voluntary euthanasia ( ve ) is the act of requesting deadly medical practices in order to terminate one s life ( 1 ) . the process of decision making ( like that for ve ) is composed of two interwoven brain based components ( 2 ) .
one is the conscious power of analyzing the condition and utilizing algorithmic like strategies , which is known as cognition ( 2 , 3 ) .
this part is important since it affects the person s ability of seeking in the condition ( 4 ) , estimating the parameters of a situation ( 5 ) and finally deciding ( 2 ) .
chronic pain patients ( cpps ) develop disappointing emotional backgrounds , which affect their mental power of decision - making ( 6 ) .
this article argues about the mental incompetence relating decision - making that accompanies chronic pain in such patients .
this can be considered as equal to the historically known conditions of torturing a person and wanting him / her to accept or confess something in return for relieving pain ( 7 ) . in case of ve ,
the agent is the internal mental burden of a disease and the thing wanted in return for reliving the pain is  dying acceptance  .
therefore , in this condition the stimulator of accepting death is the emotion of escaping from pain in return for anything .
this is the exaggerated form of the normal emotion of fearing and escaping from painful situations ( 8) . in fact , a cpp fears from experiencing excess pain . according to this outlook and having in the mind that emotions - in the way it is described in the literature ( 9 ) - are the most important determinants of the alternative to be chosen ( 10 ) , here it is proposed that cpps are emotionally and hence mentally incompetent for making critical decisions .
studies using mri technology have shown brain deficits in cpps ( 1114 ) . more specifically in the state of chronic pain it is stated that the orbitofrontal part of the brain cortex is preferentially involved .
this part functions as a link between multiple brain regions with distinct roles in the emotional assessment .
these regions include lateral prefrontal areas which handle memory , effector components of the brainstem which are responsible for producing emotional responses and those parts that are considered as the brain substrates of feelings like insula and amygdale ( 6 ) .
according to these findings a cpp does not have a biologically healthy brain for providing the accuracy of the act of choice - making especially when he / she wants to do so for emotion - laden alternatives like that of whether to escape or cope with the pain .
this can be considered as equal to the historically known conditions of torturing a person and wanting him / her to accept or confess something in return for relieving pain ( 7 ) . in case of ve ,
the agent is the internal mental burden of a disease and the thing wanted in return for reliving the pain is  dying acceptance  .
therefore , in this condition the stimulator of accepting death is the emotion of escaping from pain in return for anything .
this is the exaggerated form of the normal emotion of fearing and escaping from painful situations ( 8) . in fact , a cpp fears from experiencing excess pain . according to this outlook and having in the mind that emotions - in the way it is described in the literature ( 9 ) - are the most important determinants of the alternative to be chosen ( 10 ) , here it is proposed that cpps are emotionally and hence mentally incompetent for making critical decisions .
studies using mri technology have shown brain deficits in cpps ( 1114 ) . more specifically in the state of chronic pain it is stated that the orbitofrontal part of the brain cortex is preferentially involved .
this part functions as a link between multiple brain regions with distinct roles in the emotional assessment .
these regions include lateral prefrontal areas which handle memory , effector components of the brainstem which are responsible for producing emotional responses and those parts that are considered as the brain substrates of feelings like insula and amygdale ( 6 ) . according to these findings a cpp does not have a biologically healthy brain for providing the accuracy of the act of choice - making especially when he / she wants to do so for emotion - laden alternatives like that of whether to escape or cope with the pain .
the central concept of this article is that a person who is under the mental pressures is not capable of making critical decisions .
the same concept is already accepted for the other categories of people who can not think well such as drunken individuals ( 15 ) .
the fact that mentally under pressure patients can not think well is also indirectly accepted by all societies that refuse to obey a mentally ill patient s will in the light of labeling the patient unqualified for making a will according to the judgment of court . with the same bases ,
this article s concept can be accepted by the court and become a law in such societies .
therefore , the patient s will of terminating his / her life must not be accepted like that of a drunken person .
deciding to undergo euthanasia is the most critical decision of a person ( not only a patient ) since this decision leads to the end of making other decisions . in this respect , deciding to die is different from deciding to buy a car because the latter is reversible or can be compensated in the future and does not violate the right of making other decisions , something that the former intrudes in .
therefore the ability of making the decision of undergoing euthanasia must be considered as something different from just a right . in this
mental incompetence is the common quality in both conditions of chronic pain and will rejection in the court . therefore the accepted rules for both of these two conditions must be the same .
this means that any nation that rejects the will of a mentally incompetent individual must do the same about the request of a cpp for ve .
 emotional status and its brain bases change in a chronic pain patient and this change affects his / her decision making ability . 
 moreover , it is accepted that a mentally disturbed individual is not competent to make critical decisions . according to these bases 
 , this article demonstrates that such patients are not entitled to request voluntary euthanasia . 