What is VSED and why should it matter to us?

Fr. Tadeusz Pacholczyk

More than 20 years ago, Dr. David Eddy, writing in the Journal of the American Medical Association, described how his mother, though not suffering from a terminal illness, chose to end her life through VSED (voluntarily stopping eating and drinking). She was “very independent, very self-sufficient, and very content.” When she began to be afflicted by various ailments, including rectal prolapse, she talked with her physician-son about “how she could end her life gracefully.”

When she asked him, “Can I stop eating?”, he told her that if it was really her intention to end her life, she could also stop drinking since, “without water, no one, not even the healthiest, can live more than a few days.” After a family bash celebrating her 85th birthday, she “relished her last piece of chocolate, and then stopped eating and drinking.” She died of dehydration six days later, with her son arranging for pain medications to be administered during her final days and hours.

Choosing not to eat or drink can be packaged as a noble and well-intentioned way to avoid intense pain and suffering, but VSED ultimately represents a flawed choice. It subtly draws us into the mistake of treating the objective good of our life as if it were an evil to be quelled or extinguished. We have a moral duty to preserve and protect our life and to use ordinary means of doing so. Suicide, even by starvation and dehydration, is still suicide and is never morally acceptable.

For some critically-ill patients, continued attempts to ingest food and liquids may cause significant complications, including severe nausea, vomiting, or complex problems with elimination. Such patients may find themselves effectively incapable of eating or drinking. This is not VSED, but a direct manifestation of their advanced disease state, and does not raise any of the ethical concerns associated with VSED.

As disease or severe illness advances, and a patient draws near to death, various bodily systems may begin to fail, and a natural decrease in appetite can occur. This is also different from a voluntary decision to stop eating and drinking—VSED refers specifically to a conscious, elective decision on the part of a patient not to eat or drink when eating and drinking would be anticipated to provide benefit to them without undue burdens.

As people are dying, the real evil that often needs to be quelled or extinguished is pain, and severe pain is properly addressed by non-suicidal means, that is to say, through effective pain management and palliative care strategies.

Some have sought to suggest that patients who choose VSED may feel less pain because the nervous system becomes dulled and the body may end up releasing chemicals which provide natural analgesia or pain relief: “What my patients have told me over the last 25 years is that when they stop eating and drinking, there’s nothing unpleasant about it — in fact, it can be quite blissful and euphoric,” said Dr. Perry G. Fine, vice president of medical affairs at the National Hospice and Palliative Care Organization in Arlington, Va. “It’s a very smooth, graceful and elegant way to go.”

Such claims, however, remain highly controversial and strain credulity.

Dehydration and starvation constitute a form of assault against the integrity of the body and the whole organism, and if the body reacts by releasing chemicals, this is a form of “shock” response to an escalating traumatic situation. As noted for Dr. Eddy’s mother, pain medications were required to control the significant suffering and discomfort that would otherwise have ensued from her dehydration and starvation.

Even those who promote VSED advocate uniformly for concurrent pain control. In fact, Helga Kuhse, a well-known advocate of assisted suicide, once argued that when people see how painful a death by starvation and dehydration really is, then, “in the patient’s best interest,” they will soon come to accept active euthanasia through, for example, a lethal injection.

By its nature, VSED appears to be defined by the intent to cause death by forgoing the most basic requirements to conserve human life.  Intentionally engaging in such damaging and self-destructive behaviors, by foisting dehydration and starvation onto our mortal frames so as to shutter our earthly existence, can never represent an ordered kind of human choice.

 

COMING UP: Catholic Charities joins with St. Raphael Counseling to increase services

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Two Catholic counseling agencies serving the Denver Archdiocese have united to expand services to the community, officials said. The change was effective May 1.

St. Raphael Counseling, founded in 2009, has partnered with Catholic Charities’ Sacred Heart Counseling (formerly Regina Caeli Clinical Services), which was established in 2011. The two are now one ministry under Catholic Charities of Denver sharing the name St. Raphael Counseling.

Licensed clinical psychologist Jim Langley, co-founder of St. Raphael’s, will serve as director.

“Frankly, it seemed kind of silly for two entities to be doing the same thing from the same pool of resources,” Langley told the Denver Catholic.  “I reached out to [Catholic Charities] … to see about removing obstacles. It really must have been from the Lord because there weren’t any big obstacles.”

The combined resources mean clients seeking care aligned with Catholic values will now have access to more therapists and locations: a total of 18 clinicians at 11 offices and six schools across the Front Range region, including Denver, Littleton and northern Colorado.

In the coming months, St. Raphael’s will accept more insurances and will introduce diagnostic testing for behavioral and learning disorders and Autism to families at affordable cost, Langley said.

“We are excited to welcome the team of psychologists from St. Raphael Counseling to Catholic Charities,” said Amparo García, interim president and CEO of Catholic Charities of Denver. “Under Dr. Langley’s guidance, and with his expertise and business acumen, the team has built a trusted and professional counseling service that is faithful to the Church and compassionate to those in need.

“We are optimistic that offering expanded services in a combined organization will provide an added benefit to the community.”

St. Raphael’s offers individuals, couples and families clinical counseling services for issues ranging from depression and anxiety to grief and addiction. It also offers marriage preparation, school counseling, psychological evaluations for seminary applicants, and counseling for priests and religious. It provides outreach and education through presentations and retreats that integrate psychology and spirituality.

St. Raphael’s is named after the Archangel Raphael, who in the Old Testament Book of Tobit is sent by God to help the young man Tobias confront nature and evil. Raphael helps to bring healing to Tobias’ family. Of Hebrew origin, Raphael means “God heals.”

“The name was chosen very deliberately,” Langley said. “We [as therapists] are only instruments of God’s healing, God’s medicine; it’s ultimately God who heals.

“One of the ways the Lord has given us as a path to holiness is through our own brokenness,” he added. “We all have emotional wounds and the healing of these wounds helps us to become the saints God made us to be.

“We work with individuals and families to help them face their woundedness, their brokenness. We do it in a way that is supportive of their Catholic values and can leverage all the awesome, beautiful things about Catholic spirituality that can help us grow as people.”

The recent suicides of celebrity chef Anthony Bourdain and fashion designer Kate Spade show that no one is immune from depression and suicidal thoughts, Langley said.

“Even St. Therese [of Lisieux] said there were moments when she was tempted by the medicine bottle on the nightstand,” he noted about the saint who was named a Doctor of the Church in 1997. “We think of her as being a joyful saint, yet she too struggled immensely with depression.

“If people are struggling, they need help,” Langley said. “But counseling isn’t just for people with big issues. It’s also for those who have normal issues and are trying to have a healthy family life.

“There’s nobody who doesn’t need support and good human relationships.”

RAPHAEL COUNSELING

Visit: straphaelcounseling.com

Phone: 720-377-1359