Ethical Issues in the Treatment of Late-Stage Alzheimer's Disease

Abstract

There is hope that the continuing efforts of researchers will yield a disease-modifying drug for Alzheimer's disease. Such a drug is likely to be capable of halting, or significantly slowing, the underlying pathological processes driving cognitive decline; however, it is unlikely to be capable of restoring brain function already lost through the pathological process. A therapy capable of halting Alzheimer's disease, while not providing restoration of function, may prompt serious ethical questions. For example, is there a stage in the disease process when it becomes too late for therapeutic intervention to commence? And who bears the responsibility of making such a decision? Conversations regarding the ethics of treating neurodegenerative conditions with non-restorative drugs have been largely absent within both clinical and research communities. Such discussions are urgently required to ensure that patients' rights and well-being are protected when such therapeutic options become available.

Keywords: Alzheimer’s disease; ethics; late-stage; palliative care; restoration; therapeutics.

Fig. 1.

The progression of Alzheimer’s disease. As the pathological burden of Alzheimer’s disease increases there may come a time when it becomes medically futile to commence disease-modifying therapies. Diagnostic designations include mild cognitive impairment (MCI), and Alzheimer’s disease (AD).