Medical decision-making in patients with Parkinson's disease

In health care, the ethical principle of autonomy or the right of self-ruling represents one of the key fundaments. However, this principle assumes that patients are indeed capable of making medical decisions. Parkinson's disease (PD) is a progressive neurodegenerative disease accompanied by cognitive and emotional impairments. As the disease advances, the capacity to make medical decisions may consequently decrease, in which case it may become necessary to overrule the principle of autonomy by the ethical principle of beneficence (i.e., the right to receive care and treatment that is in accordance with the patients' best interest). An important question that arises in this context is how we can determine whether an individual patient with PD has the capacity to make medical decisions and can fulfill his or her right of autonomy. The current chapter focuses on this question and reviews what is known about the capacity to make medical decisions of PD patients.In health care, the ethical principle of autonomy or the right of self-ruling represents one of the key fundaments. However, this principle assumes that patients are indeed capable of making medical decisions. Parkinson's disease (PD) is a progressive neurodegenerative disease accompanied by cognitive and emotional impairments. As the disease advances, the capacity to make medical decisions may consequently decrease, in which case it may become necessary to overrule the principle of autonomy by the ethical principle of beneficence (i.e., the right to receive care and treatment that is in accordance with the patients' best interest). An important question that arises in this context is how we can determine whether an individual patient with PD has the capacity to make medical decisions and can fulfill his or her right of autonomy. The current chapter focuses on this question and reviews what is known about the capacity to make medical decisions of PD patients