Once thought to be limited to the motor system, ALS also can be associated with cognitive changes ranging from mild frontotemporal dysfunction to profound frontotemporal dementia. While patient autonomy is of prime importance, this free CME ethical vignette presents the conflicts that can arise between the principles of beneficence/non-maleficence and autonomy that healthcare providers face when treating patients with conditions affecting their insight. Some of the issues addressed include when the patient’s autonomy supersedes the physician’s recommendations, the concepts of determining a patient’s “competence,” and the use of informed consent, and the priority order for decision-making when an advanced directive is not in place.

EDUCATIONAL OBJECTIVES: The purpose of this monograph is to familiarize the reader with the American Association of Neuromuscular & Electrodiagnostic Medicine’s (AANEM’s) Guidelines for Ethical Behavior Relating to Clinical Practice Issues in Neuromuscular and Electrodiagnostic Medicine. By utilizing true clinical scenarios, specific application of the guidelines can be discussed. Upon completion of these vignettes, the participants will acquire skills to (1) describe when the patient’s autonomy supersedes the physician’s recommendations, (2) explain the concepts of determining a patient’s “competence,” and (3) review the use of informed consent and the priority order for decision making when an advanced directive is not in place.

ACCREDITATION STATEMENT
The AANEM is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CREDIT DESIGNATION
The AANEM designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credits ^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

DISCLOSURE INFORMATION
No one involved in the planning of this CME activity had any relevant financial relationships to disclose. Authors/Faculty had nothing to disclose.

FORMAT: PDF

Raghav Govindarajan, MD