VOLUNTARY
DEATH BY DEHYDRATION:
SAFEGUARDS
TO MAKE SURE IT IS A WISE CHOICE
SYNOPSIS:
When we are approaching the natural end of our lives,
we might
choose to give up all liquids
in order to shorten the
process of dying.
Voluntary death by
dehydration is a special pathway towards death.
If this way of
ending our lives appeals to us,
we can begin a careful process of
planning several months in advance.
If our
choice is wise and rational,
then we will receive help and
cooperation from others.
Because voluntary death by dehydration
is legal everywhere on Earth,
we can be open
about our planning for the last year of our lives.
OUTLINE:
1.
A NEW PATHWAY TOWARDS DEATH: VDD
2.
SAFEGUARDS FOR VOLUNTARY DEATH BY DEHYDRATION
A.
ADVANCE
DIRECTIVE FOR MEDICAL CARE
B.
REQUESTS
FOR
DEATH FROM THE PATIENT
C.
PSYCHOLOGICAL
CONSULTANT EVALUATES
THE
PATIENT'S ABILITY TO MAKE MEDICAL DECISIONS
D.
PHYSICIAN'S
STATEMENT OF CONDITION AND PROGNOSIS
E.
INDEPENDENT
PHYSICIAN
REVIEWS
THE CONDITION AND PROGNOSIS
F.
CERTIFICATION
OF TERMINAL ILLNESS
OR
INCURABLE CONDITION
G.
UNBEARABLE
SUFFERING
H.
UNBEARABLE
PSYCHOLOGICAL SUFFERING
I.
PALLIATIVE
CARE TRIAL
J.
INFORMED
CONSENT FROM THE PATIENT
K.
REQUESTS
FOR DEATH FROM THE PROXIES
L.
ENROLLMENT
IN
A HOSPITAL OR HOSPICE
M.
STATEMENTS
FROM HOSPITAL OR HOSPICE STAFF MEMBERS
N.
STATEMENTS
FROM FAMILY MEMBERS
AFFIRMING
OR
QUESTIONING CHOOSING DEATH
O.
A
MEMBER OF
THE CLERGY
APPROVES
OR
QUESTIONS CHOOSING DEATH
P.
RELIGIOUS
OR OTHER MORAL PRINCIPLES
APPLIED
TO THIS LIFE-ENDING DECISION
Q.
AN
INSTITUTIONAL ETHICS COMMITTEE
REVIEWS
THE PLANS FOR DEATH
R.
STATEMENTS
FROM ADVOCATES FOR DISADVANTAGED GROUPS
IF
INVITED BY THE PATIENT AND/OR THE PROXIES
S.
REVIEW
BY
THE PROSECUTOR (OR OTHER LAWYER)
BEFORE
THE DEATH TAKES PLACE
T. CIVIL
AND CRIMINAL PENALTIES
FOR
CAUSING PREMATURE DEATH
U.
WAITING
PERIODS FOR REFLECTION
V.
OPPORTUNITIES
FOR THE PATIENT
TO
RESCIND
OR POSTPONE ANY LIFE-ENDING DECISIONS
W.
PHYSICIANS
REVIEW
THE
COMPLETE DEATH-PLANNING RECORDS
X.
COMPLETE
RECORDING AND SHARING
OF
ALL MATERIAL FACTS AND OPINIONS
Y.
THE
PATIENT
MUST BE CONSCIOUS
AND
ABLE TO ACHIEVE DEATH
Z.
THE
DEATH-PLANNING COORDINATOR
ORGANIZES
THE SAFEGUARDS
3.
APPLYING THE BEST SAFEGUARDS TO OUR OWN SITUATIONS
VOLUNTARY
DEATH BY DEHYDRATION:
SAFEGUARDS
TO MAKE SURE IT IS A WISE CHOICE
by
James Leonard Park
When we decide to draw our lives to a close by voluntary
dehydration,
this is a plan we can share with everyone who cares
about us.
Family and friends might mention reasons for us to live
a bit longer.
Will a new baby soon be born? Is someone getting
married?
