How Should a Catholic Hospice Respond to Patients who Choose to Voluntarily Stop Eating and Drinking in Order to Hasten Death?

Abstract

The practice of voluntarily stopping eating and drinking (VSED) in order to hasten death poses a unique problem for the Catholic hospice. Hospice staff may be confronted with patients already on their service who decide to pursue this option for ending their lives. Patients not on hospice service who are contemplating VSED are often advised to contact hospice for symptom palliation associated with the process of VSED. Intentionally hastening death not only violates the sanctity of human life and the Ethical and Religious Directives the Catholic hospice is bound to uphold, but it also runs counter to the general philosophy that hospice neither hastens nor postpones death. At the same time, hospice programs have a strong philosophy of nonabandonment of patients. This article will analyze the ethical issues from the perspective of the Catholic tradition and suggest strategies for the Catholic hospice to respond to this group of patients.

Development of a Questionnaire to Determine Incidence and Attitudes to “Voluntary Stopping of Eating and Drinking”

“…One option is through “voluntary stopping of eating and drinking” (VSED). This method occurs when a capable and informed person deliberately stops oral intake with the intention of shortening their lifespan ( Haller, 2014 ; Klein Remane & Fringer, 2013 ), saving themselves from unacceptable suffering ( Black & Csikai, 2015 ; Cavanagh, 2014 ; Ivanović, Büche, & Fringer, 2014 ; Pope & West, 2014 ). During the dying process caused or accelerated through VSED, which can take up to 3 weeks ( Bolt et al., 2015 ; Chabot, 2012 ; Ganzini et al., 2003 ; Ivanović et al., 2014 ; Klein Remane & Fringer, 2013 ; Lachman, 2015 ; Quill, Lee, & Nunn, 2000 ; Simon & Hoekstra, 2015 ), the patient is dependent on help from relatives, as well as medical and nursing support ( Bolt et al., 2015 ; Klein Remane & Fringer, 2013 ; Lachman, 2015 ).…”

Voluntary Stopping of Eating and Drinking in Swiss Outpatient Care

“…Since then, a further end-of-life practice was established in Switzerland and included in the guideline “Management of Dying and Death” of the Swiss Academy of Medical Sciences (2018), namely, the voluntary stopping of eating and drinking (VSED). VSED has become a relevant issue in some Western societies over the last 30 years for people who wish to die independently from health and medical systems and to maintain autonomy until death (Berry & Marcus, 2000; Cavanagh, 2014; Ganzini et al, 2003; Harvath et al, 2004; Ivanović et al, 2014; Norberg et al, 1988; Quill et al, 1997; Radbruch et al, 2019). International studies show that VSED cannot be considered an isolated phenomenon.…”