Abstract

Decline in cognition brings numerous ethical challenges to the fore, as clinicians strive to balance autonomy with beneficence, non-maleficence, and justice. This chapter will describe, by way of a prototypical case, common ethical challenges encountered in each stage of dementia. First, issues in early stage dementia, such as disclosure of diagnosis, genetic testing, and the use of cognitive enhancers will be discussed. Following this, ethical issues surrounding the use of antipsychotics for management of behavioral issues in dementia will be described. Decision-making around placement in a nursing home will then be elucidated. Finally, issues in end-stage dementia and the use of a palliative approach will be described.

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