Ethical Considerations in Decision-Making  for an Elderly Alzheimer's Patient: A Case Report

Mojtaba  Parsa; Maryam  Modabber; Shiva  Khaleghparast

doi:10.18502/ijme.v17i24.18621

Mojtaba Parsa Assistant Professor, Department of Medical Ethics, School of Medicine, Medical Ethics and History of Medicine Research Center, Research Center for War-Affected People, Tehran University of Medical Sciences, Tehran, Iran.
Maryam Modabber PhD Candidate in Medical Ethics, Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Shiva Khaleghparast Associate Professor, Cardiovascular Nursing Research Center, Rajaie Cardiovascular Institute, Tehran, Iran

DOI: https://doi.org/10.18502/ijme.v17i24.18621

Keywords: Patient autonomy, Substitute decision-maker, Alzheimer's, Advance care directive.

Abstract

In the current era, the alarming increase in the number of patients with Alzheimer's disease has led to greater attention to issues related to care and alternative decision-making for this special group in society. The four ethical principles of "beneficence", "non-maleficence", "respect for autonomy", and "justice" serve as fundamental guidelines in medical decision-making. This study presents a case report of an elderly Alzheimer's patient and the ethical issues related to medical decision-making in the absence of a substitute decision-maker. Typically, for individuals lacking decision-making capacity, decisions are made by a substitute decision-maker and, in some countries, an advance care directive. In the absence of these, the medical team may make decisions in the best interest of the patient, considering the individual's cultural and social conditions, while taking into account the aforementioned ethical principles.