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: Vietnamese parish community raises $80,000 for storm relief

Sign up for a digital subscription to Denver Catholic!

About 800 Vietnamese refugees, immigrants and their relatives gathered on Veterans Day at Queen of Vietnamese Martyrs Catholic Parish event center in Wheat Ridge, raising more than $80,000 for survivors of recent storms in Texas, Florida and central Vietnam.

“We dedicate this event to God, and to Mary,” said co-organizer Viet Hua. “We’ve been praying and asking for help, in God’s way, to glorify him in our effort to help those who suffer.”

It was an evening of food, music, dance and auction goods that sold for thousands more than market value in the spirit of exceeding an ambitious $75,000, one-night fundraising goal. Half the money will go to Gulf Coast recovery, and half will go to Vietnam.

Hua, a member of the parish’s Knights of Columbus chapter, said at least 100 men, women and children volunteered to organize and operate the event.

Denver-area businesses with Catholic and Vietnamese owners, managers and employees minimized overhead with donations of food, beverages, services and auction items.

It touches my heart now to help others – from a place where I can exercise my faith, where I can succeed, and where I can gather with community.”

“This is faith, fellowship and compassion at its finest hour,” said Sang Truong, marketing director of Denver’s Beverage World Specialties, which donated cases of Chilean Paso del Sol wine.

Two major hurricanes wreaked havoc along the Gulf of Mexico this year. As of Veterans Day, 12 tropical storms and typhoons had devastated parts of Vietnam.

Typhoon Damrey struck central Vietnam November 4, destroying nearly 3,500 homes, flooding 138,000 homes, killing 123 people and leaving 395,000 Vietnamese in need of assistance.

The scene is painfully familiar to most who head the 1,800 families that comprise Queen of Vietnamese Martyrs. They endured killer typhoons in the 1960s and ’70s, as communists invaded.

“Communists took over in 1975, and these people came here because they love freedom and they want to practice their faith,” said Pastor Louis Ha Pham, who escaped Vietnam in 1975 with 350 other members of the Congregation of the Mother Co-redemptrix religious community. “They want to use their freedom and faith to help others who suffer and lack the advantages of everything we have here.”

Co-organizer Hua barely survived a typhoon that slammed into his South Vietnamese village when he was a young child in the 1960s.

As water filled the family’s bamboo hut, Hua escaped with his mother and siblings to a neighboring residence. Water soon rushed into that hut, forcing Hua and other occupants to punch through the roof.

“We’re yelling for our lives in the middle of the night,” Hua recalled.

South Vietnamese soldiers pulled them from the water and onto a boat, but the suffering had only begun when Hua and his family reached dry ground in the mountains.

“You have no clothes, no food, and no fresh water. You have nothing,” Hua said. “So it touches my heart now to help others – from a place where I can exercise my faith, where I can succeed, and where I can gather with community.”

Hua escaped Vietnam by himself as a sophomore in high school in 1975. Communists had killed his father. They had threatened him and his family with machine guns.

“I remember they had us lined up, and my grandfather stood there telling them to shoot him,” Hua said. “He lifted up his dirty white t-shirt and said ‘shoot me. Just do it.’ I’m glad they didn’t, because that would have really messed me up as a child.”

Hua built his American life around Our Lady of Vietnamese Martyrs, thanking God each day for liberties the communists took from his homeland.

“I thank God, and I thank Americans for the opportunity to be here with resources to help people back home,” Hua said. “We thank you Americans so much for helping the Vietnamese to migrate here and live free.”

Que Truong, lead organizer of the event, said all Hurricane recovery is hard. It is worse in a dictatorship.

Items were auctioned off as part of a fundraiser held at Queen of Vietnamese Martyrs Parish on Veteran’s Day to help raise money to provide aid to Vietnam, Florida and Texas, which were all recently hit by storms. In total, the parish raised over $80,000 in one evening. (Photos by Dede Laugesen)

“It is terrible over there,” Truong said. “In south Vietnam, we are not free to do anything. There, most people are poor. It’s a different story here, so we are very eager to help.”

Joining the Catholic parishioners were Vietnamese dancers and others from Denver’s Nhu Lia Buddhist Temple. Vietnamese from a Baptist church also participated.

“This is the first time we have all sat down and had dinner together,” said parish Vice President Hung Vu. “Refugees of any religion know how it is to have nothing – to have empty hands and empty stomachs.”

Vu’s father starved to death after a typhoon devastated the family’s village in 1978. Communists ruled the family’s church. Everyone in Vu’s life suffered deprivation of basic needs.

At age 8, Vu fled while working on a fishing boat.

“The boat next to ours planned to escape,” Vu recounted. “They waved me over. In an instant, without a moment to think about it, I jumped out and swam to their boat. They pulled me up and we started sailing out of the China Sea.”

The narrow, 35-foot vessel contained 97 “boat people” crammed together in fetal position. They quickly ran out of food and water, finally obtaining supplies from a passing ship.

“We wanted freedom of religion, and opportunity, and were willing to die trying to get it,” Vu said. “We have suffered. Now, we are so blessed to be here in the United States with all we have. We are so thankful for the veterans who have defended this way of life. This church is my family, and this family is blessed to help those trying to recover in Texas, Florida and Vietnam.”