Voluntarily Stopping Eating and Drinking Among Patients With Serious Advanced Illness-Clinical, Ethical, and Legal Aspects.

Autor: Quill TE; Palliative Care Division, Department of Medicine, University of Rochester Medical Center, Rochester, New York., Ganzini L; Health Services Research & Development Center of Innovation, VA Portland Health Care System, Departments of Psychiatry and Medicine, Oregon Health & Science University, Portland., Truog RD; Center for Bioethics, Harvard Medical School, Department of Anesthesia, Perioperative and Pain Medicine, Boston Children's Hospital, Boston, Massachusetts., Pope TM; Health Law Institute, Mitchell Hamline School of Law, St Paul, Minnesota.
Jazyk: angličtina
Zdroj: JAMA internal medicine [JAMA Intern Med] 2018 Jan 01; Vol. 178 (1), pp. 123-127.
DOI: 10.1001/jamainternmed.2017.6307
Abstrakt: Patients with advanced illnesses sometimes request that physicians help hasten their death. Increasingly in North America and Europe, legal options allow physicians to perform this role. Among death-hastening options, the spotlight has been on physician-assisted death. However, voluntarily stopping eating and drinking (VSED) is also a course that patients may choose. Although VSED theoretically does not require physician involvement, clinician participation is critical in terms of initial assessment and ongoing management. In this review, we examine both clinical issues in assessing patients who are considering VSED and the clinical challenges that may emerge during VSED. We also explore some of the underlying ethical and legal considerations for physicians who either care for or decline to care for these patients. Physicians who care for seriously ill patients should be prepared to respond to patients' requests to participate in VSED.
Databáze: MEDLINE