Is this person with dementia (currently) competent to request euthanasia? A complicated and underexplored question
Open accessAbstract
In euthanasia and/or assisted suicide (EAS) of persons with dementia, the controversy has mostly focused on decisionally incapable persons with very advanced dementia for whom the procedure must be based on a written advance euthanasia directive. This focus on advance euthanasia directive-based EAS has been accompanied by scant attention to the issue of decision-making capacity assessment of persons with dementia who are being evaluated for concurrent request EAS. We build on a previous analysis of concurrent request EAS cases from the Netherlands, which showed that many such cases involve persons with significant cognitive impairment. We use illustrative cases to describe the difficulty of determining decisional capacity in persons whose stage of dementia falls between severely impaired and mildly impaired. We show that the Dutch practice of capacity assessment in such dementia cases is difficult to reconcile with the widely accepted functional model of capacity—a model explicitly endorsed by the Dutch euthanasia review committees. We discuss why such deviations from the standard functional model might be occurring, as well as their ethical implications for dementia EAS policy and practice.
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MAiD-NT is extremely dangerous, especially when extended to minors and people with psychiatric disorders, as well as in those whose cognitive impairments (e.g. dementia) make it difficult to assess decisional capacity.
“Therefore, MAiD-NT is extremely dangerous, especially when extended to minors and people with psychiatric disorders, as well as in those whose cognitive impairments (e.g. dementia) make it difficult to assess decisional capacity [11, 12].”
From Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders (2022) · cites this paper as [11]
The Abstract and Conclusion support the claim that dementia can make decisional-capacity assessment for euthanasia difficult. The paper does not address extending MAiD-NT to minors or people with psychiatric disorders, or characterize MAiD-NT generally as “extremely dangerous.” (LLM, conf=0.88)
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Cites
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Flagged first, then by citations
Research works printed but not linked: 1
- Regional euthanasia review committees, euthanasia code 2018, 2018. Available: https://www. euthanasiecommissie. nl/ de-toetsingscommissies/ uitspraken/ brochures/ brochures/ euthanasiecode/ 2018/ euthanasia-code-2018
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Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders
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Euthanasia and Medical Assistance in Dying as Challenges for Physicians’ Well-Being
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- Authors
- Kim, S. Y., Mangino, D., & Nicolini, M.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Kim, Scott YH
- Venue
- Journal of Medical Ethics
- Publisher
- BMJ
- Published
- 2020-08-13
- Volume
- 47
- Issue
- 12
- Pages
- e41-e41
- ISSN
- 0306-6800 (ISSN-L)
- 1473-4257
- OpenAlex
- W3048571038
- Cited by
- 10
- References
- 20
- Citations by year
- 2025: 1 · 2023: 2 · 2022: 4 · 2021: 3
- FWCI
- 0.90
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- other-oa
- Locations
- Journal of Medical Ethics (publishedVersion, other-oa)
- PubMed (publishedVersion)
- Lirias (acceptedVersion, other-oa)
- Funders
- NIH Clinical Center (ZIA CL010539)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Healthcare Decision-Making and Restraints
- 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
- Keywords
- euthanasia, assisted suicide, dementia, decision-making capacity, capacity assessment, cognitive impairment, euthanasia policy, Netherlands
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