My mother did this when her cancer got too bad. She was strong willed but in end, some of her last words were asking me to give her an OD of the morphine in her hospice kit.
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.
Euthanasia is much more common than usually admitted.
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.
> 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.
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.
My grandmother chose to do this because euthanasia wasn’t legal in South Australia.
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.
In some cultures, this is the way. You live by their side (or they with you) till their last moments. Where I am from, old people in the family are generally considered a blessing. Same is for parents. Taking care of parents/grand parents is part of process/life.
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).
As someone who was born and raised in the West, I think it's a little bit more than just valuing independence.
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.
That is part of western culture. From the east, we see it as valuing independence.
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.
I think what OP was referring to is the lack of compassion and empathy when the children move out. It’s often poorly done; permanently damaging the relationship between parents and children.
It’s like a switch flips. You’re independent now so magically you can handle all that entails.
We do hear about parents kicking out their kids when they are 18. I use to think it's true, then later realized that no parent would do that and that's a misconception. They are raised with the idea that when they are adult, they should move out and live own their own. They don't really have to, but that's the culture part. If they don't, it will be something to be ashamed of I guess.
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.
It's not common over here to actually kick kids out once they turn 18, but it is common for parents to feel they no longer have any responsibility for the wellbeing of their adult cildren once they're able to physically/financially fend for themselves.
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.
Yes, the amount of effort it takes to care for someone with dementia and/or mobility issues is huge. You end up needing a full time care giver to either keep them from wandering away or taking them to the bathroom and feeding them 5-10 times a day. Doing that in a humane fashion is quite challenging... and at some point you realize it's largely for their surviving relatives.
In the old days we just let them wander off or wallow in bed until they died.
Call me callous but that's the point at which it's ok to die.
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.
Plenty of people want to die. The reason end-of-life care is extended as far as possible usually has little or nothing to do with the people themselves. They may rarely be lucid or even conscious.
The generational home depended on an enormous amount of unpaid labor. Elder abuse was common (much I believe, simply due to exhaustion from the sheer level of demands placed on the caregivers).
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.
I support the right of people to choose to end their life with dignity and it seems sad that people would have to resort to starving themselves to death. If this was legally sanctioned, an injection of opiates could be much quicker and less painful.
Right there with you. I mean if we're ok with doing stuff to make the suicide easier on them, why not like allow them some inert gas, drugs, or a firearm, or to be wheeled out to "see the sights from the top of a bridge." I really would not want to go out by starvation/dehydration.
I dont think avoiding legal is the only point. Many people would rather go out with VSED than via injection, as it is a more "natural" dying process.
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.
One thing I would point out is where I live, you can only get morphine via pills if you elect in-home hospice. My father was terminally ill with cancer and chose to do in home hospice and he was always constantly in pain and uncomfortable despite having a enough drugs to fill the briefcase from Fear and Loathing in Las Vegas. I think he would have been better off in a hospital or hospice facility where could have had a morphine drip. He refused to go to the hospice facility and even refused simple comforts like a recliner or hospital-style bed. It really painful to watch him slowly die and be always in pain. Hopefully when it's my time to go I can elect for lethal injection and not be a burden. I do not want to die in pain like my father.
Thats fine for you. Im just pointing out that people have different wishes and values with respect to death, and VSED is an attractive option for some.
If I decide I am done, why would I stick it out to endure the pain & suffering of slowly starving to death? Once I make the call, I'm fine with taking the long nap.
I don't think anyone is telling you what to do, but that doesn't preclude other people doing what they want. Some people would rather go through the experience of dying in a different way.
I don't think you understand the law in most US states. In most US states there is no legal mechanism to obtain drugs to voluntarily end your own life.
End of life is a topic that doesn't nearly get discussed about enough. With life expectancy and infant mortality rates being what they ware, the average person doesn't encounter this part of the lifecycle near enough to make it an expected part of life.
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.
I think the industrialization and hospitalization of death also has a big impact on people's exposure and discussion.
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.
This is some next level abuse, comparable to drinking pesticides to "fix" illness!
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!
Having seen this several times in family and close relatives it does not appear as painful as you'd think. Often times the people responsible for the care of the person dying will provide them small amounts of water, typically via a syringe, to keep their mouth wet in order to not provoke a thirst response. Food is easy enough to ignore and most people can indefinitely ignore hunger right up until they die.
