self-starvation

My mother died of Alzheimer’s disease at the ripe old age of 99. With invaluable help from hospice, my wife and I cared for her in our home for the last five months of her life.

Was it difficult? Very. Does that matter? No. Mom deserved the best care available regardless of her mental incapacity.

My mother’s brother also died of Alzheimer’s. He received excellent care in the memory unit of a Baptist-affiliated assisted living facility for the last years of his life.

Was it difficult? Very. Does that matter? No. My uncle deserved the best care available regardless of his mental incapacity.

The compassionate support my mother and uncle received was once the expected moral standard. Unfortunately, that seems to be changing. Increasingly, dementia patients are viewed by many as better off dead sooner rather than later.

Many Western countries and jurisdictions are legalizing euthanasia and assisted suicide. That opens up a problem for the death pushers. Since states aren’t going to get into the wet work of the actual killing, medical professionals and caregivers are going to be conscripted to do the deadly deeds — even if that means violating their religious beliefs and moral consciences.

Instead of resisting this rank authoritarianism, the medical and bioethics establishments are increasingly going along. This proposed coercion includes requiring doctors’ participation in suicides when patients starve and dehydrate themselves to death — known as VSED for “voluntary stop eating and drinking.”

As I wrote a few weeks ago here, the British Medical Association just so opined. And now, following closely in that guidance’s wake, a major article in the Journal of Health & Biomedical Law argues similarly — using dementia patients as the prime example — that doctors have to both inform patients about their right to commit suicide by VSED and ease the process by providing palliative care against the agony that killing oneself in that manner causes.

The subtitle of the revised and updated version of my book criticizing utilitarian bioethics, Culture of Death, is, “The Age of ‘Do Harm’ Medicine.” Helping patients kill themselves by self-starvation and dehydration — known in euthanasia parlance as VSED (for voluntary stopping eating and drinking) — certainly fits that designation.

Two major medical associations now have endorsed doctors assisting in such suicides by palliating the painful symptoms to help patients go all the way to death. The first was the American Academy of Hospice and Palliative Medicine (AAHPM) in 2023. This is especially notable because the organization shamefully went “neutral” on the legalization of assisted suicide, despite that action being the antithesis of the hospice philosophy enunciated by the great medical humanitarian Dame Cecily Saunders. The AAHPM’s journal also published a piece recently endorsing intentionally undernourishing dementia patients under certain conditions (MCF, or “minimal comfort feeding”) — VSED in slow motion, if you will.

Now, another “do harm” shoe has dropped. The British Medical Association has issued an ethical guidance that requires practitioners to participate in VSED when asked to do so by a patient. While the AAHPM guidance assumes that the act will only be done by terminally ill or seriously ill or disabled patients, the BMA guidance notably acknowledges that even those not in ill health can kill themselves in this slow manner — and that doctors must further the suicide palliatively. From the guidance (my emphasis):