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. 2021 May;51(3):37-47.
doi: 10.1002/hast.1257.

Ending One's Life in Advance

Margaret Pabst Battin, Brent M Kious

Ending One's Life in Advance

Margaret Pabst Battin et al. Hastings Cent Rep. 2021 May.

Abstract

If you developed Alzheimer disease, would you want to go all the way to the end of what might be a decade-long course? Some would; some wouldn't. Options open to those who choose to die sooner are often inadequate. Do-not-resuscitate orders and advance directives depend on others' cooperation. Preemptive suicide may mean giving up years of life one would count as good. Do-it-yourself methods can fail. What we now ask of family and clinicians caring for persons with dementia, and of patients given no better option than to go on with lives they may not want, is unacceptable. To explore how one might better control one's own dying and avoid burdening others with overwhelming care and morally painful choices, we propose a thought experiment: an advance directive implant that would enable persons with early dementia, while competent, to arrange their own deaths without the subsequent intervention of anyone else.

Keywords: Alzheimer's disease; advance directive; dementia; euthanasia; medical devices.

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References

Notes

    1. Alzheimer's Association, “Alzheimer's Disease Facts and Figures,” Alzheimer's Dementia 15, no. 3 (2020): 321-87.
    1. M. Prince et al., eds., World Alzheimer Report 2015: The Global Impact of Dementia (London: Alzheimer's Disease International, 2015).
    1. B. Reisberg et al., “Dementia Staging in Chronic Care Populations,” Alzheimer Disease and Associated Disorders 8, supplement 1 (1994): S188-S205.
    1. G. M. McKhann et al., “The Diagnosis of Dementia Due to Alzheimer's Disease: Recommendations from the National Institute on Aging-Alzheimer's Association Workgroups on Diagnostic Guidelines for Alzheimer's Disease,” Alzheimer's and Dementia 7, no. 3 (2011): 263-69; C. A. Lane et al., “Alzheimer's Disease,” European Journal of Neurology 25, no. 1 (2018): 59-70.
    1. This is a slight modification of text from M. P. Battin, “Fiction as Forecast: Euthanasia in Alzheimer's Disease?,” chap. 7 in The Least Worst Death: Essays in Bioethics on the End of Life (New York: Oxford University Press, 1994), 160.

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