Voluntarily stopping eating and drinking

Résumé

Ideally, every patient with far-advanced illness would receive optimal palliative care and comprehensive psychosocial support such that few patients ever would wish to hasten their own death. Even in areas where excellent palliative care is widely available, however, some patients with terminal illness or complex chronic medical conditions experience suffering, loss of meaning, or deterioration in quality of life to the point where they express a readiness to die and a desire to expedite the dying process. There has been extensive discussion in both the political and bioethics arenas about the ethics of taking action to affirmatively hasten death under such circumstances and the propriety of clinicians participating in such efforts. Much of the discussion has focused on physician-assisted death (PAD) (also known as physician-assisted suicide), in which a physician provides the medical means that allow a patient to actively hasten the dying process. Less attention has been paid to the practice of voluntarily stopping eating and drinking (VSED) near the end of life. In this chapter, we discuss the practice of VSED, including the arguments in support of VSED as a legal and ethical way to hasten death when a patient with advanced illness is ready to die, the ethical distinctions between VSED and PAD, some of the benefits and disadvantages of VSED as a means of hastening death, safeguards that we believe clinicians should seek to enforce when patients consider VSED, and some of the practical challenges and potential limitations of the practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved) FIN-DE-VIE GRÈVE-FAIM SOIN-PALLIATIF SUICIDE-ASSISTÉ EUTHANASIE