Overview

"In the 21st century, people in the developed world are living longer. They hope they will have a healthy longer life and then die relatively quickly and peacefully. But frequently that does not happen. While people are living healthy a little longer, they tend to live sick for a lot longer. And at the end of being sick before dying, they and their families are frequently faced with daunting decisions about whether to continue life prolonging medical treatments or whether to find meaningful and forthright ways to die more easily and quickly. In this context, some people are searching for more and better options to hasten death. They may be experiencing unacceptable suffering in the present or may fear it in the near future. But they do not know the full range of options legally available to them. Voluntary stopping eating and drinking (VSED), though relatively unknown and poorly understood, is a widely available option for hastening death. VSED is legally permitted in places where medical assistance in dying (MAID) is not. And unlike U.S. jurisdictions where MAID is legally permitted, VSED is not limited to terminal illness or to those with current decision-making capacity. VSED is a compassionate option that respects patient choice. Despite its strongly misleading image of starvation, death by VSED is typically peaceful and meaningful when accompanied by adequate clinician and/or caregiver support. Moreover, the practice is not limited to avoiding unbearable suffering, but may also be used by those who are determined to avoid living with unacceptable deterioration such as severe dementia. But VSED is ""not for everyone."" This volume provides a realistic, appropriately critical, yet supportive assessment of the practice. Eight illustrative, previously unpublished real cases are included, receiving pragmatic analysis in each chapter. The volume's integrated, multi-professional, multi-disciplinary character makes it useful for a wide range of readers: patients considering present or future end-of-life options and their families, clinicians of all kinds, ethicists, lawyers, and institutional administrators. Appendices include recommended elements of an advance directive for stopping eating and drinking in one's future if and when decision making capacity is lost, and what to record as cause of death on the death certificates of those who hasten death by VSED."

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9780190080730

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Reviews

This book is of high quality and useful in areas of the country where VSED is not common or where demand is increasing. While other books on this topic have been published, this one is most up to date and exhaustive in describing the ethical, legal, and practical considerations. * Leah D Ward, Doody * This is an extremely well-organized, practical guide to the available options for self-determination with respect to experiencing a peaceful death. * E.R. Paterson, CHOICE Connect, Vol. 59 No. 8 * This book is an essential resource for those exploring their options for palliative care. It provides authoritative advice and wisdom about whether and how to voluntarily stop eating and drinking, a path that that may be the best choice for some who are approaching the end of their lives. * Robert Truog, Director, Harvard Center for Bioethics * Much attention has been directed to Medical Assistance in Dying (MAiD) as a means of hastening death for persons with serious and debilitating medical conditions, yet other methods such as Voluntarily Stopping Eating and Drinking (VSED) have flown under the radar. This volume is an important and timely remedy for that neglect.Many who do not qualify for MAiD or find it unacceptable may wish to consider VSED as an alternative means of hastening their death. VSED also raises a number of important clinical ethical and legal issues, especially when stipulated through an advance directive. These issues are thoroughly explored in this excellent volume. For anyone interested in end-of-life options, this is a must read. * Wayne Sumner, University Professor Emeritus, University of Toronto *

This book is an essential resource for those exploring their options for palliative care. It provides authoritative advice and wisdom about whether and how to voluntarily stop eating and drinking, a path that that may be the best choice for some who are approaching the end of their lives. * Robert Truog, Director, Harvard Center for Bioethics * Much attention has been directed to Medical Assistance in Dying (MAiD) as a means of hastening death for persons with serious and debilitating medical conditions, yet other methods such as Voluntarily Stopping Eating and Drinking (VSED) have flown under the radar. This volume is an important and timely remedy for that neglect.Many who do not qualify for MAiD or find it unacceptable may wish to consider VSED as an alternative means of hastening their death. VSED also raises a number of important clinical ethical and legal issues, especially when stipulated through an advance directive. These issues are thoroughly explored in this excellent volume. For anyone interested in end-of-life options, this is a must read. * Wayne Sumner, University Professor Emeritus, University of Toronto *

Author Information

"Timothy E. Quill, MD is Professor of Medicine, Psychiatry, Medical Humanities and Nursing at the University of Rochester Medical Center (URMC). He was Past President of the American Academy of Hospice and Palliative Medicine, the Founding Director of the URMC Palliative Care Program, and the initial Director of the URMC Schyve Center for Biomedical Ethics. Dr. Quill is the author of ""Death with Dignity: A Case of Individualized Decision Making"" (1991) in the New England Journal of Medicine, and he was the lead physician plaintiff in the New York legal case challenging the law prohibiting physician-assisted death heard in 1997 by the U.S. Supreme Court (Quill v. Vacco). He is the author of 8 books and over 150 peer reviewed articles on various aspects of palliative care, hospice, primary care, medical ethics, and end-of-life policy. Paul T. Menzel, PhD is Professor of Philosophy emeritus, Pacific Lutheran University. He has published widely on moral questions in health economics and health policy, including Strong Medicine: The Ethical Rationing of Health Care (OUP, 1990), and (as co-editor) Prevention vs. Treatment: What's the Right Balance? (OUP, 2011). He has been a visiting scholar at Kennedy Institute of Ethics, Rockefeller Center-Bellagio, Brocher Foundation, Chinese University of Hong Kong, and Monash University. He is a member of the Advisory Board of The Completed Life Initiative and serves on The Hastings Center's work group for its project on Dementia and the Ethics of Choosing When to Die. Thaddeus M. Pope, JD, PhD, HEC-C is Professor of Law at Mitchell Hamline School of Law in Saint Paul, Minnesota. A foremost expert on medical law and clinical ethics, he maintains a special focus on patient rights and healthcare decision-making. Ranked among the Top 20 most cited health law scholars in the United States, Professor Pope has over 225 publications in leading medical journals, bioethics journals, and law reviews. He co-authors the definitive treatise The Right to Die: The Law of End-of-Life Decisionmaking (Wolters Kluwer, 2020), and he runs the Medical Futility Blog (with over four million page-views). Prior to joining academia, he practiced at Arnold & Porter and clerked on the U.S. Court of Appeals for the Seventh Circuit. Judith K. Schwarz, PhD, RN is the Clinical Director of End of Life Choices, New York. She has for many years provided end-of-life consultation to New Yorkers and callers from other states who seek information about options and choices that permit personal control of the circumstances and timing of death. In addition to publishing in nursing and ethics journals, she provides frequent lectures about end of life decision making to lay and professional audiences. Working with legal and palliative care colleagues, she developed the End of Life Choices New York Dementia Directive which has been completed by hundreds of New Yorkers."

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