ABSTRACT
Ethical issues arising in the management of dementia vary with progression of the disease. In the early stages, issues may range from questions of consent, to informing the patient that he or she has a dementing illness, to decision-making capacity. In the later stages, the issues revolve around appropriate levels of care, decisions about resuscitation and end-of-life issues, financial/legal arrangements and restraining. Dementia can lead not only to changes in memory but also to impairment of judgement, visuospatial difficulties and inattentiveness. All of these changes can affect driving, and there is evidence that a diagnosis of dementia is associated with an increased risk of accidents. In some cases, family members may insist that a patient should not be informed of the diagnosis. Under these circumstances it is important to clarify that a competent individual has the moral and legal right to know the diagnosis and make decisions about their future care, which also includes treatment.
