Parkinson's disease; autonomy; patient

Parkinson's disease (PD) is a chronic, progressive and incurable disease gradually leading to a loss of independence, dignity and eventually life itself. The patient is heading inevitably to the terminal phase of the disease, when he becomes mentally and physically incompetent. This article deals with various ethical and moral dilemmas that physicians and family members face when they care for patients with PD approaching the end of life. The topics discussed include steps how to assess mental capacity and decision-making ability, future care planning with non-extension of the treatment and/or its reduction, rejection of food, and with the demand not to resuscitate.