Patients Refusing to Eat, Drink are in Poor Health

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Most patients who hasten death by VSED are in poor health, and family physicians are often involved in the process.
Most patients who hasten death by VSED are in poor health, and family physicians are often involved in the process.

HealthDay News -- Most patients who hasten death by voluntarily stopping eating and drinking (VSED) are in poor health, and family physicians are often involved in the process, according to a study published in the Annals of Family Medicine.

Eva E. Bolt, MD, from the VU University Medical Center in the Netherlands, and colleagues surveyed a random national sample of 1,100 family physicians (response rate, 72%) to describe physicians' involvement in VSED as well as the characteristics and motives of patients who hasten death by VSED. Five hundred physicians received questions about their last patient who hastened death by VSED; 64.8% of the 440 eligible physicians responded.

The researchers found that 46% of the 708 total respondents had cared for a patient who hastened death by VSED. The physicians described 99 cases of VSED. Of these, 70%, 76%, and 77%, respectively, were aged older than 80 years, had severe disease (27% with cancer), and were dependent on others for everyday care. Somatic, existential, and dependence were the most frequent reasons for the patients' death wish (79%, 77%, and 58%, respectively). The median time to death was seven days; pain, fatigue, impaired cognitive functioning, and thirst or dry throat were the most common symptoms before death. In 62% of cases, family physicians were involved.

"Family physicians can play an important role in counseling the patient and their proxies and in providing palliative care," the authors wrote.

Reference

1. Bolt E, et al. Ann Fam Med.. 2015; doi: 10.1370/afm.1814.

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