Arguments for and against the early diagnosis of dementia (adapted from refs. 2, 8, 11, 17, 21, 40 and 41)
| Arguments for early diagnostic disclosure | Arguments against early diagnostic disclosure |
|---|---|
| Facilitate planning for the future | Risk of causing emotional distress and anxiety; avoiding maleficence |
| Psychological benefit to person with dementia and/or family members and carers | Inability of person with dementia to understand and/or retain the diagnosis |
| Maximise opportunity for patient to contribute to the management of their own dementia | No perceived benefits, or perceived costs outweigh perceived benefits |
| Person's ‘right to know’ | Persons right ‘not to know’ |
| Maximise treatment possibilities | Lack of robust evidence of improvements to well-being from strategies aimed at earlier diagnosis |
| Obtain access to a second opinion | Potential risk of ‘over-diagnosis’ |
| Facilitate access to patient support services | Poor access to necessary specialists and/or support services |
| Patient is already aware of problems and wishes to know | Lack of cure or effective treatments |
| Stigma associated with the diagnosis of dementia | |
| Diversion of resources away from activities of proven value |