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: Celebrate and support the sacred gift of life

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Editor’s Note: This column is adapted from Archbishop Aquila’s remarks to the 2018 Celebrate Life March, which took place on January 13th in front of the Colorado State Capitol building.

As we gather today to celebrate life, we must remember three things: 1) life is a gift, 2) life is sacred, and 3) rebuilding a culture of life requires joy.

We are here today to celebrate our joy over the gift of life. Every minute and every day we live presents us with an abundance of gifts that seem mundane and are often overlooked: our health, the gift of creation, or something as simple as having food on our plates. Above all, we should give thanks for the gift of life!

As people involved in protecting life at every stage, the challenge we face is not just one of providing resources to mothers and fathers in need or ensuring people battling a terminal illness have good palliative care. Our challenge is to also communicate to them that they are loved, that their unborn child or their own lives are gifts, no matter the circumstances.

Many of us fought in 2016 to prevent doctor-assisted suicide from becoming legal in Colorado, and one person who helped in that effort was a courageous man named J.J. Hanson. J.J. was a Marine veteran and father of two young children who was working for a real estate investment firm in Florida when he found out he had glioblastoma multiforme brain cancer. His doctors told him that it was a very aggressive cancer that meant he only had four months to live.

Despite his odds, J.J. resolved to fight. His motto was: “Every single day is a gift, and we can’t let that go.” What’s even more remarkable is the fact that J.J. dedicated his time and energy to fighting the legalization of assisted suicide around the country, all while undergoing chemotherapy and other treatments. There was hardly a speaking engagement or trip to testify before a legislature that J.J. turned down. His conviction that life was a gift propelled him to defend that gift however he could. As pro-life people, we need to have that same conviction.

Just about two weeks ago, on December 30th, J.J. was called home to the Father – three years beyond what doctors told him to expect. St. Anthony of Padua church in upstate New York, where his funeral was held, was filled with people who paid tribute to how J.J. inspired them to embrace every moment of life, no matter its difficulties as a gift, not something to be thrown away.

All of us are called to embrace life as J.J. did, and in doing so we will help recover the culture of life that is being neglected or forgotten as people cast God and truth aside.

I have said that life is a gift, and while that is true, it’s more than that. Life is also sacred. Life is sacred because it comes from God, the God who is love and who has loved us first. Our lives are also sacred because our beings are made in God’s image and likeness.

We are called to participate in the love of God and to see that every human being, from the moment of conception until natural death, is invited into relationship with God. We are called to ensure that life is set aside for God, that it is honored and recognized as sacred.

The struggle for so many today is that they do not even believe in a god; their only god is themselves. They truly do not believe in the God who is love. And because of this limited worldview, a person’s life can lose its value if their “quality of life” declines.

In the words of Pope Francis to participants in the 2013 Day for Life, “All life has inestimable value even the weakest and most vulnerable, the sick, the old, the unborn and the poor, are masterpieces of God’s creation, made in his own image, destined to live forever, and deserving of the utmost reverence and respect.”

When Jesus speaks about the Judgement of the Nations in Matthew 25, he tells us that life is always sacred by saying that when we love the weak and vulnerable, we are loving him.

The more that we can love the sacred gift of life and celebrate it with joy, the more we will contribute to building a true culture of life in the U.S.

A wonderful example of concretely loving the sacred gift of life is a story I recently heard about a 15-year-old Colorado teenager named Missy, who showed up with her parents at an abortion clinic in Albuquerque, New Mexico.

Missy was a sophomore in high school and was in her second trimester of pregnancy. As they approached the clinic, some pro-life volunteers who were parked nearby in a mobile crisis pregnancy van saw them and invited them inside. The volunteers learned that Missy wanted to complete high school and that this desire was pushing her to consider an abortion. One of the volunteers told Missy about how she was faced with the same choice as a teen and chose to keep her child. “It wasn’t easy, but it was amazing,” she reassured Missy.

Missy also worried about the father of the child not being around, to which her dad responded by taking her hand and saying, “I’ll be that man in your child’s life.”

This kind of accompaniment and willingness to heroically support the gift of life is vitally important to forming a culture that welcomes the unborn, the elderly, the disabled and the dying as a gift.

Building a culture of life begins by first receiving the love of the Father, who loves each of us as his sons and daughters. He never abandons us, even though we might abandon him or reject his love.

A culture of life grows when we share his love with others, helping them to embrace life as a gift and a joy, rather than a burden.

Life is a gift, it is sacred and our celebration of the joy of life helps build a culture of life.

I encourage you to be those who are unafraid to give witness to life. Be not afraid to give witness to life. Even though people might ridicule you, yell at you, or reject you, know that Jesus experienced it all so that you might have life, and life abundantly.

May God bless you and help you celebrate life in 2018!