On Avoiding Deep Dementia

Abstract

The scourge of Alzheimer's is daunting. For me, the specter of being mired in progressively degenerative dementia is an intolerably degrading prospect. One avoidance tactic – suicide while still competent – risks a premature demise while still enjoying a tolerable lifestyle. The question arises whether an alternative tactic – an advance directive declining all life-sustaining intervention once a certain point of debilitation is reached – might be preferable as a device to avoid a prolonged, unwanted limbo. My article in the forthcoming Hastings Center Report (HCR) presents the legal and moral foundation for my advance directive declining even simplistic interventions at a relatively early stage of post-competence cognitive decline. It is titled “On Avoiding Deep Dementia” and the cite is 48:4 HCR (July/August 2018). A final draft is attached, including excerpts from my own directive. HCR solicited 3 commentaries on my article from several bioethicists, including Rebecca Dresser and Daniel Sulmasy. Those commentaries appear in the same HCR edition.