The ephemeral self: The legitimacy of an advance euthanasia directive

It is hard to say at what point someone with dementia has changed so dramatically that the self that existed before the dementia manifested itself cannot be said to exist (anymore). This issue raises important existential questions and may call into question the validity of a living will, in particular that of an advance euthanasia directive. The idea that the request expressed in such a directive should always be respected, regardless of conflicting expressions by the severely demented individual, may conflict with the interests of that individual. Balancing the various interests is the difficult task undertaken in this paper.