Physician-Assisted Suicide in Dementia: Paradoxes, Pitfalls and the Need for Prudence
Open accessAbstract
There has been an increasing drive towards the legalization of physician-assisted suicide (PAS) in patients with dementia, particularly in patients with advanced disease and severe cognitive impairment. Advocacy for this position is often based on utilitarian philosophical principles, on appeals to the quality of life of the patient and their caregiver(s), or on economic constraints faced by caregivers as well as healthcare systems. In this paper, two lines of evidence against this position are presented. First, data on attitudes towards euthanasia for twenty-eight countries, obtained from the World Values Survey, is analyzed. An examination of this data shows that, paradoxically, positive attitudes towards this procedure are found in more economically advanced countries, and are strongly associated with specific cultural factors. Second, the literature on existing attitudes towards PAS in cases of dementia, along with ethical arguments for and against the practice, is reviewed and specific hazards for patients, caregivers and healthcare professionals are identified. On the basis of these findings, the author suggests that the practice of PAS in dementia is not one that can be widely or safely endorsed, on both cultural and ethical grounds. Instead, the medical field should work in collaboration with governmental, social welfare and patient advocacy services to ensure optimal physical, emotional and financial support to this group of patients and their caregivers.
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This approach, unsupported by scientific evidence, relies on a dichotomous conception of the mind-body relationship that does not reflect clinical reality, where somatic and psychological suffering often intertwine.
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Debating Euthanasia and Physician-Assisted Death in People with Psychiatric Disorders
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Tripi, D., Giantesani, M., Arena, J. F., & Ferracuti, S. (2026) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2026.1835123
- Authors
- Rajkumar, R. P.
- Affiliations
- Jawaharlal Institute of Post Graduate Medical Education and Research (IN)
- Corresponding author
- Rajkumar, Ravi Philip
- Venue
- Frontiers in Sociology
- Publisher
- Frontiers Media SA
- Published
- 2021-12-22
- Volume
- 6
- Pages
- 815233-815233
- ISSN
- 2297-7775 (ISSN-L)
- PMC
- PMC8727695
- OpenAlex
- W4200399851
- Cited by
- 11
- References
- 140
- Citations by year
- 2026: 1 · 2025: 4 · 2024: 3 · 2023: 2 · 2022: 1
- FWCI
- 0.27
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Sociology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ethics and bioethics in healthcare
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Keywords
- physician-assisted suicide, dementia, attitudes toward euthanasia, World Values Survey, cultural factors, utilitarianism, quality of life, caregiver burden, ethical arguments, patient safety, end-of-life care
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