhance ejaculation control and prolong ejaculation latency in rapid ejaculator rats. The ejaculation delay effect of aerobic exercise was nearly equivalent to that of acute dapoxetine. In addition, both aerobic exercise and dapoxetine treatment could lead to increased expression of BDNF and 5-HT in the raphe nucleus of rapid ejaculators. Moreover, the two interventions, when applied together, may further upregulate the expression of BDNF-5-HT duo in a complementary manner. This study highlights the positive effects of aerobic exercise on ejaculation control. Regular aerobic exercise might be a promising complementary treatment to dapoxetine in rats.

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