Abstract and Keywords
Neuroethical issues in the early detection of Alzheimer's disease (AD) are likely to be characteristic of any disorder where the boundary conditions between being impaired and unimpaired are unclear. Initial research efforts were focused on examining patients with established disease. The article discusses some challenges for the clinical diagnosis of mild cognitive impairment. The overarching ethical concern is that the term mild cognitive impairment (MCI) is being applied to patients in clinical settings, when the majority of the data pertains to risk for groups of subjects, as opposed to individuals. These same challenges regarding the boundary between normal and abnormal, and the probabilistic nature of predicting progression, apply to individuals with normal cognition. This balance between risks and benefits would, of course, change, when disease-modifying therapies are identified. Then potentially beneficial treatments could be instituted even when someone is cognitively normal.
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