In a quaint coastal village of Castricum, Netherlands, Irene Mekel faces a heart-wrenching dilemma. At 82, diagnosed with Alzheimer’s disease just a year ago, she contemplates the difficult path toward medically assisted death, an option legally available to her under Dutch law. Despite her deep-rooted love for life, including nurturing a blossoming garden and enjoying communal connections, she understands that time is critical in maintaining the dignity she values so highly.

Mekel, once a dedicated nurse, is aware of the challenging decline in her cognitive abilities, prompting her proactive approach to plan for potential future suffering. After a concerning fall that resulted in a broken elbow, she fears that she might soon be incapable of living independently. With three supportive children characterized by their own busy lives, she refuses the prospect of a nursing home—viewing it as an unacceptable loss of dignity.

In preparation, Mekel participated in a workshop by the Dutch Association for Voluntary End of Life, drafting an advance request document outlining her wishes for euthanasia under specific conditions. These include an absence of recognition for her family and an inability to engage in conversation.

However, upon presenting her advance directive to her family doctor, Mekel faced an unsettling reality: while the doctor sympathized with her position, she was legally unable to comply with her request as Mekel's condition deteriorated. This situation reflects a stigmatized area within assisted death protocols, as the law prohibits euthanasia for those who can no longer consent.

Mekel’s story sheds light on the ethical complexities and emotional turmoil faced by individuals and physicians within the euthanasia framework, underscoring the need for ongoing dialogue regarding autonomy, identity, and end-of-life choices. As she ponders the future and how to preserve her sense of self, Mekel represents a poignant case in the ever-evolving conversation about medically assisted death amidst the challenges of dementia.