Renewed Interest in an Old Advance Directive

VSEDs--short for "voluntarily stopping eating and drinking"--are being reconsidered as a method for managing the end-of-life care of patients who die with some form of dementia. With one in three seniors facing dying with mental impairments, finding strategies to allow for a humane death are becoming increasingly important. Historically, VSEDs have been used to hasten death in terminally ill patients suffering from conditions such as Lou Gehrig's disease, though in those cases patients are able to maintain cognitive function as they physically decline.

Presently, VSED requests for those with Alzheimer's are uncommon and untested as they may present legal and practical problems. A caretaker, for example, may want to honor a patient's request for a drink. Additionally, in many states, asking for water--even if the patient is demented--functions as a revocation of the advance directive. Nevertheless, ABA Journal predicts that with 5 million patients currently suffering from Alzheimer's disease, VSEDs will likely play an increasing role in advance directive plans.