Do we want to complete some meaningful projects before
we die?
Taking a
year to plan our own deaths
will
enable us to make a number of wise practical decisions.
For
example, we will not
authorize elaborate medical treatments
if
we know that we have begun the last year of our lives.
If death
comes before we give up all fluids,
then we can accept
that accident as a gift instead of resisting it,
as would be the
normal medical response to any health-crisis.
Even more explicitly, if we have chosen our
best date of death,
we
will carefully create End-of-Life
Medical Orders with our doctors,
so that just in case we have
a heart-attack during our last year,
we will allow that event to
run its course, resulting in our death,
rather than using the
medical means available
to save us from death caused by a
failing heart.
3.
APPLYING THE BEST SAFEGUARDS
TO OUR OWN
SITUATIONS
When we are approaching the natural end of our lives,
we might
decide to shorten the process of dying by giving up water.
We can do this in cooperation with several other
people
who are close to us at the end of our lives.
The more
safeguards we fulfill,
the more professional and personal opinions
we will gather.
If
we would like to count up the number of different people
who will
be involved in our end-of-life plans,
here is another chapter
that makes those numbers explicit:
The
Number of People Reviewing a Life-Ending Decision
Using the 26
Recommended Safeguards.
Safeguards are less important for choosing VDD
than for other
kinds of life-ending decisions
because the very process of dying
by giving up fluids
contains its own safeguard of stretching
out the time
in which we die to several days,
during which we can re-think
our plans for death
if our plans were somewhat misguided or poorly
conceived.
But the more other people
we involve with our end-of-life choices,
the more certain we and
others will be
that this was a truly voluntary
death
rather
than some form of irrational
suicide
or a process that will result in a premature
death.
And
when the laws regarding the recording of deaths are changed
to
recognize the differences between irrational suicide and voluntary
death,
then choosing death by dehydration will be recorded as
voluntary
death.
If we take several months to plan our own
deaths by dehydration,
we will call upon several other
people
mentioned in the safeguards discussed above.
The more
completely we fulfill the safeguards,
the better our claim will
be that we
chose a voluntary death.
Created
August 26, 2011; Revised 9-13-2011; 10-27-2011;
1-11-2012;
1-31-2012; 2-3-2012; 2-27-2012; 3-18-2012; 7-6-2012; 7-26-2012;
8-26-2012;
3-29-2013; 6-13-2013; 3-24-2014; 8-1-2014;
1-21-2015;
4-3-2015; 7-2-2015;10-8-2015; 12-24-2015;
3-15-2016; 10-26-2017; 7-27-2018; 8-22-2018; 10-31-2019;
11-6-2019; 9-10-2020;
This full exploration of 26 safeguards for life-ending decisions
as
they apply to voluntary death by dehydration
has become one
chapter of a small book:
Right-to-Die
Hospice.
How
has this review of safeguards changed your mind?
Perhaps you originally rejected safeguards as
irrelevant.
Do you now see that fulfilling
several safeguards
would help to make certain that death
at this time
and by
this method
is a good idea?
Can you see yourself applying these safeguards
to
the life-ending decision of someone you love?
Would you encourage the people closest to you at the end of your life
to use these
safeguards in helping
you
to review your own plans for death?
Links
to further information about voluntary death by dehydration:
Go
to a bibliography of books on Voluntary
Death by Dehydration.
Go to an Internet portal called
Voluntary
Death by Dehydration—Questions
and Answers.
This portal explores more details of the process
of dying by dehydration.
{more
links wanted}
Because this essay applying the 26 recommended safeguards to VDD
was
originally the last chapter of PART FOUR of
How
to Die: Safeguards for Life-Ending Decisions,
the summary is
published here.
If you would like to read any of the
summarized chapters,
simply click that chapter
number on the
right.
Summary
of Part Four
Step-by-Step
Planning for Our Own Deaths
Once we acknowledge that death is our destiny,
we can take
specific steps to prepare for the end of our lives.
First, we can create our own Advance Directives for Medical Care,
which will explain in our own words how we want to meet our
deaths,
especially concerning the medical
treatments we want
or do not
want.
