VDD:

WHY GIVING UP WATER IS BETTER THAN

OTHER MEANS OF VOLUNTARY DEATH


SYNOPSIS:

    Voluntary death differs from irrational suicide in four ways:
Voluntary death is (1) helpful, (2) rational, (3) well-planned, (4) admirable.
This essay explores a new means of choosing a voluntary death
giving up all water and other fluids
which will result in a peaceful death within two weeks.
Death by dehydration is better
than other methods of choosing a voluntary death
for the following reasons.


OUTLINE:


1.  A MEANS OF VOLUNTARY DEATH
     THAT DISCOURAGES IRRATIONAL SUICIDE

    A.  THE FOUR FEATURES OF IRRATIONAL SUICIDE.

     B.  THE FOUR FEATURES OF VOLUNTARY DEATH.


2.  A MEANS OF VOLUNTARY DEATH
     THAT DOES NOT DEPEND ON DOCTORS


3.  A MEANS OF VOLUNTARY DEATH
     THAT DOES NOT REQUIRE ANY CHANGE OF LAW


4.  A MEANS OF VOLUNTARY DEATH
     THAT ANYONE CAN USE

5.  A MEANS OF VOLUNTARY DEATH
     THAT IS RELATIVELY PAINLESS AND PEACEFUL

6.  A MEANS OF VOLUNTARY DEATH
     THAT ENCOURAGES PARTICIPATION BY OTHERS  





VDD:

WHY GIVING UP WATER IS BETTER THAN

OTHER MEANS OF VOLUNTARY DEATH


by James Leonard Park

1.  A MEANS OF VOLUNTARY DEATH
     THAT DISCOURAGES IRRATIONAL SUICIDE


    Thirty thousand people will kill themselves in the United States this year.
90-95% of these will be irrational suicides:
People will kill themselves for foolish 'reasons':
Some will kill themselves because of failed relationships.
Some will kill themselves because they lost all their money gambling.
Some will kill themselves because they mistakenly believe they have cancer.
Some will kill themselves in order to make other people feel guilty.
Some will kill themselves because they are overwhelmed by anxiety.
Some will kill themselves because they are deeply depressed.  
Some will kill themselves because of distorted religious beliefs.  

    We could probably add dozens of different irrational 'reasons'
for foolishly throwing away one's life.  

    Most people who are considering irrational suicide right now
are driven by temporary problems that might be resolved soon.
So advocates of the right-to-die for seriously ill patients
should remember the suicidal people who have no physical illness.




     A.  THE FOUR FEATURES OF IRRATIONAL SUICIDE.

    Irrational suicide differs from voluntary death in four ways:
Irrational suicide is: (1) harmful, (2) irrational, (3) capricious, & (4) regrettable:

    1. Irrational suicide is harmful to the victim.
Self-destruction does irreparable harm to the person who kills himself.
That person's life is over forever.
And all possibilities of realizing values and meanings are foreclosed.
Self-destructive behavior is a mysterious aspect of some human lives.
And irrational suicide is the most extreme form of self-destruction.

    2. Irrational suicide is not rational.  
This means that when others examine the alleged 'reasons' for suicide,
they usually do not agree that death would have been the best solution.  
Observers who are not overwhelmed by the temporary problem
are able to see more constructive solutions than committing suicide.  

    3. Irrational suicide is often capricious.
The suicidal person is responding to a sudden new situation.  
For example, right after being divorced by his wife, a man jumps off a bridge.  
If he had been prevented from killing himself because of his immediate loss,
he probably would be able to re-construct his life
without a spouse who has now rejected him.  

    4. Irrational suicide is regrettable
Almost  everyone who knew the person who committed irrational suicide
believes that it was an unfortunate choice.
And they wonder what they could have done to prevent this irrational act.  

    In the early years of the right-to-die movement,
the advocates of this right did not concern themselves very much
with the problem of irrational suicide.
They usually put the autonomy of the individual above everything else,
which includes allowing people to kill themselves even for foolish 'reasons'.

    And the methods-of-death used by the early right-to-die movement
could be used by persons committing irrational suicide
as easily as by people who were choosing a wise voluntary death.  
Opponents of the right-to-die did not have to search far
to find people who had committed irrational suicide
using the beliefs and methods of the right-to-die movement.  

    There are literally thousands of easy ways to kill ourselves.
But if we want to prevent irrational suicides,
we should not publicize these methods
to people who might misuse them to kill themselves foolishly.  

    Also, the right-to-die movement should be careful to prevent
suicidal people from appropriating the cloak of respectability and reason
that the right-to-die movement has attempted to create for itself.  

    When Jim Jones led his People's Temple cult into mass suicide in 1978,
he encourage them to "die with dignity".  
He claimed that it was some kind of political act.
But these acts of irrational suicide had nothing to do
with the right-to-die or with achieving a dignified death.

    If voluntary death by dehydration (VDD)
becomes a well-known means of choosing death,
then cult leaders will not be able to use VDD to trigger mass suicide.  
Since it takes a week or two to die by not drinking any fluids,
most of the followers of Jim Jones would have rejected
his foolish suicidal plan long before they were dead.  

    However, most irrational suicides are committed by individuals.  
These foolish deaths would be prevented if the suicidal persons
tried to kill themselves by giving up all fluids.  
How does death-by-dehydration prevent irrational suicide?  
It does so by lengthening the process of dying.  

    Deciding for death by dehydration requires many decisions.
Most methods of irrational suicide require only one momentary act.
The person who desires a dignified, rational death by dehydration
must reaffirm the decision not to drink any fluids every hour
between the beginning of the process of dying
and when death finally comes, perhaps two weeks later.  
If we consider only the hours of being awake,
this means that the choice of death must be reaffirmed
by the concrete act of refusing all fluids
more than 100 times over this period of two weeks.

