Belgian committee urges expanding euthanasia for those with advanced dementia

The Belgian Advisory Committee on Bioethics has suggested that euthanasia in the nation should be available for those with degenerative diseases like advanced dementia.

Key Takeaways:

• The Belgian Advisory Committee suggested that people be allowed to make a "living will" specifying a threshold at which they would like to die, should they have a degenerative disease.

• The situation would apply for those with late-stage dementia as well as other degenerative conditions.

• Numerous risks are inherent in allowing such measures, including that vulnerable people could face undue pressure to die.

The Details:

In its assessment, the advisory committee contended that people with dementia are currently choosing euthanasia deaths "too early," because once they reach late-stage dementia, they no longer retain the mental competency required to qualify for euthanasia deaths.

Therefore, the committee argued, it would be better to make euthanasia available even for those people who cannot competently consent to such a death.

“It is not a black-and-white assessment, but doctors do feel that procedures for people with dementia have been carried out ‘too early’ because it will no longer be legally possible to do so later,” Patrick Cras, vice-chairman of the committee, said.

The committee recommended allowing euthanasia deaths for those who “are conscious, but whose mental competence and ability to express their wishes have been irreversibly impaired by illness or accident.”

According to the Belga News Agency, the committee's recommendations would not only apply to advanced dementia patients, but also to "people with other degenerative conditions, such as Parkinson's disease, ALS, Huntington's disease, or people who experience similar consequences after a stroke or accident."

To qualify, a person must draw up a "living will" while still competent, identifying the threshold and which they would no longer be willing to live.

“The living will is not a piece of paper that someone draws up on their 60th birthday, so to speak, and then puts in a drawer,” professor Martin Hiele explained. "It is discussed with a doctor, family members and loved ones. Nor is it a document that remains the same once and for all. As long as someone is still conscious, the declaration can be amended according to the situation."

Commentary:

Allowing someone without full mental competency to "choose" a euthanasia death is incredibly dangerous, for many reasons.

• In drawing up a will with a "threshold" at which the patient no longer wants to live, that patient is asking a third party to arbitrarily decide when that threshold has been reached.

• This will make it easier for doctors to take the lives of their most vulnerable patients, and will also put more pressure on doctors to commit euthanasia.

• The directive also leaves no room for the patient to change his or her mind. If the patient does express reluctance at going through with a euthanasia death, would doctors listen, or instead insist that the advanced directive be followed?

Such fears are not baseless. One need only look to Canada, where the most extreme scenarios are already playing out, as doctors pressure patients to die, euthanasia is offered as a cost-saving alternative to healthcare, and a dementia patient was euthanized not at her own request, but at the behest of her family.

The Bottom Line:

There is never a threshold at which it's acceptable to choose euthanasia. Vulnerable populations, like those with degenerative conditions, do not need the promise of legalized death pushed upon them. Instead, they need resources and support to ensure they are getting the best care possible.