My 78-year-old mother has moderate dementia and suffers from mood swings, depression, anxiety, agitation and disturbed sleep. One of her doctors recommended a low-dosage CBD/THC gummy to alleviate these problems. She takes one daily and, combined with other therapies, now experiences more stable moods and better sleep.

The issue is my mother’s conviction that marijuana is for drug addicts and criminals, never mind that medical marijuana is legal in our state. She is so vehemently opposed to marijuana use that she disapproved when my dying sister used marijuana years ago for pain relief from inflammatory breast cancer. I have to lie to her about the ingredients in the gummies, which I casually refer to as ‘‘multivitamins.’’ Is it wrong to give my mother a drug that she would never have voluntarily taken on her own? — Name Withheld

From the Ethicist:

You think your mother’s attitude toward cannabis is irrational. I agree. Generations of government propaganda have doubtless left a mark. But the fact that your mother’s degree of hostility to the stuff is unwarranted doesn’t settle the matter.

Here are a couple of issues to take into account. One is — no surprise — the extent of her dementia, because it affects her ability to understand what you’re telling her about these gummies. From what you say, she would be perfectly capable of understanding that the gummies contain chemicals extracted from cannabis plants, one of which is responsible for psychoactive effects she regards with disapproval. And long before her current condition, you evidently weren’t able to reason with her about the possible medical benefits of THC. In general, we shouldn’t lie to people about the drugs we’re giving them, and your mother would want to know what’s in those gummies. Mild dementia wouldn’t justify denying her that information. But the more serious her dementia is, the more you have to treat her not as someone whose rational capacities must be addressed but as someone whose care is entrusted to you.

Which brings us to a second issue. When we’re acting in the interests of someone who is no longer capable of making reasonable decisions, we may have to bear in mind not just what we think is best for them but what we know they would have thought was best for them. A person who was keeping kosher before she developed dementia shouldn’t be fed bacon, unawares, because her trustee doesn’t believe in Jewish dietary laws. Even if you judge that your mother has passed the point where she can make decisions, you will still have to decide how central her longstanding hostility to cannabis was to her sense of who she was. And you will have to weigh this against the contribution of these gummies to her welfare. Weighing these issues properly involves having a detailed understanding of your mother’s situation; I hope spelling out the issues helps you to do so.

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