Euthanasia and Assisted Suicide in Dementia - the European Perspective

Abstract

In 2002, the Netherlands was the first jurisdiction worldwide that has legalized euthanasia and physician assisted suicide. Although the number of jurisdictions that has legalized euthanasia and medical assisted suicide has gradually increased over the years, the Dutch law is still progressive allowing euthanasia and physician assisted dying in non-terminal illnesses as well as advanced stages of dementia. This legislation has been praised as well as criticized. Proponents point to the principles of justice, mercy, the right to a dignified end of life, the responsibility of a doctor for a good life, including a good end of life, and the right of self-determination of people. Critics point to conflicting treatment goals, problems due to countertransference, complexity of the interpretation of due diligence, the distinction with chronic suicidality and finally the fact that many psychiatrists do not feel competent to perform euthanasia with due medical care.First, we will briefly present the current Dutch procedure, including the independent role of so-called SCEN-physicians. The Support and Consultation of Euthanasia in the Netherlands (SCEN) is a training and licensing program of the Royal Dutch Medical Association. In the first presentation, Radboud Marijnissen will present an overview of the development and current practice of euthanasia in dementia in the Netherlands. Thereafter, Lia Fernandes will present and discuss the debate on the legislation of euthanasia in Portugal, which is still controversial being a primarily Catholic country. The third presentation is a scientific evaluation of the assessment of mental capacity in 60 dementia cases that received euthanasia in the Netherlands. After the three presentations, the pros and cons of euthanasia in dementia as well as the current legislation will be discussed.