Voluntarily Stopping Eating and Drinking
compassionandchoices.org
compassionandchoices.org
If you go through hospice with someone please discuss the options before the end. I wish i had asked her for her wishes beforehand because when she was weak it was hard to know how lucid she was, and the grief clouds your judgement.
> If you go through hospice with someone please discuss the options before the end.
I'll expand on this and say that pretty much all adults should consider making a living will, or at least having discussions about what you want for end-of-life care if you're incapacitated. Do it for yourself, but also do it for your loved ones -- if they're ever in the position where they have to make those decisions for you, it's going to be hard enough for them already. At least knowing what your wishes are can help alleviate a lot of the stress in the moment, but also a lot of the guilt that can last much much longer.
If someone is dying of cancer in age care, they're in great pain, in out of consciousness etc, it is quite common for an overdose of morphine to be delivered by a nurse once family have had a chance to visit.
The nurse will state something like "we delivered pain relief but their body couldn't take any more".
Not all situations are the same, but a lot of ways of dying are very painful. Many grieving families are often not in a position to make a decision or even really understand how to have a conversation about it.
I wish that as a society we could be broadly more open and realistic about this.
My wife had cancer. She told me if she decides to leave the hospital I should accept her wish. I promised her that I would care for her as long I have the strength. We got oxycodone after the second surgery when we returned home. Half a year later she had complications, a third surgery got neccessary. Luckily the outcome was better. No remission up to today, three years later.
We don't have oxycodone anymore. When I told my wife today she could stop eating she seemed relieved. She said she wants to avoid hospital in case of a remission and would prefer to die at home. We had long discussions and they were useful. I as her husband know now what to do for her. I got her to write a declaration of her free will on a sheet of paper.
We are lucky today. We are still ready to let it go if neccessary.
She was starting (barely) to lose her marbles but the real issue was that, at 97, she had outlived all her friends! Also she had moved into an old age home a year before, and didn’t rally like being around, in her words, “old people”. Eventually she decided she was really just hanging around waiting for a centennial letter from the Queen, and that wasn’t worth waiting for.
It’s not like she did’t have family: a couple of her kids, many of her grandkids and great grandkids, but though she had a visitor pretty much every day, everybody younger was busy doing stuff and she felt like she was in their way.
This issue of out living everybody you know is a bit haunting.
There is very little quality of life and very little sense in being alive in a hospice, surrounded by strangers, hooked up to machines, living a lonely existence.
In the old days we just let them wander off or wallow in bed until they died.
I hope for significant automation (robots) in future so he family members can spend there time on the good stuff: actually being with the parent.
When my mother in law died (at 60, cancer) she died in the same room she’d been born in. The German social services (e.g. Diakonie) provided enough support that her daughters had minimal bedpan-changing and maximal social interactions with their mum, at least until she was too far gone.
There is. I thing like that with the inhumane system in the USA.
What I have understood of western culture is that independence has a very high value. Even when parents/grand parents are old and weak, they still want to stay independent or let their children remain independent. And children probably think that its best for old and weak parents/grand parents to get better care in dedicated places.
Where I am from, they would prefer being with their kids at that stage rather than being sent somewhere away from everyone they knew. There are care homes for people, but generally for different reasons (abandonment because of poverty or other domestic issues as I remember seeing an interview).
It's pretty common to see the older generation torpedo the relationship with their adult children by basically just abandoning them to work out the early stages of adulthood and marriage on their own.
Then, 20 years later when they're lonely and riddled with health problems, they come crawling back and wonder why their children don't want anything to do with them.
In the East, parents sacrifice pretty much everything for their kids. They watch over them and will do anything i.e selling their homes/draining retirement accounts or working extra hard so the kids can go to really good schools, have downpayment for their first homes etc. Here what is valued is community.
But as the society keeps evolving things are changing in the East as well. We are slowly becoming westernized as well.
There is nothing wrong with either approach. It depends on which culture you are born and brought up in.
It’s like a switch flips. You’re independent now so magically you can handle all that entails.
Don’t ask me, figure it out yourself.
But what you are saying here is that kicking out actually happens. If kids don't move out, the parents will force them to. Are kids raised as a fixed 18 year job? That's weird if true.
I guess my point was that the big 20+ year break in responsibility, which is initiated by the parents, will turn around and bite them in the arse when they themselves become dependent on their children.
Edit: I find it very interesting that some people react negatively to this sentiment. Surely we can understand and respect that people hold different values and desires with respect to death.
I think I would rather do it than morphine.
