Lost in the Present: Anterograde Amnesia and Medical Decision Making Capacity

Abstract

Although there have been a limited number of case reports of human bilateral hippocampal injury, none of these have addressed the impact of such injuries on medical decision making capacity. The authors present a case of an elderly man with discrete bilateral hippocampal injury. As a result of his injury, the patient was hopelessly "lost in the present" and only retained the basic cognitive functions necessary to have decision making capacity for a limited period of time. He was unable to appreciate the nature of his injury, the potential risks involved in his decisions, and the recommended course of treatment longer than a few minutes. The patient's resultant neurocognitive deficits left him lacking medical decision making capacity, a likely outcome for patients with persistent anterograde amnesia.