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BIOETHICS

Would You Take the New Alzheimer’s Test?

Alzheimer's doctor SOURCE: Flickr/Susan NYC A doctor doctor fills out forms following an Alzheimer's evaluation. A new test can detect with great accuracy the development of Alzheimer's years before symptoms occur. Jonathan Moreno muses on the ethical and political implications of this new medical milestone.

The news that an international team has found a biomarker for Alzheimer’s disease in spinal fluid has surely caused much soul-searching since it was reported last week. Perhaps most striking was the observation that, in the dispassionate language of medical science, “The unexpected presence of the AD signature in more than one-third of cognitively normal subjects suggests that Alzheimer’s pathology is active and detectable earlier than has heretofore been envisioned.” This finding suggests that many people who are destined for the disease can be diagnosed some time before they develop any obvious symptoms.

This development is a sign of how elegant the power of detection in modern medicine has become. But it’s also a reminder of how clumsy the power of treatment remains. We’ve seen that with genetics: For all of the talk about genetically engineering super-babies, by splicing and dicing chromosomes, it looks like information from embryonic DNA will mostly be used (for better or worse, depending on your perspective) when couples fearing genetic disease want to select healthier embryos to implant.

With Alzheimer’s, right now, the power to detect has fewer consequences for medical intervention, since the disease remains such a grim diagnosis. Some will question when to offer the test–or even whether to offer it at all. But, sometimes, knowledge really is power. And while some people might use the knowledge to contemplate assisted suicide, years in the future, most would probably use the test simply because they feel the need to have some control–the chance to plan sensibly for the time they have, the opportunity to put their affairs in order, to re-focus their lives on what is really important to them.

There are, and will be, clinical trials for new treatments: People might take the test so that, if they test positive for Alzheimer’s, they can sign up for them–both to contribute to medical science and to preserve a sense of hope. Some might undertake dietary and other lifestyle changes that seem to delay or lessen the symptoms. The evidence that these kinds of adjustments can make a difference is not definitive but it is growing. One benefit of the tests: Enabling more long-term studies of the benefits of lifestyle modifications.

Read the rest of the article at The New Republic.

Jonathan D. Moreno, Ph.D., is the David and Lyn Silfen University Professor of Ethics and Professor of Medical Ethics and of the History and Sociology of Science at the University of Pennsylvania, and the Editor-in-Chief of Science Progress.

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