There is no legally mandated death by dehydration.
Ironically guns on the other hand...
There's a surprising sentiment in this thread of hostile Judgment of people with different opinions on how they personally would like to go out.
That's not to say there aren't people dealing with it, it's just that I don't spend a lot of time communicating with them.
Phrases like 'passed peacefully in his sleep' is often code for 'the patient was terminal, so we upped the pain meds to reduce their pain'
To see a person live til they were 80...experiencing and then bouncing back from the injuries you get when your body gets frail, then see them pass when multiple subsystems just give up all at once....is a thing...and some people die at 50 and other's are still trucking along at 104.
I'm not saying it needs to be an ad campaign and reality show network....but we DON'T talk about it, and really should.
There was a time where nearly everyone died in their home in front of their family. By the time you were old, you would have had many intimate exposures to death, watching your family and perhaps friends go.
Today, most US deaths occur in hospitals with few family in attendance.
I think this drastically changes how people view death, mortality, and their own lives.
Dying from dehydration is quite painful. And there is big chance person will not finish it. They "give up" on giving up (pun intended) and break water fast after a few days. On top of old illness, they may get damaged liver, preexisting kidney stones will manifest, hypoglycemic reaction, all sorts of nasty allergies... Amazing way to make a few remaining months even less pleasant!
It seems clear to me you have never seen this procedure done. It was rather traumatic for me having to be one of the people responsible for the final caregiving (it does not seem logical to provide such comforts as small water or medicine to someone committed to dying) but it was important for closure. I hope you dont have to witness it or make this choice yourself.
Personally, I find doctor assisted suicide to be both unethical and amoral. While people may disagree with me I see no difference between MAID and paying someone to hang you as instantaneous death is guaranteed in both ways and it is done by a sanctioned murderer. VSED is entirely in the dying person's control, and thus to me is not unethical nor amoral as the control of life is in the person who owns that life.
If relative asked me to help with this, I would just get an illegal gun with all the risks. Much safer!
I am pretty sure in my country (EU) this would be qualified as domestic abuse. Not giving water to senior who can not communicate is gross neglect, probably 2 years in prison. Nobody can simply consent to this, no matter how much paper work you fill in.
And dry fast may trigger all sort of illnesses. If they terminate fast, you end with senior who needs way more care. Kidney stones are particularly painful, and may be unrepeatable at advanced age!
Lock them up and force feed them?
On 4th day person would get fewer, passes out... Skin tone changes... Everyone would be able to see this was not normal death. Coroner will have question why you did not call an ambulance... and left him there for days...
Really, gun is so much easier option. It is easy to make video that proves who pulled the trigger.
Even if it is painful, it is still their right to choose.
Your opinions are also not reflected in medical studies and surveys of hospice nurses[1][2].
I get where you're coming from about having problems with the tone of the website, and that it doesn't say "this is a nasty way to die, it's going to feel awful". But on the other hand it's trying to push for self autonomy in an area where it's criminalised.
Really laws need to change to give people options.
This charade with dry fast is way more risky for care giver. Takes several days and person would be passed out for a long time. It is like hodling your breath to die...
Yes, I understand the differences between one causing the other and in the other instance not, but it doesn't change the end results(being force fed).
I can think of examples of incredible torture that people have had imposed on them, I just don't see the relevance of the fact that it has been done before.
I'd much rather go with nitrogen or barbituates.
Check out The Peaceful Pill handbook for an overview of other options.
And please make sure to have these conversations with your loved ones or leave a clear last will and living will / poa. There's no reason to leave people burdened with confusion and uncertainty about what you would have wanted.
He had had a stroke and was stuck in the hospital knowing that he would never sculpt again due to partial paralysis. He just refused all food and water, and that was it.
I remember the friend being upset and angry(I guess - hard to describe it) about this.
Literature targeting families reassures them that despite jerking, moaning, and death rattles, their loved ones are not suffering, but hospice providers have very good reasons to want families to believe that. Just now, I found this study that concludes that caregivers are awful at detecting pain in the dying:
> Agreement between caregivers' subjective assessments and objective neurophysiological measures of consciousness and pain was very poor.
> Conclusions: Caregivers' subjective assessment of level of consciousness and pain during CSD is unreliable compared with objective neurophysiological monitoring. Our results suggest that assessments of patient comfort during CSD could have been improved substantially by including objective monitoring of level of consciousness and pain. [1]
In my opinion, it's outrageous that more research and effort is not made to ensure our hospice care is actually effective in giving patients a painless death. Current practices have similar scientific rigor to blood-letting.
