It is important to realize that this perspective is still highly prevalent in many countries, and that even the notion of euthanasia could be hugely offensive to some people, especially in sensitive situations such as end-of-life discussion. While this argument is admittedly built on subjective individual views of morality, it is still a very valid ethical view (Paterson 2003). Other ethicists take a more moderate, middle view of the issue, arguing that the right to decide when to die does apply in certain instances, but that abuses are too easily allowed in the systems set up by many countries (Cohen-Almagor 2001). The issue hinges upon the relationship between the physician and their patient, and the nature of advice, information, and persuasion. Specifically, it is the fine and often invisible line that exists between the presentation of full information to the patient and the use of persuasion on the part of the physician that can create abuses in cases of physician-assisted suicide and other forms of medically assisted euthanasia (Cohen-Almagor 2001). Complicating this still further is the manner in which the physician explains the progression of whatever dementia-causing disease -- or other disease or deterioration, for that matter -- the patient is suffering from, which in this context becomes the alternative to euthanasia (Cohen-Almagor 2001). Explaining this in certain terms can make euthanasia appear to be the only viable option for the patient, and this is just as ethically limiting as denying patients the right to decide when to die, according to the views of at least this theorist (Cohen-Almagor 2001).

What the ethical dilemma really comes down to is a matter of choice and informed consent, in this view (Cohen-Almagor 2001). Patients need to be able to objectively...

Simply promoting euthanasia as a desirable option in cases of dementia is irresponsible and ethically unsound (Cohen-Almagor 2001).
Conclusion

The lines of thinking and ultimate conclusions that are drawn in regards to the issue of voluntary and self-directed euthanasia for those that will experience severe dementia and a loss of identity are obviously widely divergent and multifaceted. Only five views have been presented here, and there are many more views and lines of reasoning that both support the idea of euthanasia for those that would seek it out and that argue against this practice as at all ethical or medically responsible. Ethical questions are always complex, and the number of ethical complexities involved in this particular issue is even greater than in many other circumstances -- there is not only the question of whether the act of euthanasia or physician-assisted suicide is ethical or not, but also of when it may or may not be ethical, when it is possible to make a decision in this regard, exactly what information should be considered, how this information should be presented, and so on.

As the medical community continues to grapple with this issue and the ethical problems it raises, what seems clear from the evidence gathered is that personal decision making must be at the forefront of the policies created. It seems likely that certain euthanasia policies will become more and more prevalent in different countries, and that the practice is likely to become more broadly accepted in the medical community. Careful ethical watchfulness of this issue must be maintained in order to ensure that this is…