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Rights of People Who Are Suffering Severe Loss of Mental Capacity

Guest IAE Blog

Rights of People Who Are Suffering Severe Loss of Mental Capacity

Bruce Yelle

Educator, and Founder of End Choices

The 1776 United States Declaration of Independence includes the statement: “…that all Men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty, and the Pursuit of Happiness.”

This sentence, written by Thomas Jefferson, has had enduring significance as our country has grown, prospered, and become a world power during the past 242 years. During these years, we as a nation have struggled to apply its basic ideas and ideals, resulting in an ever greater awakening of human rights for all, irrespective of gender, race, national origin, sexual orientation, and disabilities.

David Moursund’s recent article, Inalienable Rights of Children, makes it clear that children as well as adults have inalienable rights (Moursund, 10/31/2018; link). But something that is often forgotten is the inalienable rights of seniors and others as they begin to lose their mental capacities. The remainder of this IAE Blog entry explores the plight of such people.

Life is the condition that distinguishes animals and plants from inorganic matter including the capacity for growth, reproduction, functional activity and continual change. Life for us is that period from our birth to our death. In the Jeffersonian ideal, how one lives that life is up to the individual. As we age, we generally develop an idea of what is a personally acceptable quality of life. However, as we grow older and lose our functionality, life decisions and health decisions may not be under our control anymore. In today's society when an elder starts to lose his/her mental capacity and memory, all their decisions are taken away from them – including the conditions under which they live and die. This also can be true of younger people whose mental capacity has been lost or greatly diminished by illness or accident.

Liberty is the state of being free within society from oppressive restrictions imposed by authority on one's way of life, behavior, or political views. One of the first abuses of many seniors’ liberty is compulsory retirement or being replaced by younger workers. Age discrimination in the workforce is causing many seniors hardships. Our streets and homeless shelters are filled with seniors that are facing poverty-based discrimination every day. Although some homeless make that choice themselves, a large percentage are forced to live that life – often because they no longer have the income to secure the fundamental necessities of life, including adequate shelter and food.

The pursuit of happiness is typically taken to mean the right to freely pursue joy and live life in a way that makes you happy. Provided that you don't do anything illegal or violate the rights of others, you are allowed to pursue this happiness as a free person until you lose your mental capabilities – then you may become a happy incarcerated person. Sadly, happiness and joy can be fleeting moments in care facilities as anxiety, fear, and depression become common concerns with almost every patient.

Self Determination in End of Life Choices

As a person loses their physical and mental abilities, they also start to lose some of their other inalienable rights. You have the right to determine how to live your life – but what about the right for self-determination in the ending of life? Shouldn't we have the inalienable right to dictate when our quality of life is unacceptable because of loss-of-dignity and/or unbearable physical or mental suffering?

The current Right to Die laws that are in effect in Oregon and several other states do not fit the needs of a person who is developing or fears developing a severe mental disability due to age, illness, or accident. This person may want to make provision for a doctor or some other designated individual to administer an end-of-life medication at a time when the person no longer has the mental capacity to make such a decision and/or to self-administer the medication. Additionally, such a person wants to have the decision for this provision legalized well before reaching a stage of no longer being considered to be mentally competent.

As an example, a person who currently is “of sound mind and body” may decide that they do not want to be kept alive in an institutional setting for the mentally incapacitated. They are stating their clear choice that, when they are so mentally incapacitated that they no longer recognize their loved ones or remember the joy and happiness of their life prior to this time, they want to have their life ended and have signed documents to this effect.

My state of Oregon and several other states have a Right to Die law. In Oregon, the law is designed to fit the needs of a person who is dying from an incurable disease and has less than six months to live. In Oregon, such a person is given a death-causing medication and must self-administer it.

What I am proposing is the legalization of euthanasia under certain carefully prescribed circumstances. Quoting from the Wikipedia:

Euthanasia is illegal in most of the United States. Assisted suicide/assisted death is legal in Washington DC  and the states of California, Colorado, Oregon, Vermont, Hawaii, and Washington; its status is disputed in Montana. The key difference between euthanasia and assisted suicide is that in cases of assisted suicide, the individual receives assistance, but ultimately voluntarily causes their own death. In euthanasia the individual does not directly end their life, but another person acts to cause the individual's death.

I strongly support the idea that we each have an inalienable right of self-determination regarding our own End Choices, the right to make ending-of-life decisions that will be implemented if we become mentally incapacitated. This euthanasia option would be made legally available to all who fear suffering severe and irrecoverable loss of mental capacity by illness or injury. This including the elderly as well as younger persons foreseeing their possible loss of mental capacity due to accident or illness.


Moursund, D. (10/31/2018). Inalienable rights of children. IAE Newsletter. Retrieved 10/31/2018 from

Oregon Health Decisions (2010). Advance directive. Your life. Your decisions. Retrieved 10/27/2018 from

Wikipedia (2018). Euthanasia in the United States. Retrieved 10/28\2018 from


Bruce Yelle is an End-of-Life Educator and the founder of End Choices, an Oregon Non-Profit Corporation. The goal of End Choices is “Seeking to expand end-of-life options in Oregon.” Contact Bruce Yelle at 541-590-3204 or This email address is being protected from spambots. You need JavaScript enabled to view it.. For more information, go to the End Choices website at

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Friday, 24 September 2021

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