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Markkula Center for Applied Ethics

End-of-Life Planning with Alzheimer's Disease

image of man with cane, a tree without leaves and a clock with roman numerals

image of man with cane, a tree without leaves and a clock with roman numerals

Miyuki Dougherty

Miyuki Dougherty '18 was the 2017-2018 Honzel Fellow at the Markkula Center for Applied Ethics majoring in Biology. Her project, Ethical Considerations of End-of-Life Care with Alzheimer’s Disease was completed as part of the Honzel Fellowship. Views are her own.

What ethical issues arise when terminal neurological diseases, such as Alzheimer's prevent individuals from making medical decisions? This material explores answers to such questions and ethical considerations for end-of-life care with Alzheimer's Disease.

The Alzheimer's-Specific Advance Plan (ASAP) is a modified advance directive that facilitates conversations and documentation of an individual's wishes while they are healthy and is more than a standard advance directive, which is not specific enough to be a useful tool for individuals with Alzheimer's Disease, and for their surrogate decision-makers. The ASAP gives patients a way to attend to feelings of fear or anxiety about future loss of independence.

Aug 28, 2020
Amanda Miyuki Doughterty 2020

As a Health Care Ethics Intern the previous year, Miyuki became interested in the ethical issues of end-of-life care, especially in cases of neurological impairment such as Alzheimer’s. She states: “How we treat our patients in the most vulnerable state — when they are sick, scared, and perhaps alone — speaks volumes about our values as physicians. A compassionate physician understands that medicine is as much about treating illness as it is building trust, respecting one’s dignity, and providing comfort. I saw the effect of compassion while shadowing physicians in Skilled Nursing Facilities and Palliative Care, and I will strive to provide my future patients this kind of care.”

Miyuki completed a Master’s in Medical Physiology at Loyola University Chicago in 2020, and is currently attending medical school at Loyola University Chicago Stritch School of Medicine. In medical school, she plans to pursue a Bioethics and Professionalism Honors program. Her specialty areas include: Palliative Care, Emergency Medicine, Obstetrics and Gynecology, and Primary Care. 

In her free time, Miyuki enjoys acrylic and watercolor painting, exploring new cities and national parks, and sharing meals with friends and family. 

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