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Francis X. Shen, "Law and Dementia"

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December 12, 2017

The Sixth Annual Health Law Year in P/Review symposium featured leading experts discussing major developments during 2017 and what to watch out for in 2018. The discussion at this day-long event covered hot topics in such areas as health policy under the new administration, regulatory issues in clinical research, law at the end-of-life, patient rights and advocacy, pharmaceutical policy, reproductive health, and public health law.

For more information, visit our website at: http://petrieflom.law.harvard.edu/events/details/sixth-annual-health-law-year-in-p-review

Published in: Health & Medicine
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Francis X. Shen, "Law and Dementia"

  1. 1. Law and Dementia Dr. Francis X. Shen, JD, PhD :: Petrie-Flom Center, Harvard Law School :: Harvard MGH Center for Law, Brain & Behavior :: MacArthur Foundation Research Network on Law & Neuroscience :: University of Minnesota Law School Petrie-Flom Sixth Annual Health Law Year in P/Review Harvard Law School December 12, 2017 Photo by Rene Böhmer on Unsplash
  2. 2. Disclosure Information Petrie-Flom Center Health Law Year in Review December 12, 2017 Dr. Francis X. Shen, JD, PhD Disclosure of Relevant Financial Relationships I have no financial relationships to disclose. Disclosure of Off-Label and/or investigative Uses I will not discuss off label use and/or investigational use in my presentation.
  3. 3. For more: http://clbb.mgh.harvard.edu/elders/
  4. 4. • Bad News & Good News • The Challenge of Market Regulation • The Challenge of Legal Doctrine • The Challenge of Dementia and Democracy Law and Dementia: Reviewing 2017 // Previewing 2018
  5. 5. • Bad News & Good News • The Challenge of Market Regulation • The Challenge of Legal Doctrine • The Challenge of Dementia and Democracy Law and Dementia: Reviewing 2017 // Previewing 2018
  6. 6. Effective drugs for Alzheimer’s remain elusive. In the absence of solutions, speculation is rampant.
  7. 7. Solutions? No. Speculation? Yes.
  8. 8. https://www.express.co.uk/life-style/health/883034/dementia-symptoms-diet-uk-Alzheimer-s-disease
  9. 9. http://abcnews.go.com/Health/marriage-reduce-dementia-risk-researchers-find/story?id=51440361
  10. 10. Source: http://www.newnownext.com/singing-showtunes-proven-to-help-fight-off-dementia-alzheimers-disease/11/2017/
  11. 11. We are making (slow) progress toward a cure.
  12. 12. Better Research, Better Data
  13. 13. Source: https://sciencebusiness.net/healthy-measures/news/who-launches-global-dementia-observatory
  14. 14. Source: http://www.cnn.com/2017/11/13/health/bill-gates-announcement-alzheimers/index.html It's one of the holy grails of science: a cure for Alzheimer's. Currently, there is no treatment to stop the disease, let alone slow its progression. And billionaire Bill Gates thinks he will change that. "I believe there is a solution," he told me without hesitation.
  15. 15. http://theddfund.com/
  16. 16. Society is Responding (across the globe)
  17. 17. https://timesofsandiego.com/tech/2017/12/04/study-millennials-increasingly-looking-loved-ones-dementia/
  18. 18. https://www.forbes.com/sites/nextavenue/2017/11/12/memory-cafes-offer-connection-in-dementia/#57e4d63225db
  19. 19. Source: http://www.columbiachronicle.com/metro/article_0a87cb48-d712-11e7-b628-bbaa0561a57f.html
  20. 20. Source: http://www.sandiegouniontribune.com/news/health/sd-no-alzheimers-team-20171205- story.html
  21. 21. Source: https://phys.org/news/2017-11-built-robot-people-dementia.html
  22. 22. • Bad News & Good News • The Challenge of Market Regulation • The Challenge of Legal Doctrine • The Challenge of Dementia and Democracy Law and Dementia: Reviewing 2017 // Previewing 2018
  23. 23. Market Regulation
  24. 24. Source: https://www.nbcnews.com/health/health-news/jellyfish-memory-supplement-prevagen-hoax-ftc-says-n704886
  25. 25. • Bad News & Good News • The Challenge of Market Regulation • The Challenge of Legal Doctrine • The Challenge of Dementia and Democracy Law and Dementia: Reviewing 2017 // Previewing 2018
  26. 26. In 2017, legal doctrine around issues such as capacity, competency, and undue influence remained unchanged. On April 26, 2018, we will begin to revisit these doctrines in light of new neuroscientific insights.
  27. 27. • Bad News & Good News • The Challenge of Market Regulation • The Challenge of Legal Doctrine • The Challenge of Dementia and Democracy Law and Dementia: Reviewing 2017 // Previewing 2018
  28. 28. Aging Judges
  29. 29. Source: https://www.fjc.gov/history/exhibits/graphs-and-maps/age-and-experience-judges
  30. 30. Source: https://www.fjc.gov/history/exhibits/graphs-and-maps/age-and-experience-judges
  31. 31. Aging Politicians
  32. 32. https://newstarget.com/2017-05-01-how-long-before-nanci-pelosi-is-officially-diagnosed-with-alzheimers-or-dementia.html
  33. 33. http://www.independent.co.uk/news/world/americas/us-politics/donald-trump-dementia-early-onset-cnn-ana-navarro-commentator-news-phoenix- rally-a7907696.html
  34. 34. Source: https://www.statnews.com/2017/12/07/donald-trump-brain-specialist-disease/
  35. 35. http://www.slate.com/articles/health_and_scien ce/medical_examiner/2017/12/trump_continue s_to_be_accused_of_dementia_let_s_administ er_the_mini_mental.html when the stakes are this high, we can’t turn our backs on these kinds of questions.
  36. 36. So what, exactly, is the problem? The problem is a combination of five factors: 1. Life tenure: Federal judges have life tenure, and politicians have very significant incumbent advantages. 2. Living longer: Judges and politicians (like everyone else) are living longer than ever before. 3. Not retiring: But (unlike most) judges and politicians don’t want to spend retirement sipping mojitos on the beach. 4. Some But Not All Develop Dementia: We know that some subset of these older judges / politicians are experiencing worse than normal cognitive decline, to the point where they are no longer processing information sufficiently well to execute their job functions. 5. Hard to Identify Dementia in Individual Cases: But (unlike many jobs) it’s hard for us to know if any particular judge or politician is experiencing such cognitive decline, and the extent to which that decline is affecting job performance.
  37. 37. Because we don’t typically have access to relevant data on individual judges and politicians, the public and media are left to guess as to whether a particular judge / politician has dementia. In 2018, we ought to address this issue.
  38. 38. • Bad News & Good News • The Challenge of Market Regulation • The Challenge of Legal Doctrine • The Challenge of Dementia and Democracy Law and Dementia: Reviewing 2017 // Previewing 2018
  39. 39. Extra Slides:
  40. 40. https://www.ft.com/content/8d0db012-cda0-11e7-b781-794ce08b24dc
  41. 41. Source: https://www.ft.com/content/689d1aba-dab6-11e7-a039-c64b1c09b482
  42. 42. Source: https://www.sciencealert.com/brain-training-reduces-dementia-risk-by-almost-30-10-year-study-finds-speed-cognitive

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