Commentary
My mother died of Alzheimer’s disease at the ripe old age of 99. With invaluable help from hospice, my wife and I cared for her in our home for the last five months of her life.
Was it difficult? Very. Does that matter? No. Mom deserved the best care available, regardless of her mental incapacity.
My mother’s brother also died of Alzheimer’s. He received excellent care in the memory unit of a Baptist-affiliated assisted living facility for the last year of his life.
Was it difficult? Very. Does that matter? No. My uncle deserved the best care available, regardless of his mental incapacity.
The compassionate support my mother and uncle received was once the expected moral standard. Unfortunately, that seems to be changing. Increasingly, dementia patients are viewed by many as better off dead sooner rather than later.
Our values are not changing in a vacuum. Hastened death advocates have harnessed the understandable fear of dementia to argue that patients diagnosed with Alzheimer’s or other degenerative impairments receive medical help in committing suicide by intentional self-starvation and dehydration.
Known in euthanasia parlance as VSED for “voluntary stop eating and drinking,” activists pretend that VSED is merely a form of healthcare to ease the suffering of those who will become cognitively impaired.
But starving and dehydrating oneself to death when otherwise capable of eating and drinking is no more “medical” than intentional asphyxiation by running a car in a closed garage. It is a method of suicide, nothing more.
So where does the healthcare part come in? VSED takes about 10 days to complete, and it is not easy. Imagine the agony of being locked in a room to die without food or water.
That’s why most patients who want to die by VSED seek medical assistance beforehand. If a doctor believes that the patient’s desire to die immediately is autonomously chosen, he or she may agree to palliate the patient’s starvation and dehydration symptoms. That’s legal because no lethal substance is given to the patient.
But in my view, participating doctors are morally complicit in an assisted suicide because, absent such assurances, many VSED suicides would never be attempted.
I want to emphasize here that we are not discussing the natural phenomenon when patients stop eating in the final days before death as their bodies shut down. Unlike VSED, that isn’t suicide but a normal and peaceful part of the dying process.
Promoting VSED to still-competent people depressed by an ominous diagnosis is bad enough. But VSED peddlers now want to take things further. They argue that diagnosed dementia patients should be allowed to sign a written document ordering their future selves to be starved to death when they reach a defined stage of mental impairment.
Known as “VSED by advance directive,” the proposed policy would legally require caregivers to withhold sustenance from patients and refrain from all spoon-feeding—even if a patient willingly eats or asks for food.
Can you imagine the emotional toll that would take on caregivers? I mean, how awful would it feel to refuse a simple request for a drink of water or a morsel of fruit?
Activists understand that reluctance. So lately, they have promoted a revised VSED by advance directive plan that, they argue, would make the process less difficult for patients while reducing the moral harm experienced by caregivers.
“Minimal comfort feeding” (MCF), as it is known, would allow patients to receive food and liquids—but in insufficient quantities to sustain life. In other words, it would be VSED in slow motion.
Let’s get real. The distinction between full-bore VSED by advance directive and MCF is not one of significant moral difference. The goal in both is the same: death—either over several days when cutting off all sustenance or over many weeks via MCF.
But Wesley, what about autonomy? Don’t patients have a right to decide what level of care they receive when they become incompetent?
Of course. Patients can refuse medical treatments such as feeding tubes or antibiotics in an advance directive. But there are some things that no one has the right to demand of others. Surely, forcing caregivers to effectively kill their patients by starvation and dehydration—negligent care that would land them in jail for animal cruelty if done to a dog—is one of them.
So what is the ultimate goal of VSED activism?
Legalizing the active euthanasia of dementia patients. It’s only logical.
Once VSED suicides are normalized, people will eventually say, “Why force people with Alzheimer’s to die slowly by starvation? Wouldn’t it be more humane to simply allow doctors to kill them via lethal injection?”
Dementia patients are already being euthanized in Canada, the Netherlands, and Belgium. Once we accept the premises of VSED, that could happen here, too.
Let me end this essay where it began: with my mother. As her Alzheimer’s progressed, Mom became listless and refused all food and drink. I was sure that her end was imminent—until Helen, her saintly Visiting Angel companion, offered Mom a bowl of canned peaches. My mother took one look, smiled brightly, and quickly scarfed them down. Then, to my surprise, she asked for more!
Those peaches renewed her life force. For the next several weeks, she ate a lot of canned peaches and other meals, particularly bowls of sugary cereal. I can still hear her chirping happily, “This is delicious!”
Eventually, Alzheimer’s took its inevitable toll, and Mom slipped into a coma and died. But this much I know: The joy of eating what and as much as she wanted as her natural end approached brought her far greater comfort and joy than being medicated to ease the suffering of self-starvation ever could have.
VSED activism presents us with an urgent societal decision: Will we care for dementia patients until their natural deaths—or kill them earlier by whatever means are legal?
With a looming dementia crisis in which millions of people will experience significant cognitive decline, we had better get our ethics about this most urgent moral question right.
Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times.
