What Might Aducanumab Teach Us About Clinicians' Judgment About Whether to Recommend Emerging Alzheimer's Interventions?

Alzheimer's disease (AD) is an incurable, progressive deterioration that ends, eventually, in death. For many years, AD's hallmark etiological feature was beta-amyloid plaque accumulation in the brain, but, to date, costly drugs designed to reduce beta-amyloid levels offer only marginal clinical benefit and pose significant risk of harm. Thus, there is strong interest in finding alternative AD-modifying interventions, and, despite controversy, aducanumab-an antibody-recently received approval by the US Food and Drug Administration. This article considers how ethical issues in the care of patients with AD could influence, for better or worse, clinicians' judgment about whether and when to recommend aducanumab.