What is VSED and why should it matter to us?

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: Team Samaritan cyclist goes ‘Everesting’ for the homeless and hungry

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When it comes to the daily sufferings of those who are homeless, there’s nothing like a 29,029-foot bike ride to keep things in perspective.

That’s exactly what Corbin Clement will be doing this Saturday, June 19, with a couple of his riding buddies as they attempt an “Everesting” ride to raise money for the Samaritan House homeless shelter in Denver. Starting at Witter Gulch Road in Evergreen, the three riders will climb Squaw Pass Road to a point in Clear Creek County and ride back down the hill for over eight laps, which amounts to roughly 190 miles in distance and the equivalent of the elevation of Mt. Everest in terms of vertical climbing – hence the name “Everesting.” Their goal is to complete the feat in 20 hours or less.

Oh, and they can’t sleep. It is, indeed, just as crazy as it sounds. Those who aren’t avid cyclists might be wondering, “How in the world do you train for something like this?” 
 
“For training, it’s been just more or less ride as much as possible,” Clement told the Denver Catholic. “The training is structured around endurance, and that’s of course what Everesting is. It’s just a lot of peddling. So, a lot of my training so far has just been trying to ride as much as possible and ride longer high elevation rides.” 

In March, an Irish cyclist set the world record for Everesting when he completed the feat in six hours and 40 minutes. Clement isn’t trying to set a record, but regardless, it’s quite a feat to undertake, even for a seasoned athlete like him, whose pedigree includes snowboarding and rock climbing. 

“Our ride will be the same thing, but it’ll be pretty different,” Clement said. “We don’t have any sort of special bikes or super focused diet or a really regimented plan or a crew that’s very well-instructed on how we’re going to tackle this. I’ve read a couple of things to just kind of make it into a party — have friends come out to support you, get people to join you on certain laps…that’s kind of the approach we’re taking.” 

Clement has already raised $5,200 for Samaritan House, with a current goal of $8,000. This is Clement’s first year riding for Team Samaritan, but his dad, Kevin, has ridden for the team for several years. When his dad offered to give him an extra kit and uniform, Clement accepted, but didn’t want to take it without doing something help the cause. He could’ve simply opted for a nice ride in the countryside, but he chose to do something a bit more challenging.  

Corbin Clement used to experience the challenges that homeless people face on a daily basis when commuting through downtown Denver to work on his bike. This Saturday, he will raise money for Samaritan House homeless shelter by “Everesting,” a 190-mile bike ride that is the equivalent of the elevation of Mt. Everest in terms of vertical climbing. (Photo provided)

“For some reason, the Everesting idea popped into my head,” he explained. “I think it’s one of those things that has a little bit of shock value for people who hear about it. It’s certainly something that’s gained more popularity and visibility in the last couple of years with endurance athletes. I wanted to choose something that would actually be a challenge for myself and something that I’d have to work towards.” 

Clement currently resides in Utah, but he used to live in Denver and commute by bike to work every day. During those rides to his office, which was located near Samaritan House, he would pass many homeless people and have conversations with them. This experience was also a motivating factor for his Everesting attempt for Team Samaritan. 

“It’s very different when you’re on a bike versus in a car because you’re right there,” Clement said. “If you stop at a stoplight and a homeless person is on the corner, whether or not they’re panhandling or something like that, you hear the conversations, or you’ll have a conversation with them. There are things you smell or you hear or you see that you just never would if you were in a car. So, it kind of made sense, too, with the biking aspect. It’s part of my community that I’ve lived and worked in for a very long time.” 

Clement’s Everesting attempt is one event in a series of endurance event’s he’s doing over the summer that culminates with the Leadville 100, a single-day mountain bike race across the Colorado Rockies. In that race, he will be riding to support young adults diagnosed with cancer by raising funds for First Descents.  

Both causes are near to Clement’s heart, and he said that while his Everesting attempt will be a form of “suffering,” it pales in comparison to what the homeless face day in and day out. This is ultimately why he’s riding and raising funds for Team Samaritan. 

“Any time we see a homeless person or people who have to live on the streets,” Clement said, “That is true suffering — true endurance — with no end in sight.” 

To learn more about Corbin’s fundraising efforts or to donate, click here.