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: Read Archbishop Aquila’s letter in response to the Pennsylvania Grand Jury Report

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The following letter written by Archbishop Samuel J. Aquila in response to the Pennsylvania Grand Jury report was read at all weekend Masses Aug. 17-18.

18 August 2018

My dear Brothers and Sisters in Christ,

I write to you today with great sadness to respond to yet another scandal that has shaken the Church. Even though many of the details in the Grand Jury Report in Pennsylvania had already been reported, the full release was still undeniably shocking and its contents devasting to read. We face the undeniable fact that the Church has gone through a dark and shameful time, and while a clear majority of the Report addresses incidents occurring 20+ years in the past, we know that sin has a lasting impact and amends need to be made.

Many children have suffered from cruel behavior for which they bore no responsibility. I offer my apology for any way that the Church, its cardinals, bishops, priests, deacons, or laity have failed to live up to Jesus’ call to holiness. I especially offer this apology to the survivors, for the past abuses and for those who knowingly allowed the abuse to occur. I also apologize to the clergy who have been faithful and are deeply discouraged by these reports.

Everyone has the right to experience the natural feelings of grief as they react to this trauma – shock; denial; anger; bargaining; and depression. I want you to know I feel those emotions as well – especially anger. I believe the best way to recover is a return to God’s plan for human sexuality. In response to the Archbishop McCarrick revelations, I have written at length about the spiritual battle we are facing. That letter can be found on the archdiocese’s home page – archden.org.

I ask everyone to pray for the Church in Pennsylvania, though these dioceses over the last 20 years have greatly evolved from how they are described in the Grand Jury Report, the Church must face its past sins with great patience, responsibility, repentance and conversion.

Creating an environment where children are safe from abuse remains a top priority in the Archdiocese of Denver. In our archdiocese, we require background checks and Safe Environment Training for all priests, deacons, employees, and any volunteers who are around children. During this training, everyone is taught their role as a mandatory reporter, and what steps to follow if they witness or even suspect abuse. We also require instruction for children and young people, where they are taught about safe and appropriate boundaries, and to tell a trusted adult if they ever feel uncomfortable. We participate in regular independent audits of our practices, and we have been found in compliance every year since the national audit began in 2003.

Finally, while we have made strides to improve our Archdiocese, I am aware that the wounds of past transgressions remain. We are committed to helping victims of abuse and we are willing to meet with anyone who believes they have been mistreated.

I urge all of us to pray for holiness, for the virtues, and for a deeper relationship with Jesus Christ. Only he and he alone can heal us, forgive us, and bring us to the Father. Be assured of my prayers for all of you and most especially the victims of any type of sexual abuse committed by anyone.

Sincerely yours in Christ,
Archbishop Samuel J. Aquila