voluntary stop eating and drinking

In a newly released paper in the prestigious journal Bioethics, three prominent bioethicists argue that when someone decides to commit suicide via self-starvation and dehydration — known in euthanasia movement parlance as “voluntary stop eating and drinking” (VSED) — doctors should be allowed to “terminally sedate” the person trying to die when necessary to prevent intractable suffering. Patients who commit VSED are often not terminally ill. In fact, euthanasia organizations promote self-starvation to the elderly who are not dying and as a means of becoming eligible for assisted suicide where it is legal by making oneself “terminal” via lack of sustenance. VSED must be distinguished from the common circumstance when actively dying people stop eating. That’s a natural process and Read More ›

Geriatric suicides used to be considered a tragedy. But these days, increasingly, they are celebrated — whether Compassion and Choices (formerly, the more honestly named Hemlock Society) teaching elderly people to starve themselves to death (VSED), joint lethal jabs of aged married couples in places like the Netherlands, Belgium, and Canada, or suicides facilitated at Swiss death clinics. These clinics are proud of their toll. One Swiss clinic even “prioritizes people who are elderly but not seriously ill,” while others willingly engage in geriatric assisted suicide of depressed elders if they have other conditions. From the odious Exit International’s newsletter: “Conscious suicides are different from others,” says Jean-Jacques Bise, Co-President of Exit in French-speaking Switzerland. The figures from RTS suggest Read More ›

Moves are afoot in bioethics to require caregivers to withhold food and water by mouth from a patient made incompetent by dementia if that patient, while compos mentis, has signed such a request — and even if the patient willingly eats, enjoys meals, or asks for food. It is sometimes called “voluntary stop eating and drinking [VSED] by advance directive,” in the parlance.

I have frequently criticized VSED by directive as inhumane to the patient, cruel to caregivers (as it forces them to starve people to death), and designed to open the door to lethally jabbing those with advanced dementia as the less onerous alternative to their being made to starve to death.

Now, as supposedly some form of compromise, there is a proposal on the table to barely feed — i.e., malnourish — dementia patients who have previously signed such a directive. From, “Mr. Smith Has No Mealtimes,” published in the Journal of Pain and Symptom Management (citations omitted):

Minimal Comfort Feeding (MCF)…is the provision of only enough oral nutrition and hydration to ensure comfort. With MCF, eating and drinking is not scheduled; rather, caretakers offer food and liquids only in response to signs of hunger and thirst. Patients are neither wakened for regular mealtimes nor encouraged to eat or drink. Instead, they are offered frequent, fastidious mouth care, continued social contact, therapeutic touch, sensory distraction, and medications to relieve distress associated with apparent thirst or hunger before being provided with minimal amounts of liquid or food.