A systematic review of reasons for and against euthanasia and physician-assisted suicide in older people with a non-terminal condition.

This article systematically reviews the published ethical arguments for and against euthanasia and physician-assisted suicide (EUT/PAS) for older people without a terminal illness, including those with dementia and multiple geriatric syndromes. Seventeen peer-reviewed studies, mostly from Western countries and authored by medical practitioners and ethicists, were analyzed, identifying 70 arguments—16 in favor and 54 against—grouped into eight themes: precedent capacity, duty to die in dementia, psychological factors, health economics, ageism, abuse/coercion, sociocultural factors, and legislation. Arguments supporting EUT/PAS emphasized respect for precedent autonomy via advanced euthanasia directives and a perceived duty to die to preserve moral agency, while opposing views highlighted concerns about decisional capacity, potential coercion, societal obligations to care for the elderly, and risks of ageism and abuse. The review notes limited literature on this topic, especially outside Western contexts, and calls for broader engagement with older people and their supporters to inform ethical and policy discussions as eligibility for EUT/PAS expands beyond terminal illness in some jurisdictions.