A decision in the Netherlands to approve the euthanasia of a woman with advanced Alzheimer’s disease has raised questions over how far mercy killing can apply to patients with dementia. Under Dutch law doctors performing euthanasia must ensure that the patient has made a voluntary and well considered request. This requirement has generally excluded patients with advanced dementia, as they are no longer considered competent to express their wishes. Now the Euthanasia Assessment Committee, to which doctors must report the cases of patients they have helped to die, has made an exception in the case of one woman, emphasising her long history of requesting euthanasia and the degree of communication still possible at her death. It is seen as the first case of euthanasia of a “heavily demented” patient. The Dutch Right to Die Society, which campaigns for euthanasia, supports the case but points out on its website that the woman was “officially incompetent.”