This is not a question. I’m just sharing in case someone finds it interesting as I do. A legal dilemma.
https://www.nytimes.com/2025/02/16/health/assisted-death-alzheimers-netherlands.html?smid=nytcore-ios-share&referringSource=articleShare
Reader comments are also good and include one from a doctor who thinks we need “death doulas” rather than doctors for MAID.
snippets:
In the Netherlands, doctors and dementia patients must negotiate a fine line: Assisted death for those without capacity is legal, but doctors won’t do it.Ms. Mekel, 82, has Alzheimer’s disease. It was diagnosed a year ago. She knows her cognitive function is slowly declining, and she knows what is coming. She spent years working as a nurse, and she cared for her sister, who had vascular dementia. For now, she is managing, with help from her three children and a big screen in the corner of the living room that they update remotely to remind her of the date and any appointments.In the not-so-distant future, it will no longer be safe for her to stay at home alone. She had a bad fall and broke her elbow in August. She does not feel she can live with her children, who are busy with careers and children of their own. She is determined that she will never move to a nursing home, which she considers an intolerable loss of dignity. As a Dutch citizen, she is entitled by law to request that a doctor help her end her life when she reaches a point of unbearable suffering. And so she has applied for a medically assisted death.
But when Ms. Mekel’s family doctor read the advance directive, she said that while she supported euthanasia, she could not provide it. She will not do it for someone who has by definition lost the capacity to consent.
The situation can get even more complicated when there's another person involved who perhaps isn't quite on-board with an intentional Final Exit. If it were up to me alone, I likely would be preparing for a trip to Switzerland in the not-too-distant future. But I (age 88) have a spouse (95) who isn't as accepting of that option as I am. Although we reside in a MAiD state, neither of us has a qualifying condition at the moment.
While I totally agree that EOL choices must ALWAYS be the right of the individual, I also think that long-term care for large numbers of the very elderly, debilitated and demented is NOT sustainable for those living through it or for the larger society.
We DO have death Doulas. Please consider joining FEN (Final Exit Network). 866 654 9156. www.finalexitnetwork.org.
We DO truly have the ways and means to die if we wish to in our own country. It is not without hoops to jump through unless you simply want to turn on the gas without a flame (people accidentally die--whole families of them--yearly by accident with this means, showing just exactly how painless it can be; you read about them in the papers ever winter).
There is also VSED and I recommend the VSED Handbook by Kate Christie for a good, cheap, in depth discussion of her own mother's deliverance by this method. Yes, there are a few uncomfortable days when organ shutdown occurs. But they can easily be medicated for, and once a person is beyond help Hospice will almost always step in.
There are many ways in our own country to make an exit if that is what you choose. Do know that most people simply WANT to have the METHOD at hand. Few actually make the exit in this manner.
Also explore the MAiD laws in your state. Kaiser worked well with me in setting in place "The Plan" when and if there is a 6 month prognosis.
Everything is made so much more difficult if one waits to late, and that is the case with many elders. The only certain way to avoid that one is, as a woman recent wrote in the latest FEN magazine, a solid plan. Hers was to die at age 85, so she didn't wait until too late. She carried forth her own plan in our own country to make her exit.
One certainly can understand that once there is no mental capacity legally there is no means of making an exit voluntarily with the help of any other entity, tho it is possible at Pegasos and Dignitas. ONEROUS paperwork and time and exams, as well as costly, but can be done. Recommend Amy Bloom's books about her husband, diagnosed with early onset Alzheimer's and his final exit via Dignitas.
We are getting more near to some European laws, and that will only increase as it is recognized that the cost of an very elderly (often living to 100 now) population of the demented does no good to ANYONE and is especially a torment to the person thusly afflicted him/herself.
Many wish to live on no matter the cost of condition. THAT MUST ALWAYS BE THEIR RIGHT. And many ongoing length can be prevented by a refusal of kidney dialysis, implanted defibrillators, intubations, and etc. Make certain your own advance directive is done EARLY and done WELL. If you don't want to be kept alive forever on tube feedings you had better be certain that stipulation is in writing, by legal means, NOW.