The story of a woman who was being examined in court for possible jury duty. She looked up at the judge and said, “I am sorry, your honor, I can’t serve on the jury. I don’t believe in capital punishment. ” “Maybe you don’t understand,” the judge said, “this is a civil suit brought by a wife to recover $5,000 of her money spent by her husband on gambling and other women. ” “Oh,” she said, “I’ll serve on the jury, and I could be wrong about capital punishment!”This humorous story points out that ethical convictions may vary with respect to individuals and the specific circumstances. Most people, however, hold to prevailing ethical principles that assist them in making decisions. The ethical considerations which un gird the humane meanings of persons with Alzheimer’s. Such considerations challenge our society to support adequately families and health care personnel devoted to the care of persons with the disease. Individual, institutional, and societal values coalesce in developing an ethical response to the human dimensions of Alzheimer’s. Here Thomas F. Mc Govern, an ethicist with a background in counseling and theology, describes a framework for ethical decision making with regard to the care of a person with Alzheimer’s disease.

The right to self-determination while one is competent and the right to humane care throughout the course of the disease are of vital interest to victims of Alzheimer’s disease, their families, and their caregivers. The principle of justice, too, is of great importance because it calls for the fair treatment of persons experiencing the disease. Ethical values must provide a theoretical and practical basis for social attitudes, which espouse the essential well-being of persons whose ability to care for themselves tragically declines as the disease progresses.

The ethical issues that pertain to the care of persons with Alzheimer’s disease embrace at least three broad areas of concern. The first addresses the willingness of our society to provide adequate health care for Alzheimer patients. The second area of concern deals with the right of such persons to direct their lives while they are competent and to have their expressed wishes respected when they become incompetent. The third area of concern focuses on the ethical principles that guide families, caregivers, and institutions as they care for the Alzheimer patient throughout the progressive stages of the disease.

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