Is it ethically justifiable to use antipsychotics in long-term care facilities for managing people with behavioral and psychological symptoms of dementia?

The use of antipsychotics (APs) is common practice in long-term care facilities (LTCFs) to manage people with behavioral and psychological symptoms of dementia (BPSD). This practice gives rise to various ethical issues, particularly in light of the fact that the use of APs might have at best modest efficacy in managing people with BPSD and at worst lead to significant adverse effects. This thesis aims to explore and critically examine the ethical justifiability of the use of APs for managing people with BPSD in LTCFs. First, in the empirical part of the thesis, I conduct a scoping review to map out the relevant existing literature. The review identifies rationales given for why, how, when and by whom using APs might or might not be ethically justified. Then, I examine the ethical justifiability of using APs from the standpoint of the well-known four-principles approach to biomedical ethics. Next, I take Tronto's ethics of care approach to offer an ethical examination of using APs as a form of care provided to people with BPSD in LTCFs. Finally, by drawing on the preceding discussions, I identify and suggest potential areas for further ethical investigation.