Voluntary Stopping of Eating and Drinking to Hasten Death
DOI: 10.3238/zfa.2018.0353-0357german translation / full article
Background: Terminally ill patients’ fear of prolonged dying and suffering can lead to voluntary stopping of eating and drinking (VSED), aiming to accelerate the dying process. For family physicians, this can cause tension because there is an ethical obligation not to speed up dying, and – on the same time – respect patients’ rights of self-determination.Search method: Pragmatic literature search in electronic databases (PubMed, CINAHL, Research Gate and Google Scholar). We selected and evaluated 49 relevant papers in English and German from 2000 to 2018 and prepared a narrative review.Main messages: Symptoms associated with VSED lead to a significant need for palliative care. Medical care of these patients is not tantamount to assisted suicide. Rather, it is part of medical and nursing care for patients during their dying process. Open discussions about the expressed desire to die and the underlying motives can help to strengthen trust in family physicians. Knowledge of this possibility can in itself be a relief for some patients, without ultimately deciding to refuse food and fluids.Conclusions: Patients who decide to reject food and fluids are particularly dependent on the support of their family physicians.