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Voluntary Stopping of Eating and Drinking

Ralf J Jox, Isra Black, Gian Domenico Borasio, Johanna Anneser
BACKGROUND: Physician-assisted dying has been the subject of extensive discussion and legislative activity both in Europe and North America. In this context, dying by voluntary stopping of eating and drinking (VSED) is often proposed, and practiced, as an alternative method of self-determined dying, with medical support for VSED being regarded as ethically and legally justified. ARGUMENT: In our opinion, this view is flawed. First, we argue that VSED falls within the concept of suicide, albeit with certain unique features (non-invasiveness, initial reversibility, resemblance to the natural dying process)...
October 20, 2017: BMC Medicine
Mark Corbett
Conceivably, in an ideal world, all patients with a life-limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician-assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life...
2016: Narrative Inquiry in Bioethics
Wendy Kohlhase
No abstract text is available yet for this article.
2016: Narrative Inquiry in Bioethics
Lynn A Jansen
No abstract text is available yet for this article.
September 2015: Annals of Family Medicine
Vicki D Lachman
No abstract text is available yet for this article.
January 2015: Medsurg Nursing: Official Journal of the Academy of Medical-Surgical Nurses
Alfred Simon, Nina Luisa Hoekstra
No abstract text is available yet for this article.
July 2015: Deutsche Medizinische Wochenschrift
Ben White, Lindy Willmott, Julian Savulescu
Increasingly, individuals want control over their own destiny. This includes the way in which they die and the timing of their death. The desire for self-determination at the end of life is one of the drivers for the ever-increasing number of jurisdictions overseas that are legalising voluntary euthanasia and/or assisted suicide, and for the continuous attempts to reform State and Territory law in Australia. Despite public support for law reform in this field, legislative change in Australia is unlikely in the near future given the current political landscape...
December 2014: Journal of Law and Medicine
Suzanne van de Vathorst
Artificial nutrition is a medical treatment that first of all needs a sound scientific base before prescribing it. This base is absent for dying patients and patients in the end stage of dementia. Because feeding is a very emotional and symbolical issue, patient and family may request this treatment despite the lack of evidence. These issues should be addressed in good communication with patient and relatives. For comatose patients and patients in a persistent vegetative state artificial nutrition is a necessary support to bridge the time until either recovery is imminent or improbable...
April 2014: Best Practice & Research. Clinical Gastroenterology
Nataša Ivanović, Daniel Büche, André Fringer
BACKGROUND: The terminally ill person's autonomy and control are important in preserving the quality of life in situations of unbearable suffering. Voluntary stopping of eating and drinking (VSED) at the end of life has been discussed over the past 20 years as one possibility of hastening death. This article presents a 'systematic search and review' of published literature concerned with VSED as an option of hastening death at the end of life by adults with decision-making capacity. METHODS: Electronic databases PubMed, EBSCOhost CINAHL and Ovid PsycINFO were systematically searched...
2014: BMC Palliative Care
Kesinee Saranrittichai, Wiporn Senarak, Supannee Promthet, Surapon Wiangnon, Patravoot Vatanasapt, Supot Kamsa-Ard, Prasert Wongphuthorn, Malcolm Anthony Moore
This qualitative research within the project entitled "Multiprofessional Intervention and training for Ongoing Volunteer-based Community Health Programs in the Northeast of Thailand (MITV-NET) " was aimed at explaining changes of health behavior of community people in the Northeast after the intervention. The participants comprised 15 community volunteers and 27 villagers. Data were collected by indepth interview, focus group discussion, participation and non-participation observation, and note taking. Analyses were conducted in parallel with data collection, through content and comparative analysis...
2012: Asian Pacific Journal of Cancer Prevention: APJCP
Zail S Berry
Voluntary stopping of eating and drinking (VSED) as a legal means to hasten death has been discussed by some as an option for persons who wish to end their lives. A case is presented of a woman who elected to forgo eating and drinking to end intractable suffering. The potential for benefit and harm in physicians discussing VSED is discussed. Physicians working with terminally ill patients need to consider the discussion of VSED as a therapeutic tool in their support and care of patients with intractable suffering...
