151 Dutch case reports on euthanasia in dementia (2012–2020) were analyzed. In 2011, the first advanced-dementia-case has been authorized. The reported numbers amounted from 5 in 2005 to 170 in 2020. Ethically relevant is the prevalence of psychological and spiritual suffering (99.1% and 84.7). The study questions the factors of euthanasia requests: How voluntary is a request? Can an incapacitated patient make well-considered requests? What constitutes “unbearable suffering”? How (well) can a patient with cognitive limitations be informed? To conclude, the importance of narrowing the gap between perceived and real nursing home quality, making information about end of life options and involving patients’ own physician in a euthanasia request are highlighted.
