Medical aid in dying to avoid late-stage dementia

Area of Science:

• Medical Ethics
• Neurology
• Palliative Care

Background:

• Dementia patients often desire medical aid in dying (MAID) before capacity loss.
• Existing MAID laws present eligibility barriers for dementia patients (capacity, self-administration, terminal status).

Purpose of the Study:

• To explore the potential for dementia patients to access MAID.
• To examine the role of voluntarily stopping eating and drinking (VSED) as a bridge to MAID.
• To provide clinical guidance on supporting dementia patients pursuing MAID.

Main Methods:

• Case study analysis of an Oregon patient with early-stage Alzheimer's using VSED for MAID.
• Discussion of historical barriers to VSED as a MAID pathway for dementia.
• Review of recent legal changes impacting MAID eligibility for dementia.

Main Results:

• A case demonstrates successful use of VSED to meet MAID eligibility criteria for an early-stage dementia patient.
• Recent legal amendments and VSED strategies may overcome prior exclusions.
• This combined approach presents a new possibility for end-of-life care in dementia.

Conclusions:

• The exclusion of dementia patients from MAID may be reconsidered.
• VSED can potentially serve as a bridge to MAID for individuals with dementia.
• Further clinical guidance is needed to support this evolving end-of-life care option.