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: Father Jan Mucha remembered for his ‘joy and simplicity’

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When Father Marek Ciesla was 11 years old, he encountered a priest in his hometown in northern Poland who was visiting his parish on mission.

“I was impressed,” said Father Ciesla. “A couple of my friends and I were talking about how energetic, how wonderful this priest was. I think in this way he inspired us a little bit to follow the call to the priesthood.”

The priest was Father Jan Mucha, and little did Father Ciesla know that decades later and an ocean away, he would reunite with the man that inspired him and his friend to pursue the priesthood.

In 2010 when Father Mucha was retiring from his role as pastor of St. Joseph Polish Catholic Church in Denver, Father Ciesla was sent from Poland to the Archdiocese of Denver to take his place.

The priests spent two days together, and Father Ciesla was struck by the familiarity of Father Mucha.

“For some reason, the way he was talking and the words he was using, something rang a bell,” he said. “I asked him if he remembers visiting my parish. And he said, ‘Oh, yeah, I had it on my list. I remember.’”

Father Ciesla was amazed that the man he was there to replace was the same one who had impacted his life all those years ago.

“God works in mysterious ways,” said Father Ciesla. “I never thought I would meet him again.”

Father Mucha passed away March 21 after serving the archdiocese for 40 years. He was 88 years old.

Father Mucha was born March 16, 1930 in Gron, Poland to parents Kazimierz and Aniela Mucha. He was one of five children. Father Mucha attended high school in Kraków and went on to study philosophy and theology at a seminary in Tarnów.

Father Mucha was ordained December 19, 1954 in Tarnów by Auxiliary Bishop Karol Pękala. He served at St. Theresa Parish in Lublin, Sacred Heart Parish in Florynka and as a Latin teacher at Sacred Heart Novice House in Mszana Dolna.

He was incardinated into the Archdiocese of Denver on April 20, 1978. Before he was granted retirement status in August of 2010, he served at St. Joseph Polish for nearly 40 years.

“Father Mucha was dedicated to his people and there was a joy about him,” said Msgr. Bernard Schmitz, who had known Father Mucha since his own ordination in 1974 and more recently within his former role as Vicar for Clergy.

“I admired his joy and simplicity,” said Msgr. Schmitz. “He seemed to have no guile and what you saw is what you got. He was very proud of his Polish heritage and was unafraid to be Polish.”

Father Mucha’s move to the United States came about after he visited St. Joseph Polish while on vacation. The pastor at the time was sick, and parishioners asked Father Mucha to stay.

After receiving approval from his superiors in Poland and the archbishop in Denver, Father Mucha did stay, and ended up serving the parish for nearly four decades.

“He was happy to serve here,” said Father Ciesla. “All the time, he was a man of faith. He kept his eye on Jesus.”

Msgr. Schmitz believes Father Mucha’s faithfulness and tenacity as a priest will leave a lasting impression on those he served.

“He was dedicated to the priesthood and didn’t want to retire until he was sure his people would be well taken care of,” said Msgr. Schmitz. “He could come across as tough, but really he was a compassionate person [with] a heart open to the Lord’s work.”