In the US, I've had the privilege of watching several relatives pass away at old ages, all of whom suffered cognitive decline. What a learning experience these

In the US, I've had the privilege of watching several relatives pass away at old ages, all of whom suffered cognitive decline. What a learning experience these were. In every case, doctors did nothing that would have influenced patient autonomy. I can see vividly the challenge this article is presenting. How can we make mental health screening mandatory without unintended harmful consequences? It can't be threatening to people's identity and rights. Mental health screening should be presented as something valuable and risk free. The current approach has a built-in assumption that anyone who looks old is already transitioning responsibilities to their other family members. Not every family works like that. The bank did not ask my uncle if he had anosognosia when they foreclosed his house and took all of his equity. Even years of counseling/therapy could miss anosognosia when there is an expectation the patient wants a specific problem was addressed. Recently I was diagnosed with adult ADHD, so prior to that, I had undiagnosed anosognosia. I had been seeing a therapist to deal with the family death issues and this never came up. If doctors instituted decent mental health screening as part of their standard practice, then it would help to address a pervasive single-point-of-failure problem (where the patient has failed to adequately identify their mental health issue).