title: Complementary and Alternative Medicine in the Context of Earlier Diagnoses of Alzheimer's Disease: Opening the Conversation to Prepare Ethical Responses.
abstract: Preclinical Alzheimer's disease (AD), a newly proposed, actively researched, and hotly debated research-only diagnostic category, raises the prospect of an ethical dilemma: whether, and possibly how, to treat a disorder with no target symptoms. This proposed category rests on the detection of a number of biomarkers thought to provide evidence of AD pathophysiology years before any behavioral symptoms manifest. Faced with limited treatment options, patients and their relatives may come to consider complementary and alternative medicine (CAM) a viable option, albeit one with minimal supporting evidence. Accordingly, the hopes and needs of some preclinical patients and their relatives could further fuel market-oriented entrepreneurship for CAM. In this ethics review, we provide background and reflect on some ethical questions related to the roles of key stakeholders arising from the potential for CAM use in the context of a possible preclinical AD diagnosis.
authors.affiliation: Institut de recherches cliniques de Montréal, Neuroethics Research Unit, Montréal, QC, Canada.|Université de Montréal, Department of Medicine and Department of Social and Preventive Medicine, Montréal, QC, Canada.|McGill University, Department of Neurology and Neurosurgery, Division of Experimental Medicine & Biomedical Ethics Unit, Montréal, QC, Canada.
authors.forename: Eric
authors.initials: E
authors.lastname: Racine
authors.affiliation: University of Queensland Centre for Clinical Research, Brisbane, Australia.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Forlini
authors.affiliation: Institut de recherches cliniques de Montréal, Neuroethics Research Unit, Montréal, QC, Canada.
authors.forename: John
authors.initials: J
authors.lastname: Aspler
authors.affiliation: Faculty of Law, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chandler
mesh_terms: D000544:Alzheimer Disease / Q000175:diagnosis* / Q000628:therapy*; D000529:Complementary Therapies / Q000941:ethics* / Q000379:methods*; D042241:Early Diagnosis; D026689:Ethical Analysis; D006801:Humans
keywords: Alzheimer’s disease; bioethics; complementary therapies; health policy