Sunday, 1 June 2014

Pushing Starvation as “Death with Dignity”

Wesley Smith writes in his blog about starvation as a method of deliberate killing. It is this kind of occurrence that can easily allow people to consider that Advance Care Planning is a sinister device promoting such outcomes. However, this is not the experience in Australia and, while such plans do present some difficulties, well prepared plans can certainly provide for peace of mind and appropriate care and cannot, in Australia at least, include any directives that are unlawful.

Pushing Starvation as “Death with Dignity”

by Wesley Smith

The “death with dignity” and bioethics crowds grow increasingly extreme. Now, they are pushing starvation.

First, it was removing feeding tubes from the cognitively disabled, slow killing excused as removing medical treatment. Do it to a dog and go to jail. Do it to Terri Schiavo and it’s merely “medical ethics.”

Now, euthanasia types push VSED, e.g. voluntary stop eating and drinking. Not only that, they want nursing homes and hospitals to be forced to starve dementia patients to death who willingly eat.
I’m on the case in my biweekly column over at First Things. From, “Starvation as the New Death with Dignity:”

But what about people who can eat and drink by mouth? Assisted suicide advocates argue that it isn’t fair that they can’t die too. So, activists promote a form of “self-deliverance” that they call “voluntary stopping eating and drinking,” (VSED), by which suicidal people declare their wish to starve to death.
As a matter of respecting autonomy, doctors won’t force feed these suicidal people. Some even agree to facilitate the death by helping palliate the potential agony that can be associated with starving and dehydrating.

I believe a doctor who helps someone starve him or herself to death is akin ethically to one who helps a suicidal person find the artery to cut and guides the scalpel.

A lawsuit was filed to force a nursing home in Canada to starve a dementia patient to death. That lost and is on appeal. But the drive to force medical personnel to starve patients to death who eat, if they so instructed in an advance medical directive, was boosted recently in the Hastings Center Report:

Bioethicist Paul T. Menzel and physician M. Colette Chandler-Cramer create a sophistic argument to justify their conclusion: People have the right to commit VSED; people also have the right to refuse life-sustaining treatment in an advance medical directive; hence, people have the right to order themselves starved to death (commit VSED via advance medical directive).
Here’s the thing: They are called an “advance medical directive,” for a reason–to control medical interventions. But spoon feeding isn’t a “medical treatment!”
Spoon-feeding is considered “humane care”—not the same thing at all. Thus, under Menzel and Chandler-Cramer’s theory, a patient should also be empowered to order the non-medical withholding of other forms of humane care to hasten their deaths.
For example, why not permit a directive to order that blankets be removed during a cold snap to increase the chances of contracting pneumonia? Less certain, to be sure: But basically the same idea.
The advocacy point of the starve-them-to-death campaign should be obvious to all:
Finally, once we can starve patients, even though they willingly eat, the obvious question arises: “Why not just give them lethal injections?”
Actually, I believe that has been the goal all along. The starvation agenda is merely the horrid means intended to lead us to that horrible end.
Culture of death, Wesley? What culture of death?


  1. "I believe a doctor who helps someone starve him or herself to death is akin ethically to one who helps a suicidal person find the artery to cut and guides the scalpel."

    Well, isn't a doctor who helps a patient die by giving morphine in increasing doses whilst not feeding or watering them (just moistening the inside of the mouth with a damp sponge) doing exactly the same thing? This procedure results in certain death in a few days. As I understand it, the no-euthanasia fraternity is quite ok with it. Australian Prime Minister Tony Abbott said in an interview that this is a practical option and there is no therefore no need for active euthanasia. So I am not sure what Wesley is saying here.

  2. Your last point is painfully obvious. No, when a patient is actually and evidently dying (last days/hours) feeding and hydrating is not only pointless, it can also be cruel.