Forcing parents to participate in treatment is unlikely to succeed. Seeking to optimize the therapeutic alliance between family and pediatrician is more likely to achieve the desired outcome—the child’s short- and long-term well-being.
The early diagnosis of Alzheimer disease is a boon in that it enables advance planning, but that planning process can engender conflict between respect for future-oriented autonomy and future welfare.
Physicians need to help surrogate decision makers to make treatment and end-of-life decisions for those with severe neurological damage by proving a realistic prognosis and maintain strong lines of communication.