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1 results

  • Patient Requests for Off-Label Bioprediction of Dementia

  • MATTHEW L. BAUM
  • Journal:
    Cambridge Quarterly of Healthcare Ethics / Volume 25 / Issue 4 / October 2016
    Published online by Cambridge University Press:
    16 September 2016, pp. 686-690

  • In 2012, the FDA approved for the differential diagnosis of Alzheimer’s disease a brain-imaging technology, Amyvid-PET (aka florbetapir-PET), capable of non-invasively estimating the burden of amyloid plaques; this approval for one indication renders the technology a candidate for off-label use for another indication according to a physician’s judgment. What should a physician do if an educated, pro-active, and concerned patient requests off-label use of Amyvid-PET to help her estimate the likelihood that her mild memory complaints are “just normal aging” or are likely to profoundly worsen? I consider reasons that a physician might justify denial of such a request, including concerns of safety, uncertain benefit, and fair resource allocation, but cautiously conclude that there may be certain cases where off-label bioprediction would be permissible.