Voluntary assisted dying for dementia: international regulatory approaches and practices

An increasing number of jurisdictions now permit people to access voluntary assisted dying (VAD) to end their lives. Access to VAD is controlled by eligibility criteria, which vary in each jurisdiction meaning that not everyone who may wish to access VAD can. In this article, we focus on one specific cohort, namely people living with dementia, who may seek to access VAD on the basis of their dementia. We consider whether it may be possible for such individuals to access VAD in jurisdictions where VAD is lawful, and under what circumstances. To do this, we undertake an in-depth comparative analysis of all the relevant legal frameworks (as well as relevant policy and guidelines) to describe and categorize various VAD models where VAD for dementia may be possible. Those models include concurrent request models (where VAD is accessed and administered when a person has decision-making capacity) and advance request models (where VAD is requested when a person has decision-making capacity but accessed at a point when they no longer have such capacity). We conclude by considering the implications these models have for the availability of VAD for dementia based on eligibility, as well as potential practice implications.