Bioethics Blogs

Why Does an End Stage Patient in Oregon Need VSED when Medical Aid in Dying Is Available?

I blogged about the case of Nora Harris a few days ago.  I have now reviewed the protective order papers that were filed with the Jackson County, Oregon court.  I make two additional observations.


First, if you want clinicians to honor your wish to voluntarily stop eating and drinking in the late stages of dementia, be very clear and explicit about that.  

Unfortunately, Nora Harris never mentioned VSED or food and fluid by mouth in her advance directive.  Therefore, it is unclear whether she intended her agent to have that power.  There are some complicated burden of proof questions.  But it is generally best to address this directly in the advance directive.

Second, one of the reasons that Bill and Nora Harris moved to Oregon was because of the ODDA.  But they did not realize that the law requires the patient both to have capacity and be terminally ill at the time of the request.  Dementia patients cannot satisfy both the these eligibility requirements.  

The medical aid in dying laws in Oregon, Washington, Vermont, and California all leave out dementia patients.  Unless the eligibility criteria are expanded, we really need to focus more on best practices for VSED.  The Quebec medical board has recognized this.  Other must too.    
  

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.