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.
I done 2 day dry fast and 3 week water fast. I know something about this stuff. It is VERY painful and stupid.
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!
Fasting as a healthy person is very different from someone nearing the end of their life. Many people suffering from sickness lose most of their appetite already and have little energy to bring themselves to eat.
I'm not sure what you are saying. I don't think it is a moral or appropriate thing to do to a free individual who isn't hurting anyone, or even a prisoner for that matter.
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.
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.
It just seems strange to me how hostile you are to the idea of someone going out in the manner of their own choosing. I get and respect that you wouldn't choose it for yourself, but why not extend that respect to other people and their personal wishes. It's not like they're hurting you
Information in that article are just wrong. This is not some voluntary peaceful departure, but very slow and painful process. Look into death by dehydration.
This is why people will often make a video recording their intention and their reasoning, and try to demonstrate that they are of sound mind before making the decision to end their lives through a method like this. I can assure you that buying a gun in a country where owning firearms is illegal.. and then shooting a loved one.. is not something that can in any way be compared to an action like this, in the eyes of the law at the _very_ least.
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.
You do not get it. Senior would be the one who buys a gun, and who pulls the trigger. I have no problem to help someone to dispatch themselfs, but I would not risk my neck in process.
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...
Okay, think there was some misunderstanding. I was thinking of the situation where the person is so chronically ill that they cannot do any of those things. They either need someone's help, thereby making them break the law, or they take the only other option to end their lives which is to stop eating or drinking.
Seems rather long and drawn out, potentially even bordering on torturous.
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.
The awful thing is that, due to assisting suicide being illegal in many places, if you are no longer physically capable of ending your life without assistance, this is your only choice.
The sculptor Stanisław Szukalski chose to die this way.
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.
My father did this. It allowed him to close out a full life on his own terms and is definitely an option I would consider if I were to ever find myself in that kind of place.
Watching my grandfather slowly die in at-home hospice care, seemingly in great pain--though he was not lucid--was personally radicalizing. The family is told to administer pain meds as needed, but if they don't pick up on the wink, wink, nudge, nudge, the patient languishes in needless limbo.
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.
Compassion & Choices is working to raise awareness about the option of voluntarily stopping eating and drinking for a decisionally-capable adult who would like to reduce the length of time they suffer from any terminal disease including progressive diseases such as dementia.
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.
I’m all for truly voluntary (no governmental pressure etc) euthanasia as an option to avoid incurable suffering, but something about renaming intentional terminal dehydration to ‘VSED’ and displaying it with corporate slides feels particularly grim.
It’s a bit like the mismatch in tone when there’s a powerpoint/hype video for a particularly gruesome anti-personnel weapon.
It always makes me think of Robert W. Chambers' collection The King in Yellow. It's a great read. It also heavily inspired the first season of True Detective.
The fact that we’re reduced to that really bothers me. How can we possibly be free if we’re not free to end our own suffering? Forcing our loved ones to die of thirst is not compassionate at all. Compassionate would be recognizing that the choice to end one’s own suffering is a legitimate choice and removing the legal hurdle.
I think the reality is that a lot of people really die from an overdose of morphine at the end. Once you are in hospice, the advice is to give enough to make the person comfortable, and eventually that leads to death.
In Theravada Buddhism, at the final stage of enlightenment, the arahant or Buddha can enter Parinirvana ( final liberation) through a meditative State called Niroda Samapatti at will.
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.
Based on reading other parts of the website, it advocates for assisted suicide more generally. In this context, voluntarily-not-eating-or-drinking's main benefit appears to be that you can't punish me or my family or my doctor for doing it.
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.
Really dumb question, but can't the doctor just ignore your conscious informed denial of consent for nutrition?
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.
Interesting. This article corroborates what you're saying:
> 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.
I read this story here already, but posted definitely not under this alias.
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...
> you can't punish me or my family or my doctor for doing it.
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.
I find it interesting that so many different groups of people around the world are advocating all sort of "compassionate" ways for people to commit suicide! Isn't it better to arrive at ways of helping the person do better or have greater joy than condemning them to these methods so that they stop living?
While I agree people should have all the options on the table, I disagree that it is a bad way to go. People do this in states and countries with voluntary euthanasia as a matter of personal choice, and I don't think we should look down on the practice. I think it would be my preferred way to go.
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.