AMA Journal of Ethics theme editor Subha Perni, MD, a recent graduate of the Columbia University College of Physicians and Surgeons, interviewed Elizabeth Epstein, PhD, RN, about strategies for understanding and address moral distress in clinical settings.

Arts participation can counterbalance the social stigma of Alzheimer’s disease by fostering the autonomy and creativity of those with the diagnosis.

Authentic partnerships with people with dementia motivate full social participation and resist fatalism around experiences of illness.

Viewing dementia as a distinct disease promotes funding for research but may stigmatize those who have dementia and lead to disinvestment in caregiving.

Research is needed on surrogates’ susceptibility to believing that clinical trials provide individual therapeutic benefit.

Acknowledging the roles and views of the caregiver may be the first step to resolving disagreements between caregivers and clinicians over artificial nutrition at the end of life.

Long-term care facilities should assess residents for capacity to consent to sexual activity and be prepared to accommodate sexual intimacy.

As a matter of medical ethics, physicians must address the health care needs of and be advocates for family caregivers of their patients with dementia.

Off-label prescribing of drugs is appropriate when their use is in the patient’s best interest on the basis of credible, published scientific data.

One major difficulty in collecting data on which to base injury prevention strategies is the lack of large epidemiologic studies and comprehensive injury surveillance.