Right to life, duty to live? The case of euthanasia for persons with dementia

Abstract

Every three seconds a person develops dementia and with the aging world population the number of people affected by it is only expected to grow in the following years. Therefore as it is important to address end-of-life decisions including that of euthanasia; this work centers around the case of euthanasia for persons with dementia. In the context of this research the term euthanasia applies to situations in which a physician ends or assists in ending a life of a patient who is continuously and unbearably suffering, mentally or physically, and has no prospect of recovery. It encompasses explicit requests of patients that are capable to confirm their consent and cases in which a third person decides on behalf of an incompetent patient. First, the focus of this research is dedicated to answering the question whether euthanasia itself could be considered as a possible future human right. Hereby, the prospects of its development are addressed through the provisions of the existing human rights framework as established at the level of the United Nations and the Council of Europe. I argue that the present position of the two analysed human right bodies reflects positive indications towards the right of passive euthanasia. However, the practice of physician-assisted suicide and active euthanasia is still regarded as controversial. Nonetheless, this does not necessarily mean that the door is closed for the future establishment of a human right to euthanasia. Furthermore, this work deals with addressing a potential human right to euthanasia concerning persons with dementia. I argue that completely excluding persons with dementia from the scope of a human right to euthanasia qualifies as discrimination. Nevertheless, as persons with dementia are a vulnerable group they should be granted special support and protection when exercising this right. Lastly, this work presents the unique challenge that the progression of dementia poses on the proposed human right to euthanasia. Here, I argue that if the purpose of advanced directives is to give voice to the voiceless, persons in the advanced stages of dementia remain unheard. Key words: euthanasia, human rights, dementia, advance directive, decision-making capability, the Netherlands