Dementia and Democracy: America’s Aging Judges and Politicians
November 15, 2017 12:00 PM
Pound Hall, Room 102
Harvard Law School, 1563 Massachusetts Ave., Cambridge, MA
Our judiciary and our elected officials are getting old. Five of the nine Supreme Court Justices are 67 or older, with two over age 80. The President is 71, the Senate Majority Leader is 75, and the House Minority Leader is 77. Does the public have a right to know whether these officials have been screened for dementia? If the individuals don’t self-report their dementia status, should experts continue to adhere to the “Goldwater Rule” and refrain from offering an armchair diagnosis? As the nation reflects on its midterm elections, and prepares for the 2020 election cycle, these questions are timely and challenging.
Panelists
- Rebecca Brendel, JD, MD, Assistant Professor of Psychiatry, Harvard Medical School; Director, Master’s in Bioethics Program, Center for Bioethics, Harvard Medical School; Director of Law & Ethics, Center for Law, Brain & Behavior, Massachusetts General Hospital
- Bruce Price, MD, Chief, Department of Neurology at McLean Hospital; Associate in Neurology, Massachusetts General Hospital; Associate Professor of Neurology, Harvard Medical School; Co-Founder and Co-Director of the Center for Law, Brain & Behavior, Massachusetts General Hospital
- Francis X. Shen, PhD, JD, Senior Fellow in Law and Applied Neuroscience, the Petrie-Flom Center in Health Law Policy, Biotechnology, and Bioethics at Harvard Law School and the Center for Law, Brain & Behavior at Massachusetts General Hospital; Associate Professor of Law and McKnight Land-Grant Professor, University of Minnesota Law School; Executive Director of Education and Outreach, the MacArthur Foundation Research Network on Law and Neuroscience
Part of the Project on Law and Applied Neuroscience, a collaboration between the Center for Law, Brain & Behavior at Massachusetts General Hospital and the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School.
The same issue has been raised with aging doctors. Most believe that cognitive screening of all doctors above a designated age is not the answer. Screening for cause, when behavior suggests a cognitive problem seems to the better approach. Doctors tend to be very smart and cognitive testing without a baseline test may reveal normal results in spite of a decline in function. If one wishes to screen a cohort of doctors the best way is to audit their professional skills. Chart review and observation of their skills in evaluation centers seems the best way to screen a cohort. As mentioned, observed behavior, forgetfulness, etc. should trigger a full cognitive evaluation. It is not clear to me what behavior to look for in politicians. Judges, like doctors, have a work product that can be evaluated.