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Ethics Consult: Euthanize Resistant Dementia Patient?

— You make the call

Last Updated December 17, 2019
MedpageToday

Welcome to Ethics Consult -- an opportunity to discuss, debate (respectfully), and learn together. We present an ethical dilemma in patient care; you vote on your decision in the case. Next week, we'll reveal how you all made the call. And stay tuned -- Gregory Dolin, MD, JD, will weigh in next week with an ethical framework to help you learn and prepare.

A healthy 67-year-old woman wrote and signed a letter given to her family requesting euthanasia if her health condition deteriorated to the point where she would need to be admitted to a nursing home.

Five years later, the woman had developed dementia. She was often disoriented and would get lost, and sometimes couldn't recognize loved ones or her own reflection. She could no longer live independently.

However, when the physician discussed euthanasia with the patient, she disavowed the letter, and vehemently insisted she did not want to die. Her physician consulted with the family and decided to proceed with the written request for euthanasia.

On the day of the determined death, the patient became agitated to the point of screaming and pushing the physician away when he approached. It became clear that she would need to be sedated and physically restrained to administer the lethal injection.

Keep in mind that this scenario takes place in a state where physician-assisted suicide is legal.

See the results and what an expert has to say.

Based on the following case from the New York Times:

, is associate professor of law and co-director, Center for Medicine and Law at the University of Baltimore, where he also studies biopharmaceutical patent law. His work includes a number of scholarly articles, presentations, amicus briefs, and congressional testimony.

And check out some of our past Ethics Consult cases: 'Freeze' Little Girl in 6-Year-Old Body?, Deaf Couple Only Wants Deaf Baby, and Critical Patient With DNR Tattoo.