Do People with Dementia Have Free Will?

#STRask — Stand to Reason

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Do People with Dementia Have Free Will?

June 16, 2025

#STRaskStand to Reason

Question about whether or not people with dementia have free will and are morally responsible for the sins they commit.

* Do people with dementia have free will? Are they morally responsible for the sins they commit, like their hurtful words and aggressive actions towards others?

Transcript

Welcome, everyone, to Stand to Reason's hashtag SDR-esque podcast. I'm Amy Hall, and I'm here with Greg Koukl, and we're here to answer your questions that you send on X with the hashtag SDR-esque, hence the name. Okay, Greg, we have, it's a little bit more philosophical type questions today, and I'm here to answer your questions that you send on X with the hashtag SDR-esque, hence the name.

Okay, Greg, we have, it's a little bit more philosophical type questions today, and- And the first one comes from Sirton Lee. Do people with dementia have free will? Are they morally responsible for the sins they commit, like their hurtful words and aggressive actions towards others? Well, this is an interesting question, because I've just been reading in Leviticus about sacrifice. And the thing that I'm reading, and I don't know if it's Leviticus 10.

Did not expect you to go there. This is a surprise. Well, it- Let me just look at my marker here.

Yeah, I'm in Leviticus 8. What's curious about Leviticus is it has- it prescribes sacrifices for- for the guilt people have for sins they didn't know they committed. I think in other places it calls a pretentious sin or something like that. It's- And maybe that's not the word it used, but in any event, it's- they didn't know they committed.

If a person commits a sin and doesn't know it, then he has- he bears guilt and he's got to provide a sacrifice. So, now this goes back to a principle that relates to this question. The principle is the moral principle which seems common-sensical to our moral intuition, and that is guilt, or I should say ought, implies can.

Ought implies can. That is, you know, it's not a problem. You ought to do certain things unless you are not able to do that, and if you are not able to do what you ought to do, then you don't bear any moral responsibility for it, all right? Now, that's our just genuine intuition, but it turns out this isn't a biblical principle, as evidenced by these series of sacrifices, and I mentioned Leviticus 8. I think the chapter before, it starts talking about those kinds of sacrifices, presumptuous sins.

I think that is a phrase they use, but in any event, this raises a question then. Well, how is it that we could be morally responsible for sins we didn't realize we committed, and that I don't have an answer for because, like I said, it flies in the face of our moral intuition, but there it is. It's right there in the text, and in fact, maybe I'll find a reference to it.

Now, this relates to our question here, though I hadn't really thought about it yet before, and maybe it relates. Now, again, this is one of those issues we kind of have to step through carefully. So if you have an infant who cries, sees his mother and is angry.

I remember once when Annabeth was an infant, she was sitting and laying in a little thing, you know, she must have been about eight months or nine months old or whatever it was. I think it was her first time to Wisconsin. I was on the porch there working on my fishing tackle and I sneezed, and she exploded, and it was very obvious mothers especially can recognize this.

She wasn't just startled. She was angry, and she was letting me have it with her squalls. All right.

Now, okay, there's anger there towards her dad. I don't count that as a sin because I don't know that she's even capable morally of making these distinctions. The sacrifices in the Leviticus relate to things that people do who are morally aware and can make choices and end up making a choice to do something wrong that apparently they didn't know was wrong, then find out that it was wrong and therefore then have to make a sacrifice to cleanse.

All right. That isn't the case in Annabeth's circumstance. And my suspicion is people who have severe mental limitations are in the same kind of circumstance that maybe Annabeth was in.

They don't. I'm just speculating here or rather stipulating as per the question. Someone in a circumstance that because of that impairment have no capability or very little capability to even understand in moral categories to know that one thing is right or one wrong.

It isn't like in Leviticus where you have healthy individuals who are misinformed. This question is about people who have some kind of liability in making a moral assessment. Now, in order to be guiltless in a circumstance like that, they'd have to be completely bereft of ability to do that like an infant.

I think most people who have mental incapacity to congenital defect or whatever still understand the difference between right and wrong and therefore can be held responsible for their for that capacity. Even if it's more limited, it's still a capacity that allows for moral culpability. And I'm thinking of somebody, as I was growing up as a young Christian, he had Hope Chaplin, Hermosa Beach.

There was a young man who was spastic. I don't know what the proper term for that is now, but he had this disability, you know, and he drooled and whatever. He was a very nice young man in many ways, but he was also very self-centered.

And one of the reasons you're self-centered is because people would show him undue attention in virtue of that. Okay. So if you're talking with a group of people and this young man kind of came up and started interfering, everybody would stop and give attention to him.

Instead of addressing the interruption as being impolite. Now, not everybody would do that. I can think of another friend of mine, a gal.

