Physician Assisted Suicide in cases of Dementia/Alzheimers

Physician-assisted suicide for patients with dementia and Alzheimer's is a complex and taboo topic. Dementia slowly takes away a person's ability to function, often leading to death by forgetting how to swallow. While some countries and states allow physician-assisted suicide for patients with terminal illnesses, it becomes complicated when dementia patients reach a stage where they can no longer make informed decisions. Sandy Bem, a retired psychology professor with Alzheimer's, decided to end her life on her own terms using Nembutol. Accessing the drug was a challenge, requiring her to import it. The article highlights the need for better end-of-life care options and personal autonomy. However, a 2021 study suggests that physician-assisted suicide for dementia patients cannot be widely endorsed due to ethical and cultural reasons. This topic requires more discussion and support for patients and caregivers. In the meantime, patients with dementia will continue to choose their own path Hi there. Today I'm going to be talking about a slightly taboo topic. We're going to be talking about physician-assisted suicide in cases of elder people with Alzheimer's and dementia. This is a topic that I believe is not very much talked about and not very widely understood. Dementia itself is a degenerative disease that doesn't kill people per se. It slowly takes people away from the person that they once were and kills them in a much slower, much more inhumane way where a lot of the time it's killing by virtue of a person forgetting how to swallow. In most countries and states where it's legal, a patient must have a terminal illness and be in the final stages of their disease to be eligible for physician-assisted suicide. However, some countries and states have expanded this to include patients with chronic debilitating illnesses such as dementia. Unfortunately, where it gets extremely complex for patients with dementia and Alzheimer's is when a patient is far enough along that they are no longer eligible to make informed decisions and request the procedure. So unfortunately, in a lot of cases when a person with dementia has decided that they want to end their life on their own terms before dementia takes over, they don't want to do it at that moment. However, when they are ready to end their life and when the dementia has taken over their body, they aren't able to advocate for themselves at that point anymore. So it becomes a very tricky topic for a lot of doctors, families, and patients to decide on their own. It's really hard as well because a lot of people with dementia, they don't want to end their lives while they're still living a good life before the dementia has taken over too much. So it's just a very fine line of when are they ready to go, but also when are they still able to use their right to use physician-assisted suicide and end their life in that safe way versus when are they too far gone and they can no longer say that for themselves. The article titled, The Last Day of Her Life, written by Robin Moran-Tang and published in the New York Times in 2015, tells the story of Sandy Bem, who was a retired psychology professor who decided to end her life on her own terms after she was diagnosed with Alzheimer's. The article follows her journey as she prepares for her death, including her decision to stop taking medication and live her life to the fullest before her Alzheimer's ultimately took over and she was no longer able to be the same person that she was before. Once Sandy was diagnosed with Alzheimer's, she knew immediately that she wanted to end her life on her own terms and would not let the disease, which she knew so much about, take over as she had seen in documentaries and shows before. She immediately looked online and discussed with doctors options. She was not met with a lot of help and decided she needed to look into things on her own. Sandy ultimately decided to use Nembutol. Nembutol is the same drug used by veterinarians to euthanize animals. It is also used in state-sanctioned physician-assisted suicides. After reading about it, Sandy thought that this drug was what she was looking for. It was reliable, fast-acting, and most important to her, it was a gentle way to die. It caused not a sudden unconsciousness, but rather a gradual slowing of the heart. However, the difficult part was not in choosing how she would die, it was choosing when. Sandy struggled with choosing a date, but knew she needed to set a date in stone well in advance before the date came. She couldn't decide on a date before she was too far gone, and she needed a date that was well enough in the future that she would be at a point where she was starting to fade, but not in a point too far where she was no longer herself and couldn't administer the drug to herself. Sandy knew that she needed to administer this drug to herself, so that way no one else would be accused of causing her death. In short, when Sandy decided on a date, she had all of her family around her, as well as her ex-husband, who she maintained a good relationship with. He was at her bedside as she administered the drug and held her as she took her last breath. While Sandy's death was ultimately peaceful, it was an extreme uphill battle for Sandy to get her hands on this medication, which she had to import from another country. Sandy's story should spark a discussion about the importance of personal autonomy and the need for better end-of-life care options for patients with terminal illnesses. Before we discuss these better end-of-life care options, it is first very important to understand Alzheimer's disease from a scientific standpoint. When a person is battling this disease, the brain develops abnormal protein deposits called amyloid plaques and tau tangles, which disrupt the normal functioning of neurons and causes them to die. This process initially affects the regions of the brain responsible for the memory and other cognitive functions. But as the disease progresses, it can spread to other parts of your brain and cause a range of symptoms, such as personality changes, difficulty with coordination, and problems with visual and spatial awareness. This information was sourced from psychcentral.com if you'd like to read more. A 2021 PubMed article titled, Physician-Assisted Suicide and Dementia Paradoxes, Pitfalls, and the Need for Prudence, discusses the increasing drive towards the legalization of physician-assisted suicide in patients with dementia. In the peer-reviewed article, data on attitudes towards euthanasia for 28 countries is obtained from the World Value Surveys. This data is analyzed, and his findings are that, there are positive attitudes towards this procedure, and these positive attitudes are found in more economically advanced countries and are strongly associated with specific cultural factors. However, the author suggests that based on these findings, the practice of TAS, physician-assisted suicide, in dementia, is not one that can be widely or safely endorsed on both cultural and ethical grounds. Instead, the medical field should work in collaboration with governmental, social welfare, and patient advocacy services to ensure optimal physical and emotional support to this group of patients and their caregivers. Unfortunately, these findings are not what we would like to hear. This study shows that there is still a lot of conversations to be had regarding physician-assisted suicide in cases of dementia, and that we are not quite there yet. This topic needs to be talked about more so that patients can have this resource available to them. In my opinion, physician-assisted suicide should be available in the same way that abortions should. I believe that this is a healthcare option, and it should be widely accepted, and it should be a person's personal decision. Unfortunately for now, physician-assisted suicide in cases of cognitive decline remains virtually inaccessible for people in a safe way. People with dementia and Alzheimer's will continue to end their life on their own terms. Unfortunately, they will just not be able to do it in a safe way in a medical environment. Thanks for listening.