Dealing with Alzheimers Ethically - Essay Example

Dealing with Alzheimer’s ethically Alzheimer’s disease (AD) is a very common form of dementia and a very complex too. AD starts with a physical troubling of a brain working, and thus, reveals itself as a physical temporary illness. Yet later, with the physical damage progressing, Alzheimer’s also causes mental and behavioral disorders and finally, necessary ends with a complete damage of a brain and, and specifically, its mental intellectual abilities. Other words, due to this specific of the disease, a person with Alzheimer’s experiences great changes of a personality during the period of illness, until his/ her full physical disability of making decisions about own life. The ambiguity naturally appears already when noticing Alzheimer’s symptoms similarity to a normal aging, and mostly appears when treating and taking care of the ill person. While official clinical institutions, like Alzheimer’s Association and Alzheimer’s Society, provide a clear definition of AD from a normal aging on a ground physical brain changes, Rob J. M. Dillmann and Julian C. Hughes, Ph. D. explore a socio-cultural and ethical side of AD treatment. Alzheimer’s generally reveals itself as a disease which is hard to treat in a wright way. Specifically, Alzheimer’s is the disease which is hard to deal ethically with. It’s firstly hard to distinguish AD from normal aging process due to a similarity of symptoms on early stages. Alzheimer’s Association says, what commonly considered as elderly absent-mindedness, “may be a symptom of Alzheimer’s or another dementia” (“10 Early Signs”). Thus, to enlighten a disease specific, it’s firstly explored how AD differs from normal aging. The accent is put on physical symptoms’ interrelation with changes in person’s mentality. Secondly, as a person with Alzheimer’s, especially on latter stages, commonly demonstrates “the impaired decision-making abilities”, a socio-cultural context of the treatment is explode (Hughes 381). The discussion on ethical side of treating person with AD originates from those ill human beings’ loss of personality and from ambiguous determination of AD as a disease, not a normal form of aging. Enlightening “the disease” development The first symptom of Alzheimer’s as well as for many other dementias is a memory loss, because the disease starts with a physical brain damaging. According to Alzheimer’s Society, “During the course of the disease, proteins build up in the brain to form structures called “plaques” and “tangles” (“What is Alzheimer’s disease”). Nerve cells lose their connections and brain tissue is damaged. The disease specifically affects the cortex, which is responsible for thinking functions. Thus, a damage of brain areas which are responsible for every intellectual activity slowly begins (“Inside the Brain”). First of all it affects “the hippocampus which has a central role in day-to-day memory (“What is Alzheimer’s disease”). A person with AD naturally experience troubles when recalling recent events, asking for the same information many times. According to Alzheimer’s Association, a normal elderly tend to experience the forgetting, but remembering the information later, while people with AD experience a memory loss (“10 Early Signs”). While elderly may have occasional errors with making numbers, people with AD generally lose the ability of solving problems and planning, which the cortex is also responsible for. Due to a memory loss people with AD start to experience troubles when completing even familiar tasks, while elderly normally may experience troubles with understanding new devices or some new activities. Later symptoms are less peculiar to what is defined as a normal aging. As the disease is spreading within the cortex, a person has problems with understanding a surrounding environment, and visual images). Meanwhile, elderly may be troubling to recall a day of a week or a date, and elderly vision problems are usually reasoned by cataracts only (“10 Early Signs”). As well as people with AD, elderly may misplace things sometimes, but they are able to retrace steps (recent chain of events) and remember how a thing has appeared on a new place. Meanwhile, such recent information, which is also connected with a planning, cannot be even remembered by people with AD. They cannot know, what they were recently doing, and behavioral problems appear. On later stages AD spreads further on cortex areas which are responsible for linguistic activities and reasoning (“Inside the Brain”). A person starts experiencing problems with making a logic conversation. He/ she also makes poor judgments and generally, “experiences changes in decision-making” (“10 Early Signs”). While elderly may simply feel tired of family obligations and some social activities, a person with AD tends to remove him/ herself even from most favorite social activities and hobbies. These are clear symptoms of changes of personality, and confused about these changes, a person demonstrates mental and behavioral disorders (“10 Early Signs”). Among the most common outcomes are: the members of a family may be not recognized, and that a person him/ herself is confused with very familiar environment and well-known, even basic activities from a day-to-day life, like eating and walking (“What is Alzheimer’s disease”). Due to the disease development and