Aren't these inherently contradictory? A person with dementia may not make voluntary decisions. But I overall support assisted suicide. I think it's another option that can lower healthcare costs, reduce suffering.
It’s a bit like the mismatch in tone when there’s a powerpoint/hype video for a particularly gruesome anti-personnel weapon.
In this uninterruptible meditative state of mind and body , the meditative State can last any desirable amount of time but up if one didn't rise up by 7th day, the one is considered liberated.
I had witness first hand while attending to care my mentor head monk's last moments who was 92 years old .
In our tradition , enlightened one notifies his yogis if he decides to enter Final Niroda Samapatti, if nobody protests, he can enter.
He notified first time while he was 90 years old, at that time he is very healthy, can still teach meditation well. At his first notification, followers beg him not to so, he continues then at 91 years old he started to fall sick and need to attend hospital, for the first time in his life. At the hospital then he notified for second time, but followers cried, beg him not to.
Also he met a lot of new potential yogi which he wanted to train meditation who are nurses and doctors who cared for him so he decided to wait till they can join meditation center. He said many of them could be enlightened, he mentored them as soon as he was discharged for 2 months, and then he fell sick again , this time his kidney is failing, he have UTI and need dialysis.
After dialysis ,all his vitals are good, heart rate fine, pressure is fine , he is well conscious, then he ordered all non-monk followers to leave hospital. Only doctor couple who are deciples and 11 monk , who are his disciples meditation mentors , who going to become his successors and after leaving them messages he entered Niroda Samapatti ,the doctor observed his pressure and heart rate was all fine and then after a few minutes of meditation they all drop to zero, they were ordered not to disturb or revive his meditation.
He entered final liberation peacefully. He was carried back to his monastery and kept there 7 days, which the max days a enlightened being can enter Niroda Samapatti state.After that is considered one had permanently liberated.
Before he entered Niroda state, He ordered that after 7th day he can be cremated.
For whole 7 day I had been there. And his body only started to decompose after 7th days.
Followers still want to wait and protested cremation on 7th day so we had to wait till 14th day.
This is final goal of Buddhism, the ultimate end of suffering on own term, peacefully.
https://www.oxfordreference.com/display/10.1093/oi/authority...
https://www.palikanon.com/english/wtb/n_r/nirodha_samaapatti...
My guess is the underlying strategy is to get voluntarily-not-eating-or-drinking widely accepted both legally and culturally, and then leverage suffering-reduction to introduce more humane methods. I hope it works. We de-facto torture people at the end of their lives, for no reason, and it's fucking awful [1]. We're more humane to our pets than to ourselves.
1: https://slatestarcodex.com/2013/07/17/who-by-very-slow-decay...
I had a cop completely fabricate a story I had ingested a bunch of drugs and he dragged me to the hospital in cuffs. I was stone cold sober and they documented I was fully alert and oriented and had denied consent, but I got cussed out by a nurse for denying consent and then she started touching and performing medical care on me anyway. I complained to the state board and my complaint was summarily denied on the basis the nurse can do whatever she likes as medical care providers actually do not have any legal duty to respect consent of patients, even when there is no court order.
I really walked away with that with the conclusion you have precious little choice over your medical care, and your care providers will do whatever they like and you have little choice even to deny it.
> Because healthcare providers have not respected patient rights to autonomy and bodily integrity and courts have not vindicated violations of these rights, legislative change is necessary[1].
I know someone whose young child was vaccinated against their parents' will at a public school. Lawyers told them they didn't have any recourse unless they could show some harm was done. I'm pro-vaccine, but the idea that my child could come home from school one day having had a medical procedure performed on them without my knowledge or consent is disturbing.
1. https://elibrary.law.psu.edu/cgi/viewcontent.cgi?article=145...
As to your question:
There are legal... nuances everywhere. The most important is what the subject should be, in the eyes of the law, sane. The second one, for US, is what the doc/clinic shouldn't be targetable for the absence of care lawsuit. The third one is what if the state recognizes DNR requests.
Overall, force feeding is the tool of psychiatric clinics and oppressive, tyrannic governments. Sometimes the former is needed, eg there is a manic episode but overall the person is quite stable and have a high chance of recovery. The latter...
In the end stages of dying, it's a common but obviously little-talked about process to give patients quite a bit of opiates - not enough to kill outright from OD, but enough to ease suffering significantly while also hastening death.
Just give them enough fentanyl to go out happy and let them be. Starving yourself to death or dying of thirst seems extremely cruel.