Bioethics Blogs

VSED Needs More Attention – Safety and Comfort Evidence

VSED has been increasingly promoted as a safe and comfortable mechanism to hasten death.  It is an important pathway that materially supplements other “exit options.”

First, where medical aid in dying is not available, it is one of the only options available for those not dependent on life-sustaining treatment.  Second, even in states where medical aid in dying is now available (OR, WA, MT, VT and soon CA, NM), it is not available to those with late-stage dementia. Unlike with AID, a patient with capacity can make an “advance” decision for VSED (to take effect in the later stages of dementia.

While the available evidence on VSED overwhelmingly supports its safety and efficacy, that entire data set is rather limited.  And much of the recent discussion is based on individual first-person reports from family members (some collected here) instead of broader and systematic studies.  

Now, we are seeing more contrary reports that challenge the peacefulness and comfort of VSED.  See, for example, the new book by Diane Rehm.  This reinforces the need to better assess and evaluate VSED.  Particularly for the growing late-stage dementia population, it is an exit option that needs more attention.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.