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Opening Arguments

Knowing, or not

If a test shows you have a greater risk of Alzheimer's, should the doctor tell you? Would you want to know? Those are two different questions.  On the first question, notes The New York Times, five different consensus statements by ethicists and neuorilogists were all in favor of no, do not tell. But in a study of people with a first-degree relative suffering from Alzheimer's, most people wanted to know.:

But his subjects were fine with the testing. After they gave the subjects their test results, researchers looked for psychological effects, observing participants in conversations and administering standardized questions designed to detect anxiety or depression or suicidal thoughts. They found nothing.

The downside of knowing is that there is no way to prevent Alzheimer's or keep it from progressing once it is present, so why torture yourself with that knolwedge. The reason to know, though, is that we can plan our lives a little better. Not quite sure if I'd want to know or not. Would you?


William Larsen
Thu, 12/30/2010 - 6:10pm

I would want to know. Life is short and you live it. How many people have planned for their eventual death or in this case disability. Many say they have, but the fact is very few have.

Does it change things if you know? Having suffered through an explosion, traumatic head injury and years in recuperation, I was told that these injuries would some day return and quite possibly with a vengence. Each year you look back and may not see the changes, but others do.

Forgetting what you did yesterday is terrible. Forgetting to take medicines can be bad as well. Getting lost driving in a city you grew up in can really cause a person concern.

There is medication out there that provide some help if caught early. I think a person who is told this prior to full blown will have more of a chance they are having problems and accept it more readily.

For me, I would want to know.

john b. kalb
Thu, 12/30/2010 - 6:52pm

I also would want to be informed - knowledge is always best.

Thu, 12/30/2010 - 7:48pm

Drugs such as aricept treat the symptoms of dementia by slowing the onset but there is no cure. I have always believed that patients with alzheimers are frustrated by the disease but are less upset about having it than their caring family and friends.

Being fully cognizant of the terribly debilitating effect of the disease is left to those with healthy brain function. Stable and mature adults do not ponder their own last years nor obsess about their own death, so I would conclude that constant worrying about dementia and death is not a good indications of one's sanity.

In other words, we should question just how well-adjusted we are psychologically to want to be tested because their is nothing that can be done about the inevitable onset of the disease,

larry morris
Fri, 12/31/2010 - 6:17pm

"Stable and mature adults do not ponder their own last years nor obsess about their own death, so I would conclude that constant worrying about dementia and death is not a good indications of one

Fri, 12/31/2010 - 10:38pm


I guess that we will agree to disagree. Loved ones generally are aware of family history and will notice changes in the things you talk about, the mental level of your conversations and the inevitable changes in speech patterns and inability to recall words, much before you are prepared to discuss the subject (which I think would be after you have the lost the capability of fully rational thought).

If I am rational, I will arrange my own funeral, tighten up my will, say goodbye and take that dream trip. How many people have you observed, even with mild dementia, taking such positive steps when the disease appears? You might argue that if you know about the outcome ahead of time, you can do the things I describe . . . but at what price? Happiness may the first casualty.

Andrew J.
Sat, 01/01/2011 - 9:50am

What about if your circle of "loved ones" is limited? You are widowed; you had no children. Are your golfing buddies, drinking partners the ones to start noticing, and telling you, hey, we need to talk because the mental level of our conversations is getting surreal?
Knowledge is king. The first one who should have the knowledge about themselves should be you, not family or friends. Only you can really take care of yourself, first and foremost.

larry morris
Sat, 01/01/2011 - 2:03pm

I think I would still rather know and be able to do what I can to mitigate an unfortunate on-coming disease.
Happiness as the first casualty ? I would hope not - I've done some pretty stupid things in my life, I would hope that wasting whatever time I had left being unhappy in this situation wouldn

William Larsen
Tue, 01/04/2011 - 2:37am

When you see a person every day, do you really see the small changes? Do you see more of a change when you see a person periodically?

When I was hurt in the navy, I could not speak very well after the explosion. Words came out wrong. I misunderstood what others were saying. My memory was terrible, but for some reason my analytical skills were still pretty good. I grasped for words and everything was on the "tip of the tongue." It is very frustrating trying to communicate with someone knowing what you want to say, but it does not come out at all in a way that can be understood.

I find I could write far better than I could speak or hear. The brain can re-route and to some extent relearn. It took years, but I achieved a level that was better than expected.

I believe an individual sees the signs before others. They forget, the get lost, they drop things, etc. Speech becomes more difficult and the person resorts to limited use of words and maybe not actually saying much but agreeing with what is said. The problem becomes that if it gets too late, then financial planning becomes very difficult and end of life decisions are not known. I believe up front information can make a world of difference in transitioning. Family members may notice the changes, but not understand them causing friction.