November 2009: Journal of Pain and Symptom Management
W J Scott
1. The majority of rats (Mus norvegicus), because of accessory cortical tissue, will survive double adrenalectomy indefinitely under optimum conditions. 2. Resistance to morphine is greatly diminished in healthy adrenalectomized rats tested before hypertrophy of the accessories occurs. 3. This greater sensitiveness seems to be due to some fundamental alteration in metabolism dependent on a partial adrenal insufficiency. Protocol 1.-Rat 13; brown and white, male. Sept. 15, 1922. In stock. Sept. 18. Active, vigorous, and very vicious...
October 31, 1923: Journal of Experimental Medicine
Lynn A Jansen
In recent years, a number of writers have proposed voluntary stopping of eating and drinking as an alternative to physician-assisted suicide. This paper calls attention to and discusses some of the ethical complications that surround the practice of voluntary stopping of eating and drinking. The paper argues that voluntary stopping of eating and drinking raises very difficult ethical questions. These questions center on the moral responsibility of clinicians who care for the terminally ill as well as the nature and limits of the authority they exercise over them...
February 2004: Journal of Medicine and Philosophy
Karen L Rich, Janie B Butts
BACKGROUND: The ambiguities involving end-of-life issues, such as physician-assisted suicide and voluntary stopping of eating and drinking, have caused a blurring of the definition of rational suicide and have prompted rich dialogue with moral deliberations that seem to be on disparate paths among bioethicists and other health care professionals. With the evolution of advanced medical technology extending life expectancy in older, disabled, and terminally ill people, rational suicide has become a critical issue of debate...
May 2004: Journal of Advanced Nursing
R T Koopmans, I P Sindram, W J Dekkers
Refusal of food and/or fluids frequently occurs in nursing home patients. If the patient's decision to stop eating and drinking has been taken consciously and with due consideration of the consequences, it is referred to in Dutch as 'versterven'. A mentally competent, 73-year-old male nursing home patient suffering from progressive supranuclear palsy wished, in order to prevent further suffering, to end his life by taking sleeping tablets that he had saved up and by refusing artificial food and liquids. This wish met with a lot of legal and moral objections from the board of directors of the nursing home as well from experts consulted by the nursing home physician...
March 13, 2004: Nederlands Tijdschrift Voor Geneeskunde
Linda Ganzini, Elizabeth R Goy, Lois L Miller, Theresa A Harvath, Ann Jackson, Molly A Delorit
BACKGROUND: Voluntary refusal of food and fluids has been proposed as an alternative to physician-assisted suicide for terminally ill patients who wish to hasten death. There are few reports of patients who have made this choice. METHODS: We mailed a questionnaire to all nurses employed by hospice programs in Oregon and analyzed the results. RESULTS: Of 429 eligible nurses, 307 (72 percent) returned the questionnaire, and 102 of the respondents (33 percent) reported that in the previous four years they had cared for a patient who deliberately hastened death by voluntary refusal of food and fluids...
July 24, 2003: New England Journal of Medicine
T E Quill, B C Lee, S Nunn
Comprehensive palliative care, as exemplified by many state-of-the-art hospice programs, is the standard of care for the dying. Although palliative care is very effective, physicians, nurses, patients, families, and loved ones regularly face clinically, ethically, legally, and morally challenging decisions throughout the dying process. This is especially true when terminally ill patients are ready to die in the face of complex, difficult-to-treat suffering and request assistance from their health care providers...
March 21, 2000: Annals of Internal Medicine
T E Quill, B Lo, D W Brock
Palliative care is generally agreed to be the standard of care for the dying, but there remain some patients for whom intolerable suffering persists. In the face of ethical and legal controversy about the acceptability of physician-assisted suicide and voluntary active euthanasia, voluntarily stopping eating and drinking and terminal sedation have been proposed as ethically superior responses of last resort that do not require changes in professional standards or the law. The clinical and ethical differences and similarities between these 4 practices are critically compared in light of the doctrine of double effect, the active/passive distinction, patient voluntariness, proportionality between risks and benefits, and the physician's potential conflict of duties...
December 17, 1997: JAMA: the Journal of the American Medical Association
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