VSED Definedįor many years, it has been a settled issue in both law and ethics that an adult with decision-making capacity who is unable to take food and fluids by mouth has the right to refuse nutrition and hydration by medical means (usually a feeding tube), even if doing so will has ten death. 3 Because VSED is an available option, physician disclosure and discussion of its availability may be both necessary and appropriate for fully informed decision-making.īecause of the growing interest in VSED and because there are many unanswered legal, ethical and practical questions about it, we discuss this practice in some detail below. Possibly it is a consequence of Vermont’s Patient’s Bill of Rights, which now requires that patients with terminal illness be informed of “all available options for terminal care,” regardless whether they make an inquiry. Possibly, this is attribut able to legalization of Physician-Assisted Dying (PAD) in Vermont, as people seek alternatives. VEN is receiving increasing inquiries about VSED. 1 Often overlooked in physician-patient conversations about end-of-life options, VSED is nonetheless practiced here, 2 sometimes in combina tion with other end-of-life care. While not widely discussed in the medical or legal literature, this method of hastening death is legal in Vermont and in all other states. For these patients, as well as those with advanced illness, Voluntary Stopping of Eating and Drinking (VSED) is an available option. Sometimes despite a physi cian’s best efforts to address the sources of the patient’s suffering, a satisfactory solution cannot be found. While palliative care is available to all who suffer from serious illness, it is not a panacea. In this category are illnesses such as ALS (Lou Gehrig’s Disease), Huntington’s, AIDS, quadriplegia, dementia and can cers not yet at end stage, to name a few. Maybe the illness is not yet far enough advanced to qualify for hospice or PAD, or there is little pain but great suffer ing at the prospect of future decline. Others have a termi nal diagnosis, but there are no treatments to decline or machines to disconnect. Some people suffer from a devastating illness or from multiple chronic ailments that seriously compromise quality of life but are not terminal. Some have the option to stop or not start unwanted life-sustaining treatments, and for others, Physician-Assisted Dying (PAD) is now an option.īut not all who suffer from debilitating or progressive illness have these options. For those whose suffering is primarily physical, good palliative care is often the best choice. The question of how to respond to intractable suffering in patients with debilitating and life-limiting illness has no easy answers. ![]() The following content is based on an article by Cathy Suskin that originally appeared in the Winter 2015 issue of our Health Decisions newsletter. Voluntary Stopping of Eating and Drinking (VSED) Building Capacity & Supporting Health Care Workers. ![]() Allocating Scarce Resources: Model Policies & Additional Guidance.Ethics & Policy Considerations for Reopening the Economy.Resources for Health Care Providers & Facilities.Hospice & Palliative Care Services During COVID-19.COVID-19: Ethics Considerations & Resources.Voluntarily Stopping Eating and Drinking.
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