While dopamine transporter single-photon emission computed tomography (DAT-SPECT) imaging is sensitive and specific when performed in patients with signs or symptoms of parkinsonism, its predictive value is uncertain in healthy subjects, even with patients who have first-degree relatives affected by Parkinson disease. In deciding whether to honor a patient’s request for a DAT-SPECT, neurologists must balance a patient’s autonomy rights with beneficence and nonmaleficence and also consider the distributive justice implications of ordering the test. Generally speaking, the benefits of a DAT-SPECT will be too small to justify its use in an asymptomatic patient concerned about developing Parkinson disease.
Address correspondence to Dr Thomas I. Cochrane, Brigham and Women’s Hospital, 75 Francis St, Tower 5D EMG, Boston, MA 02115-6110, email@example.com.
Relationship Disclosure: Dr Cochrane serves as a consultant for Merck & Co, Inc.
Unlabeled Use of Products/Investigational Use Disclosure: Dr Cochrane reports no disclosure.