Article Text

Download PDFPDF
Dementia and advance directives: some empirical and normative concerns
  1. Karin R Jongsma,
  2. Marijke C Kars,
  3. Johannes J M van Delden
  1. Julius Center for Health Sciences and Primary Care Utrecht, University Medical Center Utrecht, Utrecht, The Netherlands
  1. Correspondence to Dr Karin R Jongsma, Julius Center, University Medical Center Utrecht, Utrecht University, Utrecht 3508 GA, The Netherlands; K.R.Jongsma{at}


The authors of the paper ‘Advance euthanasia directives: a controversial case and its ethical implications’ articulate concerns and reasons with regard to the conduct of euthanasia in persons with dementia based on advance directives. While we agree on the conclusion that there needs to be more attention for such directives in the preparation phase, we disagree with the reasons provided by the authors to support their conclusions. We will outline two concerns with their reasoning by drawing on empirical research and by providing reasons that contradict their assumptions about competence of people with dementia and the (un)importance of happiness in reasoning about advance directives of people with dementia. We will draw attention to the important normative questions that have been overstepped in their paper, and we will outline why further research is required.

  • dementia
  • euthanasia
  • living wills/advance directives
  • ethics
  • competence/incompetence

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors All three authors have contributed to qualify for authorship: substantial contributions to the conception of the paper; drafting the work or revising it critically for important intellectual content; final approval of the version to be published; agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Not commissioned; internally peer reviewed.

Linked Articles