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.
Mueller PS, Strand JJ, Tilburt JC. Voluntarily Stopping Eating and Drinking Among Patients With Serious Advanced Illness—A Label in Search of a Problem? JAMA Intern Med. 2018;178(5):726. doi:10.1001/jamainternmed.2018.1150
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