This chapter discusses the ethical aspects of end-of-life decisions in dementia. It is written against the background of societal opinions, moral values and practices regarding dementia care in the Netherlands. The range of medical decisions concerning the end-of-life in dementia varies from refraining from treatment (non-treatment decision) to decisions to actively terminate the life of the patient (i.e. physician assisted suicide and euthanasia). The different due care criteria—particularly hopeless and unbearable suffering—are explored, as well as the moral and legal status of advance directives in dementia care. It is important that the patient’s perspective is included as much as possible in the decision-making process, not only at the level of the individual patient, but also as far as it concerns policy issues regarding the promotion of the good life and good care in dementia.