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Posted on January 12, 2021 at 10:09 PM

Once a patient loses capacity from dementia, medical aid in dying is usually no longer a last resort option. This is exemplified by the case of Christine Bregnard profiled in the Swiss media this week. 

Only in the Netherlands can one (while capacitated) make an advance request for euthanasia (to be implemented in advanced dementia). So what other options are available?

Option 1: The individual with progressing dementia can act early – using MAID, VSED, or a non-medical option. She must act while she still has capacity. Yet that often unattractive because that is also when she still finds life meaningful and worthwhile. 

Option 2: The individual (while capacitated) can complete an advance request for stopping eating and drinking (AD for SED). That way, the individual would not hasten her death until the point she specifies would make life intolerable. 

Option 3: The individual’s surrogate can direct SED without an advance directive directing it from the patient herself. This is suggested as a good approach for Christine Bregnard. But it may exceed the scope of surrogate authority in many jurisdictions.  

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