In an increasing number of jurisdictions, including several US states, physician-assisted death (PAD) has been made possible. In the medical ethical debate, 2 conditions are generally mentioned for PAD to be justifiable. The first condition is the presence of unbearable and irremediable suffering, which for physicians may lead to a conflict of obligations between the duty to preserve life and the duty to relieve suffering. The second condition is a competent request by the patient to end life. When a patient requests PAD owing to dementia, both justifications may be challenged.