The ethical problems associated with dementia have been thrown into focus by the ageing population. The elderly form a disadvantaged group in society and the author wonders if it is morally justified to pursue research into ways of arresting pathology without concomitant attention being paid to the quality of life of the surviving elderly. Precise diagnosis of dementia requires invasive, and potentially injurious, brain biopsy. Recent thinking has pointed to some of the advantages of biopsy. The question of consent in a patient with impaired mental function has to be borne in mind. As for the special ethical problems associated with Huntington's chorea, it is argued there is no justification for withholding information from, or for authoritarian direction of, patients and 'at risk' relatives but the importance of full discussion before undertaking predictive procedures is stressed.
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