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.
Variations among physicians in diagnosis and X-ray interpretation, the percentages of which have remained essentially unchanged for five decades, raise serious ethical concerns.
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.