Abstract
Objectives: To explore attitudes towards assisted dying in dementia (ADID) and the rationales underlying these attitudes, among younger and older adults.Method: We conducted separate focus groups with younger (n = 11) and older adults (n = 14) in the United Kingdom with personal or professional experience of dementia. Discussions were prompted by two vignettes depicting scenarios of ADID. The data were transcribed and analysed using thematic analysis.Results: Though sometimes stronger in the older adults, many of the attitudes and underlying rationales were common across the age groups. Analysis generated four themes: 'Perceptions of the disease', 'A case for empowerment', 'The morality of killing' and 'Logistical complexities'.Conclusions: For some, ADID was a hopeful alternative to the challenges they had witnessed in dementia. For others, the logistical problems surrounding ADID were insurmountable. Discussions were informed and insightful, highlighting the importance of including the general public in this ongoing debate.
Highlights
IntroductionThe rising prevalence of dementia presents significant challenges for the individual and society; dementia is the most feared illness in over 65s (Richards, 2017) and the yearly public costs by 2040 are estimated at £55bn in the United Kingdom alone (Prince et al, 2014)
By 2050, an estimated one in four people in Europe will be aged 65 or over, compared with just one in 11 at present
For some, assisted dying in dementia (ADID) was a hopeful alternative to the challenges they had witnessed in dementia
Summary
The rising prevalence of dementia presents significant challenges for the individual and society; dementia is the most feared illness in over 65s (Richards, 2017) and the yearly public costs by 2040 are estimated at £55bn in the United Kingdom alone (Prince et al, 2014). Countries where assisted dying is legal have strict safeguards to ensure the safety and security of both the patient and the doctors involved. These safeguards limit assistance to terminally ill adults who are suffering unbearably and are deemed to be competent to make a voluntary request to die (Kouwenhoven et al, 2015). In the majority of jurisdictions where assisted dying is legal, it is not permitted for individuals with dementia, as the progressive functional decline characteristic of the disease affects mental competence and decision-making ability (De Boer et al, 2011)
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