title: Slowing the progression of Alzheimer disease: ethical issues.
abstract: Slowing the progression of Alzheimer disease (AD) can be regarded as an unambiguous benefit only up to a point. Beyond that point, the greater human good will involve letting the downward progression proceed. However, defining this point is not easy. It may be useful to distinguish the then-self, i.e., the intact self that relates past, present, and future, from the now-self, i.e., a state in which the demented individual recognizes only the present. In decisions involving treatment and the prolongation of life, many believe that the (precedently expressed wishes of the) then-self takes precedence. Decisions about slowing disease progression involve not only the then-self but the medical community and the caregivers. They, too, may agree that slowing the progression of AD beyond a critical point is unacceptable.
authors.affiliation: School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA.
authors.forename: S G
authors.initials: SG
authors.lastname: Post
mesh_terms: D016223:Advance Directives; D000544:Alzheimer Disease / Q000191:economics / Q000628:therapy*; D003657:Decision Making; D018450:Disease Progression; D004992:Ethics, Medical; D005192:Family Health; D006801:Humans; D016743:Mental Competency; D010344:Patient Advocacy; D011788:Quality of Life