Friday, October 21, 2016

Thoughts and Experiences with VSED (Voluntary Stopping Eating and Drinking)

There is increasing public discourse and debate about the ethics of ending one's life "in a dignified manner" when entering its terminal phase. But what if one is not terminal, yet finds themselves in an intolerable condition and wants to die?

Recently at the Seattle University Law School a remarkable two day symposium was held bringing together the leading national thinkers in this area - along with personal stories from real time experiences. These have be summarized in the "Narrative Inquiry in Bioethics" - the summer 2016 issue.

Paula Span from the NYT was a speaker and reports her take on the conference. "In end-of-life circles, this option is called VSED (usually pronounced VEEsed), for voluntarily stopping eating and drinking. It causes death by dehydration, usually within seven to 14 days. To people with serious illnesses who want to hasten their deaths, a small but determined group, VSED can sound like a reasonable exit strategy.

"Unlike aid with dying, now legal in five states, it doesn’t require governmental action or physicians’ authorization. Patients don’t need a terminal diagnosis, and they don’t have to prove mental capacity. They do need resolve. “It’s for strong-willed, independent people with very supportive families,” said Dr. Timothy Quill, a veteran palliative care physician at the University of Rochester Medical Center."

My view: VSED, no doubt, has been with us since the beginning of time and may be much more common than we realize. A particular problem is dementia. With the aging population dementia is a distinct feared reality which will affect 30% of us above age 90. VSED appears to be a viable moral option for some people but, that said, there is a need more study and research. An additional problem is the length of time VSED takes and the varying control of suffering.

Systems will need to develop for education and support. Hospice and Palliative Care will need to have their positions enhanced to include VSED. Medical and nursing groups will need to develop a caring stance. So there's lots to be done. The conference at Seattle University Law School provides a landmark introduction to help us begin to understand the future of VSED.

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