Questioning the Myth of Alzheimer's
(A guest post by Dr. Peter Whitehouse, MD, PhD (Psychology) and MA (Bioethics), professor at Case Western Reserve University and a world renowned expert in the Alzheimer's field. Dr. Whitehouse is author of the Myth of Alzheimer's Disease and blogs about brain aging at Beyond the Myth.)
I have spent my life within the scientific, political, economic, and social institutions of the AD field-universities, hospitals, pharmaceutical companies-studying and treating human aging and disease. Now I am ready to challenge the power that the mainstream "Alzheimer's disease" myth has over us, helping people see what I have seen and to think critically about the evolution in thought that has occurred over the past several decades, which has shaped the way we see our aging bodies and minds and the way we act towards them. I want to spread a story of brain aging that can be a starting point for helping us better cope with and prepare for the travails of cognitive decline.
For nearly twenty-five years, I have served as a trusted clinician and leader in the Alzheimer's field, where I have helped international Alzheimer's organizations and pharmaceutical companies shape the rules, guidelines, diagnostic categories, and accepted clinical approaches to Alzheimer's disease. Discoveries that I made as a researcher at Johns Hopkins in the 1980s led to the development of the first drugs for Alzheimer's, and I have since consulted for numerous pharmaceutical companies. My experiences and relationships with other colleagues have endowed me with some influence and power and have enabled me to become what the science community calls a "thought leader" (or KOL - "key opinion leader")-one who guides our conventional thinking about a particular condition.
In the beginning of my career, at a time when no medicines had been approved specifically for Alzheimer's and companies were unsure about how to proceed in drug development, the pharmaceutical industry reached out to me and listened to my thoughts and opinions about treating persons with memory challenges. Once drugs made their way to the market in the 1990s the relationship shifted. Rather than being interested in having my thoughts influence their views, it seemed as if industry wanted to change my mind and convince me that their drugs were worth giving to my patients. Drugs also changed the political scene. Alzheimer's organizations seized upon the pharmacological movement and developed business plans that emphasized the anguish of aging and over-promised the possibility of achieving a cure.
This focus on biological, reductionist approaches to brain aging across our society has shifted the whole dynamic of the field away from caring for the aging patient and his family and towards drugs as the primary means of ensuring the quality of his life. Too often, aging patients and their families leave the doctor's office with little more than a pill prescription (often encompassing several pills) and fear generated by the Alzheimer's myth, knowing little about how to effectively care for the condition.
We must begin to transform our approach to brain aging. No longer can we safely assume that the march of progress in the "War against AD" is moving at the hoped for speed or direction; no longer can we maintain the mythical illusion that AD is a battle against a specific singular disease that we will eventually "win"; no longer can we keep looking at aging persons, however embattled, as somehow "diseased" and "other." Defining brain aging as a disease and then trying to cure it is at its root unscientific and misguided.
Skepticism is at the heart of science; stories, the core of our humanity; and ethics central to our survival. History informs the possibilities for our future. The stories that currently dominate public discourse about "Alzheimer's" reflect the limited scientific view that reductionistic genetic medicine can cure all ills. But AD is not one condition. Rather, it represents a plurality of biological, clinical and cultural phenomenology. It is also intimately related to brain aging. Bioethics is on the edge of becoming unethical as it has too often been co-opted by medicine and rarely steps up to encourage scientific and cultural skepticism about mythical stories that threaten our health in a world increasingly challenged by social injustice and global climate change. Creating rich intergenerational learning environments is one key to enhancing the chances that being sentient is not an evolutionary failure.
STS/Bioethics Brownbag Talk
From Biomedical Research to Bioethical Critique: A Conversation with Peter Whitehouse on the Past and Future of Alzheimer's, Brain Aging and Bioethics
Monday April 4th
12:30 - 1:45
Room 102 Old Botany
Penn State, University Park Campus
Peter Whitehouse, MD, PhD (Psychology) and MA (Bioethics), is a professor at Case Western Reserve University and a world renowned expert in the Alzheimer's field. As a neuroscientist and geriatric neurologist in the 1980s, Dr. Whitehouse was at the forefront of research that led to the development of currently licensed drugs for dementia and became one of the most prominent experts on Alzheimer's disease. But over the past decade, he has increasingly explored bioethics and narrative approaches to medicine and, with the publication of The Myth of Alzheimer's with medical anthropologist Danny George, he has become perhaps the most recognized critic of the dominance of the biomedical model of Alzheimer's disease and pharmacological approaches to treating dementia.
In this talk, Dr. Whitehouse will discuss his transition from a key opinion leader in the AD field to its leading critic, and reflect on the future of Alzheimer's disease, bioethics and the medical humanities.