Search results

Hospice is the premiere end of life program in the United States, but its requirement that patients forgo disease-directed therapies and that they have a prognosis of 6 months or less means that it serves less than half of dying patients and often for very short periods of time. Palliative care offers careful attention to pain and symptom management, added support for patients and families, and assistance with difficult medical decision making alongside any and all desired medical treatments, but it does not include a comprehensive system of care as is provided by hospice. The practice of pall

"Four stories of real patients who considered and then activated plans to voluntarily stop eating and drinking (VSED) are presented. Each had unique personal and clinical circumstances, but all wanted to know what "escape options" might be possible if their anticipated or actual suffering or deterioration became unacceptable to them. Most were initially unaware of VSED as a life-ending option until informed by the treating clinicians, and some were disappointed that they could not receive medical aid-in-dying which they clearly would have preferred. The process of becoming aware and then ultimately choosing and completing VSED are explored. The prospect of losing decision-making capacity late in VSED and expressing a basic desire for food and drink should be anticipated and planned for. VSED was ultimately effective in helping these patients achieve a wished-for death, but the process was not without challenges"--