We both had the attitude, no, you can't do this. I'm talking right now. I'll get to you in just a moment.

And so we required of that individual to be polite, which he was capable of doing in that circumstance. And invariably, when we did that, he walked away and went to another group of people to butt it on. Okay.

So I think that was not virtuous behavior and it was behavior he could have controlled. And, but there were very few people in his life that made that requirement of him because he was handicapped. And so they made concessions that enabled this behavior with the exception of my friend, who's also named Amy, by the way, and me and maybe some others too.

But we've had a very clear sense that we wanted to manage this and we weren't going to let him do what was inappropriate. We were not unkind to him at all. We just said, have to wait a minute.

I'm having this conversation to get in a minute and invariably he would walk away. So back to this question of this, the foundation there. And do people with dementia have? Why don't you read it again, Amy? Do they have free will? Are they morally responsible for the sense they commit, like their hurtful words and aggressive actions towards others? I would say in most cases, yes.

A lot would depend on how bad the dementia is and dementia usually is something that follows a life of mental health and then there's deterioration. I do think I can get to a point of deterioration where the individuals no longer in control, in conscious control of their behavior. All right.

But even though I've said what I've said, in a certain sense, it is irrelevant to a broader question. It may be relevant to engaging people and trying to get appropriate behavior like Mike, the young man I was talking about. But when it comes to a salvation issue, a person is either forgiven or he's not.

If he's not forgiven, he's not forgiven for anything. If he is forgiven, he's forgiven for everything. I call it perfect justice or perfect mercy, a phrase I got from some friends down in San Diego and got found their way into the book story of reality.

But I think it's a great way of putting it. Either perfect justice, punishment for everything you've ever done wrong and God misses nothing or perfect mercy, forgiveness for everything you've never done wrong and God misses nothing. So if this person was a genuine believer trusting in Christ and therefore cleansed and falls into dementia and manifest these behaviors, it still would be appropriate to try to manage those behaviors with that person.

If they have any capability at all of doing it, but nevertheless, their sins are still forgiven. It's not justification for the sin, but it's just stating the extent of grace. And if they aren't, even if they manage it really well and turn out to be really nice, then whatever sins they are responsible for are not forgiven and that's the circumstance they're in before God.

That's kind of the direction I was going to take this in because I don't think their situation is all that different from ours because the truth is we all get really irritated when we're stressed and we're confused. So imagine that you lost your ability to control your reaction. I don't think inside, I think inside, we'll probably have a lot more in common with them than we think.

And we're all fallen human beings. It's just that we are able to control our reaction more than somebody who has lost that ability to control. But inside, I wonder if you're thinking of something in particular right now, your own ability to, I get it.

I know it goes on inside of me when I'm stress-infused and it takes a lot of willpower to control my reaction. But inside, I have the same thing going on in me. If I had no ability to control it, I would be reacting in the same way.

So I think this can help us to understand God's grace towards us. When we see that happening, we can think that is who I am inside. And God treats me with grace and this gives us an opportunity to show grace towards them and to pray for the strength to show them grace.

That's very hard. So are they responsible? I would say yes. I think it's revealing their heart.

Can they stop it? No. And this is where I think our compassion and our grace come in because we also have fallen hearts even if we're better at hiding that than they are. So I'm sorry to say that you are responsible for what is hidden inside you also.

I think we're all responsible for that because that is who we are. So even if you don't express it, I think it's still in your heart. I mean, Jesus talks about what is in our heart matters.

Even if we don't express it like lusting after someone, even if you don't do anything on that, that's still sinful. In the same way, having these angry thoughts towards others and wanting to lash out, that's also sinful. And we all do that.

We are all groaning, as it says in Romans 7. We are all waiting to be made like Christ. And we all have sinful hearts that we're hiding from others. And guess what? Jesus still saves us.

So this goes back to what you were saying. If you're saved, whether you're able to express it or whether you're able to control it or you can't control it and you're expressing it. We're all in the same boat and we're all saved by Christ if we're trusting in Him.

I'm glad you cited Jesus there about talking about what's inside of us. He made a comment. It's not talking about food.

It's not what goes inside that defiles but what comes outside. Then he gives a list of sinful attitudes and behaviors and the person suffering from dementia who acts this way. In a certain sense, because of the dementia has no filter.

So they're not stopping this natural impulse. Just like you said, we feel angry about things but we were able to act virtuously in spite of the sinful attitude that's still in our heart. That's trying to come out.

So in the case of dementia, the attitude of the sinful heart is coming out without restriction because of the dementia but the attitude is still the attitude. It's still what's down in there. Now, I wonder if you have somebody who has, and I have no way of testing this or whatever nor any anecdotal information but it's just a speculation.

