Ethical Considerations for the Use of Next-Generation Alzheimer Drugs in Symptomatic and At-Risk Patients

Serge Gauthier, CM, MD, FRCPC; Pedro Rosa-Neto, MD, PhD; Joseph S. Kass, MD, JD, FAAN Dementia p. 615-618 April 2016, Vol.22, No.2 doi: 10.1212/CON.0000000000000306
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ABSTRACT: This article presents a case in which a patient with mild Alzheimer disease requests a prescription for a newly developed Alzheimer disease drug, after which the patient’s daughter inquires about its potential usefulness as a prevention strategy for herself. The article discusses the physician’s responsibility to balance the ethical principles of beneficence, nonmaleficence, and respect for patient autonomy when evaluating requests for medications from patients with neurocognitive disease as well as from asymptomatic but at-risk patients.

Address correspondence to Dr Serge Gauthier, Douglas Hospital, McGill Centre for Studies in Aging, 6825 LaSalle Boulevard, Verdun, QC H4H 1R3, Canada,

Relationship Disclosure: Dr Gauthier receives personal compensation for serving on the scientific advisory boards of AFFiRiS, Eli Lilly and Company, and Hoffmann-La Roche Ltd; for serving as chair of the scientific advisory board of TauRx Therapeutics; and as a lecturer for Ever Pharma and Schwabe, Williamson & Wyatt. Dr Gauthier serves as an editorial board member of Alzheimer’s & Dementia: The Journal of The Alzheimer’s Association, Current Medical Research & Opinion, Dementia and Geriatric Cognitive Disorders, Eurasian Journal of Medicine, European Neurology,and the World Journal of Biological Psychiatry. Dr Gauthier receives research funding as site principal investigator of the Eli Lilly and Company and Hoffmann-La Roche Ltd, and receives funding for this work from the Canadian Institutes of Health Research and the Canadian Consortium on Neurodegeneration in Aging as chair of the Ethical, Legal, and Social Issues advisory committee. Dr Gauthier receives book royalties from Cambridge University Press. Dr Rosa-Neto receives grant support from the Alzheimer’s Association. Dr Kass has received personal compensation for expert testimony in legal cases involving personal injury, defamation, and malpractice.

Unlabeled Use of Products/Investigational Use Disclosure: Drs Gauthier, Rosa-Neto, and Kass report no disclosures.

© 2016 American Academy of Neurology