An end run around the letter of the law
A government agency in the state of Washington state has created an advance directive for patients who prefer to waste away through thirst and starvation than live with dementia.
End of Life Washington, which promotes the state’s 2009 Death with Dignity Act, recently posted “Instructions for Oral Feeding and Drinking” on its website.
The document provides a two-page template with instructions for caregivers not to provide oral food or fluids under certain circumstances. The instructions are not legally binding and can easily be overridden. But if neither the caregivers nor the nursing home objects, the instructions would probably be heeded.
“No matter what my condition appears to be, I do not want to be cajoled, harassed or forced to eat or drink,” the document says. A “reflexive opening” of the mouth should not be interpreted as consent to eating.
The problem, from End of Life Washington’s point of view, is that current legislation does not permit assisted suicide for non-competent persons. Furthermore, the Act states that the patient must have only six months to live, while dementia patients can linger on for years. Voluntary stopping of eating and drinking (often called VSED) is a way to get around a significant restriction imposed by the Act. It’s odd that it is being promoted by a state agency entrusted with promoting the Act.
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