Chapter
28
If we will die while under some form
of medical care,
we (or someone else) will probably make
life-ending
choices.
Chapter
29
Even more explicitly, we can decide
now (while we are in good health)
that we prefer to skip the last
month under standard medical care.
If that month will have little
meaning and high cost,
what will be lost if we omit the last
month in the
hospital?
Chapter
30
As we approach the likely end of our
lives, we can even select the best date.
We do not want to die too
soon; we do not want to die too late.
So
what would be the best day to
die?
Chapter
31
Also, in addition of choosing the
ideal day,
we can select a method of dying that appeals to us and
our families.
Would we prefer: 1. comfort-care only; 2. induced terminal
coma;
3. withdrawal of
medical treatments and life-supports; or
4. voluntary
dehydration?
Chapter
32
We can also decide exactly what
events we want to precede our deaths.
All pathways lead to death,
but we can still choose the best one.
Chapter
33
And we will be able to take death in
stride
if we have already made our plans concerning such things
as:
our medical care, distributing our assets, disposing of our
remains,
& planning our funerals or memorial
services.
Chapter
34
As we make plans for the last year of our
lives, we can ask:
How will we know when we have completed our
lives?
Chapter
35
Because of the danger that we might
lose the capacity to choose death,
we should make clear
arrangements to preserve our right-to-die.
Chapter
36
We might consider voluntary death by
dehydration
Chapter
37
because it contains several advantages over other methods
of choosing death.
In fact, all 26
recommended safeguards can be applied
to the choice of voluntary
death by
dehydration.
Chapter
38
Other
related chapters from the same book,
plus a few other on-line
essays:
Why
Giving Up Water is Better than other Means of Voluntary Death
Losing
the Marks of Personhood:
Discussing
Degrees of Mental Decline
The
One-Month-Less Club:
Live Well Now, Omit the Last Month
Taking
Death in Stride: Practical Planning
Pulling
the Plug:
A Paradigm for Life-Ending Decisions
A
New Way to Secure the Right to Die:
Laws Against Causing Premature
Death
Two
Approaches to Right-to-Die Laws:
Granting Permission and Banning
Harms
Advance
Directives for Medical Care:
24 Important Questions to Answer
Fifteen
Safeguards for Life-Ending Decisions
Will
this Death be an "Irrational Suicide" or a "Voluntary
Death"?
Will
this Death be a "Mercy-Killing" or a "Merciful Death"?
Four
Medical Methods of Managing Dying
Induced Terminal Coma:
Dying in Your Sleep—Guaranteed
Depressed?
Don't
Kill Yourself!
Further Reading:
Best
Books on Voluntary Death
Best
Books on Preparing for Death
Books
on Helping Patients to Die
First
Books on Voluntary Death by Dehydration
Medical
Methods of Managing Dying
Books
Supporting the Right-to-Die
Books
Opposing the Right-to-Die
Go to the Right-to-Die Portal.
This
chapter on using safeguards to help decide
when might be the best
time to die by dehydration
is included in:
Medical
Ethics at the End of Life.
WOULD
YOU LIKE TO MEET OTHER SUPPORTERS
OF
RIGHT-TO-DIE HOSPICE?
If
you agree that careful safeguards should be used
in considering
voluntary death by dehydration,
you might join a Facebook Group
and Seminar called Right-to-Die Hospice.
The
essay above explaining safeguard for voluntary dehydration
has
become Chapter 9 of Right-to-Die
Hospice.
Here
is a complete description of this on-line gathering of advocates of
the right-to-die:
https://s3.amazonaws.com/aws-website-jamesleonardpark---freelibrary-3puxk/ED-RTDH.html
And
here is the direct link to our Facebook Group:
Right-to-Die
Hospice:
https://www.facebook.com/groups/145796889119091/
Go to
the Book
Review Index
to discover 350 book reviews
organized into
more than 60 bibliographies.
Which bibliography speaks to your present interests?
Return to the DEATH page.
Go to the Medical Ethics index page.
Go to
on-line
essays by James Park,
organized into 10 subject-areas.