Misplaced Moral Argument about Predicting Alzheimer's

Contributed by: Dennis Fortier, President, Medical Care Corporation

When following the press in the brain health space, it is very common to find well-written opinion letters and perspective pieces about the moral dilemma of predicting Alzheimer's disease in healthy adults. Common headlines vary around the "would you want to know" or "would you take the test" theme. The crux of the argument is that, with no cure, we should not bother predicting the disease and revealing such a tragic fate.

In a nutshell, these are the usual defenses:
  • Predictions allow vigilant monitoring and timely intervention when symptoms appear which leads to better treatment.
  • Predictions allow for financial, legal, and spiritual preparation for end of life.
  • Predictions identify important research subjects who can greatly improve scientific efforts to develop new treatments by volunteering for trials.
There are other arguments but those are the most common and most compelling justifications.

The purpose of this post is neither to condemn nor condone the notion of predicting Alzheimer's disease but to point out how often the moral debate is misplaced. For predictive approaches, like genetic tests, I say let the debate rage. However, for identifying approaches, those that indicate with certainty if a person has Alzheimer's pathology that has not yet progressed to a stage producing obvious symptoms, then the whole notion of "prediction" is misplaced.

But the moral debaters do not respect this important difference between predicting the disease and identifying the disease. People who have it, have it. And when they present to a physician and complain of cognitive difficulties, they are asking their physician to figure out the cause of the problem and treat it as best as possible. No moral dilemma; these people want to know.

Remember, everyone has the right to not visit their doctor and not investigate emerging cognitive problems. Those who want to actively manage their health should be allowed and those who wish to remain ignorant have rights as well.

Soon, we will have the ability to identify Alzheimer's pathology with a PET scan which will enable earlier and more accurate diagnoses. In the not too distant future, we will likely have a spinal fluid test (followed by a blood test) that will accurately diagnose Alzheimer's disease at even early stages through more cost effective means. These are great steps forward and there is no moral or ethical downside to gaining these important clinical abilities.

Predicting Alzheimer's disease is a topic worthy of moral debate; identifying the disease is a categorically constructive step in the right direction.

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1 comment :

  1. Also I think that it is better to know before hand if you are going to have it. People should try to have a early treatment that it can be better.