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BMC Medicine
Published in: BMC Medicine 1/2017

Open Access 01-12-2017 | Debate

Voluntary stopping of eating and drinking: is medical support ethically justified?

Authors: Ralf J. Jox, Isra Black, Gian Domenico Borasio, Johanna Anneser

Published in: BMC Medicine | Issue 1/2017

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Abstract

Background

Physician-assisted dying has been the subject of extensive discussion and legislative activity both in Europe and North America. In this context, dying by voluntary stopping of eating and drinking (VSED) is often proposed, and practiced, as an alternative method of self-determined dying, with medical support for VSED being regarded as ethically and legally justified.

Argument

In our opinion, this view is flawed. First, we argue that VSED falls within the concept of suicide, albeit with certain unique features (non-invasiveness, initial reversibility, resemblance to the natural dying process). Second, we demonstrate, on the basis of paradigmatic clinical cases, that medically supported VSED is, at least in some instances, tantamount to assisted suicide. This is especially the case if a patient’s choice of VSED depends on the physician’s assurance to provide medical support.

Conclusion

Thus, for many jurisdictions worldwide, medically supported VSED may fall within the legal prohibitions on suicide assistance. Physicians, lawmakers, and societies should discuss specific ways of regulating medical support for VSED in order to provide clear guidance for both patients and healthcare professionals.
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Metadata
Title
Voluntary stopping of eating and drinking: is medical support ethically justified?
Authors
Ralf J. Jox
Isra Black
Gian Domenico Borasio
Johanna Anneser
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2017
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-017-0950-1

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