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

BMC Medicine

卷:15

Ralf J. Jox¹  Johanna Anneser²  Gian Domenico Borasio³  Isra Black⁴ 

[1] Institute for Ethics, History and Theory of Medicine, University of Munich;

[2] Palliative Care Service, Technical University Munich;

[3] Service de Soins Palliatifs et de Support, Centre Hospitalier Universitaire Vaudois;

[4] York Law School, The University of York;

关键词: Decision making;    Nutrition and hydration;    Palliative care;    Ethical analysis;    Medical ethics;    Legal aspects;   

DOI  :  10.1186/s12916-017-0950-1

来源: DOAJ

【 摘 要 】

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. Please see related article: http://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0951-0 .

【 授权许可】

Unknown