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Posted on June 27, 2020 at 4:00 AM

Many individuals want to avoid living in late stage dementia. But medical aid in dying (MAID) is not an exit option that can help in the United States. Every U.S. MAID jurisdiction requires that to make a MAID request the individual must both (1) have decision-making capacity and (2) be terminally ill. Dementia patients cannot satisfy both of the eligibility conditions at the same time.

Consequently, some (like Kelly Bone) are looking at options in other countries. There are two. First, one could get MAID now in a country (like Switzerland) with less stringent eligibility conditions that do not require terminal illness. But since these countries still require capacity, the patient must act sooner than they might have liked.

Second, a more attractive option for many would be to make an advance request for euthanasia (in the Netherlands). That way, they need to worry about acting prematurely or losing capacity. They could enjoy all their remaining meaningful life. A physician would administer euthanasia at a time the patient specified in her advance directive. (Note that given the patient’s incapacity, this is clinician-administered and thus properly described as euthanasia, not MAID.)

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