those physical and mental changes it brings, people with AD commonly experience depression and changes of mood (“10 Early Signs”). On later stages mental disorders become more serious as more brain areas is damaged, and people with AD often have hallucinations and problems with sleeping and demonstrate aggressive behavior, during which they may hurt themselves or a person which takes care of them (“What is Alzheimer’s disease”). Thus, AD naturally implies medical (directed on relief of physical symptoms) and psychological (primary talking therapies on mental disorders) complex treatment. “This will involve drug and non-drug care, support and activities” implied on every stage of disease development (“What is Alzheimer’s disease”). On very later stages a person with AD may need a special care and thus, are widely hospitalized. Questioning “the disease” treatment In refer to the specifics of above described symptoms, it’s clear that along the disease development, a person with Alzheimer’s constantly experience a decreases of any intellectual activity. Official medical institutions generally base their diagnosis on physical body analysis like MRI and other types of a brain scanning. What they observe is a spreading within the cortex brain damage which ends with “the brain shrinks dramatically over time” (“Inside the Brain”). Yet Dillmann points, that during the whole history of AD, a possibility of a distinction of the disease only “on clear clinical or pathological grounds” has been widely argued (137). The point is that Alzheimer’s have obvious similarities with a normal aging, and thus, has been widely compared to a normal aging, even in present times (Dillmann 137). The statistics firstly gives the opportunity of the ambiguity. “The disease mainly affects people over 65”, and risk increase along with aging: “One in six people over 80 have dementia” (“What is Alzheimer’s disease”). In its turn, a clinical medicine points on rare cases of early Alzheimer’s (“What is Alzheimer’s disease”). Meanwhile, the brain damage, caused by AD also inconvertible (drugs may only bring a relief and delay) and leads to a full inability of decision-making. Therefore, on later stages doctors and family usually treat a person with AD with a disregard to his/ her will of being treated. Thus, a socio-cultural context is involved: can other person (persons) or society in general, make a decision on the behalf of the ill person? Hughes points on a modern health care and social tendency on autonomy: “Autonomy is generally in priority” (381). That means, a person with a dementia should be treated, but if this person wishes not to take drugs or not to attend talking therapies, a treatment should be declined (Hughes 381). Yet due to a specific of AD, on later stages a person with Alzheimer’s cannot make a decision about on life because of a physical damage. Hughes thinks, that such a change of narrative allows others to make a decision (381). AD decreases a personhood (characteristics which makes individual a person), and thus, social and personal rights of a human being are also decreased. He also points, “Some philosophers define a personhood in terms of consciousness and in particular, in terms of memory”, and thus, personality is vanishing with intellectual activity decreasing and memory loss caused by AD (Hughes 383). Being a personally made decision, the autonomy also decreased. Yet some moral obligations to a once healthy person stay among family members, who now also are involved in the process of decision making. For example, “Children who have promised their mother, when she was well, not to put her in a home, find themselves in a terrible dilemma when she then develops dementia and starts to wander in the streets at the night only partially clothed” (Hughes 381). It keeps the discussion alive. Conclusion Due to a specific of the development, Alzheimer’s disease reveals itself as a quite ambiguous illness. In its symptomatic, AD has many similarities to a normal aging, and thus is widely compared to normal conditions of elderly. Yet Alzheimer’s is officially defined as the abnormal form of aging and requires a complex treatment. The definition is primary reasoned by clinical evidences only, which may be a reason to question AD’s abnormality. The further treatment of Alzheimer’s can also be questioned on a subject of its ethics. However, the society and official medicine tends to justify disregard of the ill person autonomy due to an inconvertible vanishing of a personhood, which a person with AD demonstrates. Some moral concerns, however, keeps the question open. Works Cited “10 Early Signs and Symptoms of Alzheimer’s”. Alzheimer’s Association. Web. 21 March 2015. Dillmann, R. J. M. “Alzheimer Disease. Epistemological Lessons from History?”. In Whitehouse, P.J., Maurer, K and J. F. Ballenger (Eds.) Concepts of Alzheimer Disease: Biological, Clinical, and Cultural Perspectives, Chapter 8, pp. 129-158. JHU Press, 2000. Hughes, J. C. “Ethical Issues and Patterns of Practice”. In Weiner, M. F. and Lipton A. M. (Eds.) The American Psychiatric Publishing Textbook of Alzheimer Disease and Other Dementias, Chapter 22, pp. 379-407. American Psychiatric Publishing, 2009. “Inside the Brain: An Interactive Tour”. Alzheimer’s Association. Web. 21 March 2015. “What is Alzheimer’s disease?”. Alzheimer’s Society. Web. 21 March 2015. Read More