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Comment & Response
May 2018

Voluntarily Stopping Eating and Drinking Among Patients With Serious Advanced Illness—A Label in Search of a Problem?

Author Affiliations
  • 1Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota
  • 2Office of Clinical Ethics and Biomedical Ethics Research Program, Mayo Clinic, Rochester, Minnesota
  • 3Section of Palliative Medicine, Mayo Clinic, Rochester, Minnesota
JAMA Intern Med. 2018;178(5):726. doi:10.1001/jamainternmed.2018.1150

To the Editor In a Special Communication published in a recent issue of JAMA Internal Medicine, Quill et al1 offer a thoughtful analysis of circumstances when dying patients voluntarily stop eating and drinking (VSED). We suggest several amendments to their analysis.

Although a clever acronym, VSED is not novel and ought not to be equated with other forms of actively hastening death; VSED rests on a spectrum of normal end-of-life patient behaviors that few would equate with suicide. Underlying disease processes can impair appetite and thirst and prompt patient desires for a quick death. Before the VSED label, no one was forcing dying patients to eat or drink.

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