In the case study “Research Involving Alzheimer’s Patients,” St. Mary’s Nursing Home Director Ann Wilson rejects Dr. Sandra Selleck’s request for subjects for her clinical trial on a new Alzheimer’s drug. Ann quickly jumped to the conclusion that she would not permit a clinical trial that uses her elderly patients as “guinea pigs,” “exploits” her patients, could increase their vulnerability (Thomas 116). While I can sympathize with Ann’s quick snap decision, barring her patients from even being considered for a study, and not allowing them to use their personal autonomy or freedom to decision making could potentially cause more harm than the study itself.

According to the Centers for Disease Control, over 70 million American citizens will be considered elderly by 2030—a growth that is unprecedented in history (http://www.cdc.gov/aging/data/stateofaging.htm). This closely relates to Alzheimer’s because the symptoms of the disease first appear after age 60 and the risk increases with age, the CDC says. Current CDC statistics state that the number of people with the disease doubles every five years after age 65, and this number is projected to rise to 14 million—a three-times increase—by 2050 (CDC, http://www.cdc.gov/aging/aginginfo/alzheimers.htm). These statistics are important to highlight the ever-increasing need for new drugs and remedies to cure or alleviate Alzheimer’s. Dr. Selleck’s study has been approved by her Hospital Research Ethics Board, so it has been cleared ethically and structurally.

The dilemma in this case is the debate of whether elderly patients, particularly those whom are potentially of lesser competency, should have the right to make their own decision to participate in the trial. In Ann’s eyes, they are vulnerable because of their condition and elderly state, and should not be made more vulnerable or taken advantage of due to their mental capacity. In Dr. Selleck’s eyes, this trial takes the necessary precautions to ensure all subjects are fully approving the trial, and is an important trial to hopefully reduce the prevalence of Alzheimer’s in the future.

The concept of institutionalism is vital to making an informed ethical decision in this case. For patients in an institution like a nursing home, they may feel pressures to conform, contribute, and please those in charge of them—particularly for the elderly due to their traditional positions in society (Thomas 118). Because of the ageist society we live in, elderly are viewed as helpless, possibly burdensome members of society. In Ann’s viewpoint, participating in the study would further exploit them and make them feel more helpless. However, removing their ability to consent for themselves reduces their autonomy—which is already limited due to their place in an institution. Ethically, the patients—old or not—have a right to make an informed decision for themselves. And while some may argue that since the patients aren’t all mentally competent, the three guidelines that Dr. Selleck states (1. Patient must provide written consent. 2. Patient’s closest relative must provide written consent. 3. Health care staff must not object), allows third party opinions to be heard (Thomas 116).

For those in institutions, keeping autonomy high is of utmost importance. For elderly in particular, having their personal freedoms stripped after living a life with them is challenging. Thus, even allowing a patient the chance to make their own decision is better than having the decision made for them.

 Works Cited

“Alzheimer’s Disease.” Centers for Disease Control and Prevention. N.p., 25 July 2014. Web. 21 Jan. 2015.

“The State of Aging and Health in America.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, n.d. Web. 23 Jan. 2015.

Thomas, John, Wilfrid Waluchow, and Elisabeth Gedge. Well and Good. 4th ed. N.p.: Broadview, n.d. Print.