Some European jurisdictions have legalised euthanasia and physician-assisted suicide (EUT/PAS) for people with dementia and ‘multiple geriatric syndromes’. We therefore sought to determine the published rationales for and against providing EUT/PAS to older people without a terminal illness.
Method
A systematic review was undertaken according to PRISMA guidelines. Content, thematic and discourse analyses were used to identify papers that delineated ethical arguments for and against the provision of EUT/PAS to older people without a terminal illness, and to synthesise arguments into overarching themes.
Results
Seventeen studies were included, eight of which were written by medical practitioners, the rest by ethicists. All but two of the papers were written by authors from western nations. A total of 70 arguments were identified, 16 (22.9%) being in favour of EUT/PAS, and 54 (77.1%) against. The themes identified were: a person with dementia had a duty to die, precedent capacity, ageism, abuse/coercion, psychological factors, healthcare economics, sociocultural factors and legislation.
Conclusion
Despite broad scepticism about the provision of EUT/PAS to older people without a terminal illness, the literature is preliminary. There is a need for ethicists and policymakers to engage with a range of older people with physical, cognitive and social needs, as well as their supporters.
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