Anosognosia in Alzheimer’s Disease: Clinical Psychology and Medico-Legal Issues. Informed Consent in Healthcare

Anosognosia in Alzheimer’s Disease: Clinical Psychology and Medico-Legal Issues. Informed Consent in Healthcare
Tomasello Letters, Miriana Ranno, Claudia Pitrone
New Medical Innovations and Research, 28 March 2024
Abstract
    Insight or deficit awareness have been used interchangeably to refer the lack of knowledge or recognition of one’s deficit. Our aim was to investigate whether this lack could influence Alzheimer’s disease patients’ ability to understand and do.

Disease awareness is a phenomenon that in recent years is obtaining an increasing interest in a clinical and research point of view. It has important implications on patient care and management. The present study is aimed to contribute to the comprehension of disturbing awareness in patients with Alzheimer disease, and provided a starting point on a complex disease linked to medical and psychological scopes but also involve Bioethics and Law.

Informed consent and decision-making skills
   Informed consent is a fundamental prerequisite of every medical act and the autonomy of a patient, in the fullness of his ability to decide on treatments and possible therapeutic treatments. Presupposition of informed consent, beyond the information (well given and well understood) and freedom (absence of conditioning factors or at least awareness of their presence), is the ability to decide. The ability to decide on medical treatment is inherent in the legal concept of capacity to act (Art. 2 of the CC). The definition, proposed by Wong et al. (1999) (10), provides an indication of the relationships between the ability of the individual and the society around him: “capacity is what distinguishes a person, who is able to make a decision and whose choice must be respected, regardless of the reasonableness of the choice, by a person for whom decisions must be made by others”. There are cases where a person may no longer be able to manage his or her current account but may be able to give his or her consent to simple medical treatment. The ability to decide must be presumed, until proven otherwise. Dementia is, therefore, a risk factor for incapacity, but it does not inevitably involve it. The ability (or inability) is always relative to a certain task. For example, a person may be able to make a decision for simple medical treatment but not be able to discern complex alternatives with different risk/benefit profiles…