I wonder if there are people who are just so wonderfully godly. I'm thinking of my aunt right now. She was the most godly my father's sister who was actually instrumental in bringing him to the Lord.

Finally, just before he died. I wonder if somebody like that who is just so just overflowing with the love of Jesus. I don't know how to say it sounds kind of corny, but just like that.

If they got dementia with the thing that manifests itself is the renewed character, virtuous character that had been built up for so many years. And developed. So what would come out is maybe demented responses but not reflecting the fallen nature which she had largely overcome in her conscious life, so to speak, in her godly development.

But rather godliness would come out, maybe stupidly or foolishly or in a cock maybe kind of way, but it would just, oh yeah, she's demented. She's giving everything away at her house or something. I don't know what.

I just wonder if that would make a difference. And if the godliness that Paul tells us to develop in this life, if we end up falling into dementia, if that will somehow serve us even in that circumstance. I don't know, it's a speculation.

I think so Greg. And the reason why I say that is because. And I don't maybe probably not completely because again we're still like false.

We're still all groaning. But if we're putting our sin to death with the Holy Spirit and this is the difference between merely following a law and having the Holy Spirit who actually puts your sin to death. If you're merely, if this is all willpower, then no, there's nothing stopping you.

But if you have the Holy Spirit and all who trust in Christ have the Holy Spirit according to Romans 8, we're putting our sin to death. I do think we are being conformed to the image of Christ over time. And depending on how far along we get on that path, you would see different results.

I think if you lost your ability to control yourself, because I do think there's. We are not, as Paul says, we're still waiting for the redemption of our bodies. We're still waiting to be to have all of our sin removed.

But he does say we are the Holy Spirit is giving us life. He is putting to death our sin and giving us life over time. So this is a great reminder of why we need to be very conscious of putting our sin to death and praying for that.

And seeking to be conformed to the image of Christ, for real, not just according to our willpower. Well, I'm sure you'll be fine, Amy, if you get demented. But the fact is I will probably suffer from dementia long before you do.

So you'll have to be the one who judges. I do want to read from Leviticus, these two passages. Now I'm looking in chapter four, just FYI, the audience, right? The first couple verses, chapter four, then the Lord spoke to Moses saying, speak to the sons of Israel saying, if a person sins unintentionally in any of the things which the Lord has commanded not to be done and commits any of them, if the anointed priest sins so as to bring guilt on the people, then let him offer to the Lord a bull without defect as a sin offering for the sin he has committed.

So those two are coupled together, the priest and the people, but also verse 22. When a leader sins and unintentionally does any one of the things which the Lord has commanded not to be done, and he becomes guilty, then he has to make atonement with regards to his sin and he shall be forgiven. So that's a pretty strong statement, that's Leviticus four, two different passages there, one, the first couple verses then, verse 22 and then jumping down to 26 where it talks about making atonement to be forgiven.

So there you have a very interesting circumstance where it appears that ought doesn't always imply can, or maybe one to be more precise here, maybe you could have done the right thing, but you didn't know the right thing to do, and then you did the wrong thing, and the text is saying under that circumstance, then you are still guilty and need to have atonement made for that sin. Anyway, that might help. And I will also say, you don't even have to, I mean, this is a reminder to all of us.

Well, first let me say this, when you encounter this or you're caring for someone, and I assume that probably certain is experiencing something to do with this, this is an opportunity for us to recognize in ourselves our own, the evil that's still in us, to repent of that, to thank God for his forgiveness, his undeserved forgiveness, dying for people who hated him, he could see the depth of all of the sin that we hide. He could see all of that. So it's a chance to thank him, and it's a chance to show grace, and it's a chance to pray for his help in doing all of that.

But even if it's an also reminder to be killing our sin because, and I've seen this happening with people over time, your sins tend to become more and more ingrained over time and get more and more pronounced, and if you think about what you want to be characterized when you get older, even if you don't have dementia, what do you want to characterize you and be thinking about killing your sin now so that it doesn't come to characterize you later? We want to look like Christ, and I think we should probably all be more intentional about that. That's such an important point. You know, the movie Grumpy Old Men, well, there's a truth to that.

At least I would just say in my own experience, the older I get, the more tempted I am to be grumpy. And when I see these things on the line, it says five things not to do if you're over 70 or something like that. And they're always like, quick complaining.

Don't talk about your health to everybody. Don't be grumpy and blah, blah, blah. As we get older, to be challenged more in those areas, and that means we have to be more vigilant like what you're suggesting.

Well, thank you so much, certain, and if this episode raised any questions about original sin, well, it just happens. The next question I'm going to ask Greg on the next episode is going to have to do with that. So we hope you join us again on the hashtag STRS podcast.

This is Amy Hall and Greg Cocle for Stand to Reason.