Where Do We Draw the Line? The Ethics of Diagnosing Dementia

Dan Blazer_pictureThe development of DSM-V has engendered much controversy over the ethics of diagnosis, including the potential for pathologizing otherwise normative experience or life transitions. In this workshop, Dr. Blazer draws from his extensive experience, including committee work on the DSM-V, to discuss the ethical issues involved in introducing new diagnostic categories and widening existing ones. He focuses on dementia as an illustrative battleground with far-reaching consequences. On one hand, neurocognitive disorders have clear biological markers of brain pathology—even in early or mild cases—yet, treatment is largely ineffective. This workshop challenges us to consider potential implications of diagnosing “mild neurocognitive disorders,” which may be predictive but not disabling or treatable. Advocates see these new diagnoses as opportunities for early detection of progressive disease; while critics see a bonanza for the pharmaceutical companies with little benefit for the diagnosed. In this provocative workshop, Dr. Blazer invites us to consider evidence on both sides of this argument and their implications.

Dan G. Blazer, MD, MPH, Ph.D., is former Dean of Medical Education and currently J.P. Gibbons Professor of Psychiatry and Behavioral Sciences and Vice Chair for Academic Development at Duke University Medical Center. He also serves as adjunct professor in the Epidemiology and the School of Public Health at the University of North Carolina. According to ISI listings, Dr. Blazer is among the most highly cited authors in psychiatry and the social sciences, with his contribution of more than 30 books, 180 book chapters,  and 400 peer-reviewed articles, on topics of depression, epidemiology, and spirituality, especially with the elderly. Dr. Blazer has won numerous distinguished awards for his contributions to psychiatry and excellence in teaching and mentorship. In 1995, he was elected to the Institute of Medicine, National Academy of Sciences, where he has chaired the membership committee. He currently serves on the editorial board of the Archives of General Psychiatry, is acting chair of the Neurocognitive Workgroup, and a member of the Scientific Review Committee for DSM-V.