I am not opposed to it, because advance medical directives are the law. So I have to follow them. I comply with the law, but I still believe that we have to avoid including medical assistance in dying in directives that are so coercive, legally speaking. In my opinion, there is no autonomy possible in advance medical directives or advance euthanasia directives. That goes with what I was saying earlier about any document that legally compels the medical team to provide a precise type of care, contrary to the advance medical directives, which prevent the physician or care team from doing things against the person's will. Medical assistance in dying would be included as a mandatory directive to be followed. So the physician is being required to perform an act.
This is the subject I first feel uneasy about. We have to consider that in many cases, people are not give adequate guidance and don't properly understand what medical assistance in dying, advance medical directives or advance euthanasia directives consist of. Experience in the Netherlands also shows that the directives are often not reliable, they don't really align with the context or practice, and people did not always include elements that really made sense for them.
A person may think that because they have expressed their wishes in advance, it will be reliable, coherent and enforceable. However, it does not always express the person's experience well. When the actual situation arises, we find that directives are not always reliable, coherent and enforceable. My unease is due to the fact that we find ourselves dealing with something mandatory and incoherent, that is sometimes neither reliable nor comprehensible.
My unease relates most importantly to ending the days of aged persons suffering from dementia, very vulnerable persons who have not made an informed decision. It may be that the document wasn't reliable and they made a flawed decision. In my opinion, to kill someone, we must be pretty certain that it is what the person wants.
I said I don't practise medical assistance in dying, because a majority—