Monday, July 20, 2020

Assisted death for people with dementia paves the way for non voluntary euthanasia.

Alex Schadenberg
Euthanasia Prevention Coalition

Last April the Netherlands Supreme Court approved the euthanasia death of an incompetent woman with dementia who resisted at the death. 

The woman with dementia had stated in her advanced directive that she wanted euthanasia but when the doctor came to inject her she said NO and resisted. The doctor put drugs in her coffee to sedate her but the woman continued to resist so the doctor had the family hold her down while the doctor injected her.

The effect of the Dutch Supreme Court decision is to permit a doctor to lethally inject a person with dementia based on past statements without needing to confirm the person's final wish.

Last month, the Dutch media published an interview with Marinou Arends the doctor who carried out the euthanasia death of the woman with dementia. Arends said that she would do it again and advised other doctors in similar situations to "just do it." 

A few days ago I read an LA Times article calling for the expansion of the California assisted suicide law to include people with dementia.

The World Health Organization defines dementia as:
a syndrome – usually of a chronic or progressive nature – in which there is deterioration in cognitive function (i.e. the ability to process thought) beyond what might be expected from normal ageing. It affects memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement. Consciousness is not affected. The impairment in cognitive function is commonly accompanied, and occasionally preceded, by deterioration in emotional control, social behaviour, or motivation.
California legalized assisted suicide in 2016. Assisted suicide is done by a physician prescribing lethally drugs for a person, but the person is required to self-administer the drugs. 

The latest report indicated that the number of assisted suicides, in California, increased by 20% in 2019.

The Netherlands legalized euthanasia in 2002. Euthanasia is done by a physician who lethally injects a person, whether it is voluntary or non-voluntary. 

The death of the Dutch woman with dementia who resisted was controversial because the woman said NO and resisted but the doctor injected her anyway.

Legalizing assisted death for people with dementia requires a change in the law to permit euthanasia (lethal injection) even when it is not voluntary. Euthanasia is legalized by creating an exception to homicide in the criminal code.
Assisted suicide requires a person to self-administer the lethal drug cocktail. However many people are not diagnosed with dementia early and some forms of dementia advance quickly, therefore some cases of dementia would require the doctor to administer the lethal drugs (euthanasia) rather than assisted suicide.

Since the effects of dementia vary, there are people who will be approved for assisted, but at the time of death will be incapable of consenting. Similar to the Dutch case, this would lead to non-voluntary euthanasia.

Sadly, Canada is debating expanding euthanasia to include non voluntary euthanasia. Bill C-7 will permit euthanasia (lethal injection), under the term MAiD, of a person who is incompetent, so long as the person was approved for euthanasia while competent.

There are many sad stories about dementia, nonetheless, killing people with dementia often requires killing people who cannot consent meaning non-voluntary euthanasia. Caring not Killing.

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