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Cited by 65Ethics and bioethics in healthcarePalliative Care and End-of-Life IssuesHealthcare Decision-Making and Restraints

Advance directives, dementia, and physician-assisted death

Menzel, Paul T., Steinbock, Bonnie·2013·Journal of Law, Medicine & Ethics
DOI 10.1111/jlme.12057
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Abstract

Physician-assisted suicide laws in Oregon and Washington require the person's current competency and a prognosis of terminal illness. In The Netherlands voluntariness and unbearable suffering are required for euthanasia. Many people are more concerned about the loss of autonomy and independence in years of severe dementia than about pain and suffering in their last months. To address this concern, people could write advance directives for physician-assisted death in dementia. Should such directives be implemented even though, at the time, the person is no longer competent and would not be either terminally ill or suffering unbearably? We argue that in many cases they should be, and that a sliding scale which considers both autonomy and the capacity for enjoyment provides the best justification for determining when: when written by a previously well-informed and competent person, such a directive gains in authority as the later person's capacities to generate new critical interests and to enjoy life decrease. Such an extension of legalized death assistance is grounded in the same central value of voluntariness that undergirds the current more limited legalization.

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Crossref · 10.1111/jlme.12057

Cites

31 of 31 references verified0 citation errors · 0 not checkable

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  • Much of the debate about dementia EAS focuses on challenges in determining decisional capacity, evaluating an advance euthanasia directive's applicability, assessing unbearable suffering, and implementing the EAS procedure in advance request cases.

    “Much of the debate about dementia EAS focuses on challenges in determining decisional capacity, evaluating an advance euthanasia directive’s applicability, assessing unbearable suffering, and implementing the EAS procedure in advance request cases.(2, 11–16)”

    From Euthanasia and Assisted Suicide of Persons With Dementia in the Netherlands (2020) · cites this paper as [15]

  • Key points of debate regarding advance requests-including difficulties interpreting advance euthanasia directives, assessing unbearable suffering, and implementing the EAS procedure-are indeed problems that arise in advance request EAS.

    “It also appears that key points of debate regarding advance requests(11–16)—including difficulties interpreting advance euthanasia directives, assessing unbearable suffering, and implementing the EAS procedure—are indeed problems that arise in advance request EAS.”

    From Euthanasia and Assisted Suicide of Persons With Dementia in the Netherlands (2020) · cites this paper as [15]

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Authors
Menzel, P. T., & Steinbock, B.
Affiliations
  • Pacific Lutheran University (US)
  • University at Albany, State University of New York (US)
ORCID
Menzel, Paul T.
Venue
Journal of Law, Medicine & Ethics
Publisher
Cambridge University Press (CUP)
Published
2013
Volume
41
Issue
2
Pages
484-500
ISSN
  • 1073-1105 (ISSN-L)
  • 1748-720X
DOI
10.1111/jlme.12057
OpenAlex
W2102731403
Cited by
65
References
32
Citations by year
2026: 2 · 2025: 3 · 2024: 1 · 2023: 4 · 2022: 5 · 2021: 10 · 2020: 8 · 2019: 7 · 2018: 6 · 2017: 8 · 2016: 4 · 2015: 3 · 2014: 4
FWCI
3.74
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • The Journal of Law Medicine & Ethics (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • World Health Organization
  • Fondation Brocher
  • Université de Genève
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
Keywords
advance directives, dementia, physician-assisted death, euthanasia, voluntary euthanasia, competence, autonomy, enjoyment of life, terminal illness, Oregon Death with Dignity Act, Dutch euthanasia law
MeSH terms
Dementia, Euthanasia, Humans, Advance Directives, Mental Competency, Personal Autonomy, Value of Life

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