Music therapy is first-line treatment for a range of neuropsychiatric symptoms for patients along the Alzheimer’s Disease (AD) spectrum: it does not contribute to polypharmacy and it is generally regarded as safe and beneficial. Health care systems can scale up capacity to meet the musical memory-care needs of patients with AD by streamlining system-wide music therapy referrals. Growth of music therapy as a field also requires generating protocols that are standardized enough to have reliable evidence-bases about neurobiological foundations of music perception but individualized enough to avoid harms, such as overstimulation. Music-based interventions can also evoke a range of memories that can cause patients to experience distress or confusion, which are clinically significant responses that warrant documentation and need skilled follow-up.
Although music is commonly assumed to be benign as “background noise” or even benevolent, as the “universal language” epithet seems to suggest, it is ethically and clinically important to understand some musical tones’ potential to be experienced by a patient as invasive or harmful. Despite benefits to music therapy as a field that can accompany protocol standardization, individual music therapists tend to be wary of generalizability and are trained to closely observe each patient’s unique musical-memory vulnerabilities. This theme issue investigates this irony and considers how music therapy as a field might grow and expand to meet the needs of a large and growing number of patients, while continuing to center harm-avoidance and patients’ specific musical memory experiences.
Manuscripts submitted for peer review consideration and inclusion in this issue must follow Instructions for Authors and be submitted by 30 August 2025.
The AMA Journal of Ethics® invites original, English-language contributions for peer review consideration on the upcoming themes.