Jerome Medalie can’t imagine life with Alzheimer’s. And, he has made it known that he doesn’t want to be around if he can’t “recognize his loved ones” or “articulate coherent thoughts and sentences.” He did so formally and legally in his Advance Medical Directive.
According to a recent New York Times blog post, if Jerome Medalie, who resides in Massachusetts, develops Alzheimer’s disease or another form of dementia, he has specified that he refuses “ordinary means of nutrition and hydration.” He specifically listed 10 triggering conditions, and if any three such disabilities persist for several weeks, he wants his health care proxy — his wife, Beth Lowd — to ensure that nobody tries to keep him alive by spoon-feeding or offering him liquids.
VSED, short for “voluntarily stopping eating and drinking,” is not unheard-of as an end-of-life strategy, typically used by older adults who hope to hasten their decline from terminal conditions, such as dementia. Including VSED in Advance Medical Directives sparks several ethical considerations. (Please see italicized text below.) Readers, we want to hear from you! Please comment with your feedback on the following:
In your opinion, do you think people who develop dementia should be able to use VSED to end their lives by including such instructions in an advance directive? As the New York Times article states, “Can one’s current, competent self make decisions on behalf of one’s future demented self — who may find modest pleasure, years later, in a life once deemed intolerable? What if that later self asks for, or points to, applesauce?”
Thanks in advance for your comments on this topic!
About Evan H Farr, CELA, CAP
Yes, I think each person should be able to make this decision.
I know from experience that disaster can ensue if a loved one is left to make decisions he or she would not have wanted when lucid – protecting one from “one’s future demented self.” However, it’s often a very subjective process to determine when one crosses that line.