Sunday, September 06, 2009

The ethics of getting tested for Alzheimer's

The New York Times is reporting that European researchers have discovered two genetic variants for Alzheimer's which "account for about 20 percent of the genetic risk of the disease." A second research team has also found one of the variants, as well as an additional one of their own.[1]

Not surprisingly, this brings up the old question--would you want to get tested for having a disease for which there is no cure? As in all Ethical issues, I imagine that people's intuitions would differ on this matter. For example, a young, single person might think that the knowledge of an event which is very far off could only lower the quality of life in the here and now. But an older person with lots of family members reliant on his income or status might consider it a prudent way of managing an otherwise uncontrollable end.

A relevant consideration is Alzheimer's cost:
"In a 1994 report from the American Journal of Public Health on the economical and social costs of Alzheimer’s, it was the third most expensive disease in the United States after heart disease and cancer. They reported that the average lifetime cost of care for an Alzheimer’s patient is $174,000 with a two to twenty year life expectancy after diagnosis. This figure does not include the loss of wages both for the Alzheimer’s sufferer or the caregiver."[2]
Given this, some might argue that there is an ethical imperative to get tested early, no matter what your age. Health care costs go up as the symptoms of Alzheimer's worsen. The earlier somebody is diagnosed, the better position they will be in to financially prepare for when it occurs. Therefore, in a medical system which is partially reliant on taxpayers (i.e. in Medicare), one owes it to the financially supporting community to put all information on the table.

Consider a somewhat parallel case where one owes the community an acknowledgment of any blood disease when donating blood, since tainted blood would immediately harm those in the community. Alzheimer's also harms the community, though its peculiar harm is merely financial. Does that make a difference in the imperative to get tested?



[image] Jim Baen's Universe Blog

[1] Nicholas Wade "Scientists Connect Gene Variations to Alzheimer’s" New York Times Sept. 6, 2009.

[2] Carolyn Dean, MD "The High Cost of Alzheimer’s" (Accessed Sept. 6, 2009)

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