Respecting autonomy in the guardianship appointment process for individuals with dementia in Finland: Legal and medical perspectives

This study explores how legal experts and physicians ensure the autonomy of individuals with dementia when assessing the need for legal guardianship and appointing guardians. Through interviews with 20 legal experts and 30 physicians, and thematic analysis, the research identified key analytical groups. Legal experts focus on (1) Ascertaining the individual’s views and (2) Minimising interference with autonomy. Physicians emphasise (1) ascertaining the individual’s views, (2) Supporting the realisation of autonomy and (3) Providing accurate information on the legal process. The study found that legal experts strongly respect autonomy, sometimes even deviating from strict legal requirements to ensure that individuals with dementia are heard and their opinions considered during court proceedings. Although physicians generally stress the patient’s autonomy, they prioritise protecting the individual more than legal experts.