Voluntarily stopping eating and drinking

Categories: Care.

If a hospice patient decides to forgo eating and drinking in order to hasten his or her own death, how should a hospice respond?

From a legal standpoint, “voluntarily stopping eating and drinking” (VSED) is an option for individuals in all 50 states and distinct from the natural reduction in nutritional intake that accompanies the dying process. It is a voluntary decision by patients with decision-making capacity, with the explicit intention of hastening death.1

While legal, however, the peer-reviewed literature does not reflect strong ethical consensus about whether, how, and for what reasons hospices should or should not participate in patients’ care decisions about VSED.

The NHPCO Ethics Advisory Council offers a case study and questions in the spirit of fostering robust discussion on this difficult ethical issue. The Council also encourages each hospice to explore these questions in their organizational ethics committees, with the ultimate goal of establishing a policy or guidelines to address VSED so staff is prepared when such situations arise. Some resources that may help inform these internal discussions are provided at the end of the available article (see link below).

Access the complete case study online.

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1 Quill, T. E., Lo, B., & Brock, D. W. (1997). A comparison of voluntarily stopping eating and drinking, terminal sedation, physician-assisted suicide, and voluntary active euthanasia. JAMA, 278(23), 2099-2104.

Members of NHPCO’s Ethics Advisory Council who worked on the case study are Patrick T. Smith; Elizabeth Collins; Tim Cox; Deborah Jacques; Bonnie Meyer; and Kate Pepin.

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