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Voluntary Stopping Eating and Drinking.
John W Wax1, Amy W An1, Nicole Kosier1
1Palliative Care Division, Department of Medicine, University of Rochester Medical Center, Rochester, New York.
Journal of the American Geriatrics Society
|March 14, 2018
Summary
Voluntary stopping of eating and drinking (VSED) is a deliberate choice to hasten death when suffering is intolerable. Experienced clinical guidance is crucial for managing VSED
Area of Science:
- Medical Ethics
- Palliative Care
- End-of-Life Studies
Background:
- Voluntary stopping of eating and drinking (VSED) is a self-initiated method to hasten death.
- Individuals considering VSED often have significant illness burden and value independence.
- VSED presents unique ethical and legal considerations compared to other end-of-life options.
Purpose of the Study:
- To propose a structured system for VSED evaluation and management.
- To provide guidance on assessing patient appropriateness for VSED.
- To outline symptom management strategies during VSED.
Main Methods:
- Literature review on VSED.
- Analysis of ethical and legal aspects of VSED.
- Development of a proposed clinical management framework.
Main Results:
- VSED is an intense process with potential somatic and emotional suffering.
- Common symptoms include thirst, hunger, dysuria, disability, delirium, and somnolence.
- Clinical supervision is recommended for assessment, guidance, and symptom management.
Conclusions:
- VSED requires careful screening for psychiatric conditions, symptoms, and coercion.
- An organized approach to VSED evaluation and symptom management is proposed.
- Experienced clinical support is vital for individuals undergoing VSED and their caregivers.
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