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.

CME/CEUs is not available on this product.

Raghav Govindarajan, MD