Should Voluntary Stopping Eating and Drinking (Passive Euthanasia) Be Legal?

In the New York Times article Deciding to Die, Then Shown the Door, Armond and Dorothy Rudolph had fears of a lingering decline in their final years. For years, they came to the mutual consensus that they wanted to end their lives early while they were both functioning and independent, rather than prolonging their lives at the expense of others. As their lives progressed, the Rudolphs began facing various amounts of pain and inabilities. Armond, at 92, suffered from spinal stenosis, while Dorothy, at 90, had become mostly immobile, with both exhibiting symptoms of early dementia. At this point, both moved into The Village at Alameda, an assisted living facility, with the intention of making it their last home. From then on, they Voluntarily Stopped Eating and Drinking (VSED). On day four of their fast, the facility tried to evict them, calling authorities and reported them for attempting suicide. Evicted, the two had no place to stay. Eventually, their children transferred the Rudolph couple to a rented house in Albuquerque, allowing them to commit VSED as they wished. Armond was the first to die, 10 days after the fast began, with his wife following the day after.

The question that then presents itself is: should VSED be legal?

Indeed, under federal law, VSED is legal in every state, according to Charles Sabatino, director of the American Bar Association Commission on Law and Aging. “That a competent person can refuse any medical intervention, including tube feeding, has been recognized by the Supreme Court,” he said. Furthermore according to the federal Patient Self-Determination, even a dementia diagnosis may not mean that someone lacks the legal capacity necessary to make the decision to undergo VSED.

One of the arguments supporting VSED draws upon emotional appeal. When interviewed, Dorothy revealed that she had nursed her own mother through four years of bone cancer and saw her mother through a “slow, wasting death”, one that was filled with pain. Throughout the years, she felt pinned down for years, as well as guilt about feeling pinned down. By forcing others to stay alive, those surrounding the person would be forced to undergo emotional suffering. In a similar way, the person in question would be forced to go through meaningless years before dying a tortuous death. The idea of rotting away in a nursing home “was hell for them, to have people waiting on them, to have no independence,” according to their son, Neil Rudolphe. VSED saves both the dying and those around them from going through avoidable emotional and physical suffering. As the Rudolphes had learned, VSED is a legal way to hasten death without drugs or violence, usually finished within the span of two weeks. Had Armond and Dorothy not been successful, most likely they would have been forced to go through years of physical pain, all the while being demented without the ability to control their own minds.

Another argument is supported by statistical evidence, from human sciences. In a survey of nurses in Oregon, published in The New England Journal of Medicine in 2003, most of their terminally ill patients who had deliberately refused foods and fluids were able to conclude their lives with low levels of pain or suffering.

An argument against VSED is based on religious appeal. According to several religions, life is a gift from God, or the chosen spiritual figure of said religion. Religiously, it is a sin to take our lives willingly, whether it be passively or actively. It goes against the concept that life is sacred. For example, in the case of Christianity, many verses go against the passive taking of one’s own life. For instance, from John 16: 1 – 3, “All this I have told you so that you will not go astray . . . a time is coming when anyone who kills you will think he is offering a service to God. They will do such things because they have not known the Father or Me.”

Another argument is based on the ethical perspective as well. In the Debatepedia, in an article concerning the debate for assisted suicide, it has been stated, “it is a moral duty to attempt to prevent suicide in general; euthanasia too”. Does it qualify as murder if one knowingly allows another to pass away, even knowing that the person can be saved, even temporarily? As humans, there is a moral duty to try and stop the committing of suicide, including passive deaths. Instead, the arguments that one should help a person with their terminal sickness, but not help them die. Furthermore, as asked in the article, End of Life, physicians have the duty of preventing prolonged suffering for those in need. However, VSED may, in fact, prolong their suffering. Should physicians be able to watch VSED occur?

The emotional perspective also goes against VSED as well. If the family or members around the dying do not wish for their loved ones to die, it may be critical to evaluate the emotional harm that would be caused from VSED. However, alternatively, a person may be pushed into wanting VSED because of the guilt they feel at leaving their loved ones burdens, by giving them a person to take care of, one who is destined to die in the near future.

The ultimate TOK question comes back to: should humans retain the right to die at a time of their choice? Not only does this apply to VSED, but active euthanasia, as well as suicide. If VSED is allowed as a type of passive euthanasia, should abandoning life support be allowed? Similarly, should suicide then, be allowed? For example, as reported from Associated Press, in the article Parents seek advice for son's concussion, suicide, Austin Trenum, a teenager, committed suicide by hanging himself in his room. If humans have the right to die at a time of their choice, his choice to commit suicide should not be an issue. In both cases, the taking of their own lives were voluntary, the decisions clear.However, as natural sciences and brain research found out through investigations, a concussion Austin had received from football had impaired his judgment and impulse control significantly, to the extent that it can be safely assumed that he did not have the mental capability to control the impulse to commit suicide. Prior to the act, Austin exhibited no signs of depression and had made plans for the hours after his suicide. Here it can be questioned: did Austin truly want to commit suicide? By allowing humans to retain the right to die at a time of their choice, cases in which those that lack the mental capacity to make rational decisions may suffer. Where should the lines be drawn then? This question continues to be a topic of controversy throughout the world.