    Most temporary 'reasons' for irrational suicide
will not last long enough for death-by-dehydration to be achieved.  

    The suicidal person who wants to die because of the loss of love
will find that the hunger and thirst of dying by this method
is worse than the psychological pain of being rejected.  
So this suicidal person will be saved from the irrational urge
by the slowness of the process of dying
and by the fact that it is so easy to start drinking fluids again
once the grief of the moment has passed.

    In most situations that would otherwise lead to irrational suicide,
the person who abandons water and other fluids in order to die
will resume drinking water before any permanent damage is done.
Other methods of attempting an irrational suicide
often do leave lasting (and sometimes permanent) damage.  

    But someone who is choosing a rational voluntary death
will not be deterred from that purpose
by the fact that it takes up to two weeks to die
and that the process of dying is uncomfortable. 




    B.  THE FOUR FEATURES OF VOLUNTARY DEATH.

    Voluntary death differs from irrational suicide because it is:
(1) helpful, (2) rational, (3) well-planned, & (4) admirable.
(These four features reverse
the features of irrational suicide described above.)

    1. A voluntary death is helpful
to the person who chooses this way to draw life to a close.
The patient has examined all possible pathways to death
and has decided that giving up food and water is the best path.
Perhaps other pathways include meaningless suffering.
Then voluntary death by dehydration
could be a definite benefit to the one who chooses this pathway.

    2. A voluntary death is rational.
This choice to die is based on complete medical information
and careful analysis of the whole life-situation of the patient.
Others who are close to the patient
can also examine and understand all the facts, opinions, & options
that lead the patient to choose a voluntary death.
A comprehensive, rational analysis leads them to agree
that death now is better than death at some later time.  

    3. A voluntary death is well-planned.  
In contrast to the capricious act of irrational suicide,
the person who is rationally choosing a voluntary death
might be engaged in the planning process for as long as a year. 
Even years before, the patient philosophically favored VDD.
But when the final factors tip the balance toward the choice of death,
the planning for the final months can be put into effect.  

    4. A voluntary death takes everyone else's feelings into account.  
And when they know all the facts and opinions,
they admire the choice for death rather than regret it.
In contrast, irrational suicides leave the family and friends in deep sorrow,
wondering what they should have done to prevent that self-destruction.
Voluntary deaths elicit admiration from those who were closest.  




2.  A MEANS OF VOLUNTARY DEATH
     THAT DOES NOT DEPEND ON DOCTORS


    In the early years of the right-to-die movement,
most of the methods-of-death that were discussed
involved active participation by doctors and/or nurses.  
This was because the primary means of voluntary death
was taking lethal doses of chemicals,
which were readily available to doctors and nurses.

    And opponents of the right-to-die rightly objected
to such participation by medical professionals.
They said: "Doctors must not kill."  
And many organizations of doctors took official stands
against any participation by doctors in chosen deaths.  

    However, if we choose death-by-dehydration
as our preferred means of voluntary death,
doctors need not have a central role in the final scene of that life.  

    Doctors would be able to keep their purposes clear
both in their own minds and in their public image.  
They would not be needed to help people to die.  
Their role would be limited to explaining
the medical condition of the patient.
The doctors will explain various treatment options,
along with the side-effects and likely outcome of each choice.  
Certainly pain-control measures will be provided by doctors.

    And the doctor can reassure the patient and the family
that death by dehydration is not a terrible death.  

    If fluids are being provided by means of tubes,
then doctors will be involved in ordering
such artificial hydration discontinued.  
But that differs sharply from writing a prescription for a lethal dose.  
The patient will not die as the result of the doctor's action.
The immediate cause of death will be voluntary dehydration,
a course of action chosen freely and rationally by the patient,
probably in consultation with his or her family and other advisors.  

    Doctors who want to have nothing to do with such deaths
can resign from the case
when the patient decides to die by dehydration.
The doctor need have nothing further to do with that patient.  
And the patient (with the emotional support of others)
has full capacity to carry out the plan for death-by-dehydration
without any further involvement by any physician.
However, the patient might choose VDD
with the compassionate help of a hospice program.

    After death has been achieved by dehydration,
a doctor will be called upon to write the death-certificate,
which will name the underlying disease or condition
as well as the immediate cause of death: dehydration.
 



3.  A MEANS OF VOLUNTARY DEATH
     THAT DOES NOT REQUIRE ANY CHANGE OF LAW


    In its early years, the right-to-die movement
spent thousands of human hours and millions of dollars
trying to modify the laws that prevented voluntary death
at least prohibiting the methods
that the right-to-die movement wanted to use.

    In some cases, the laws were successfully changed
so that doctors could prescribe lethal chemicals, for example,
under tightly controlled circumstances.  

    And such efforts to change the laws to permit
the rational choice of a well-planned death should probably continue.
Even if the laws are never changed,
the discussion should help all rational people to consider
whether they would ever choose a voluntary death
if their life were to worsen to such-and-such a degree.  

    However, one beauty of death-by-dehydration
is that no laws need be changed.  
Everywhere in the world, drinking fluids is a free act.
And deciding not to drink fluids is also a free act.  
No laws are likely ever to be written
which will force people to accept water
when they have decided to refuse it.  

    This method of voluntary death is already
completely within the reach of every person
who knows the difference between drinking fluids and not drinking fluids.  

    Even persons already in hospitals
have the complete right to order the end to all life-support systems,
including, of course, the provision of fluids by any method.

    No legislators need to spend even one minute thinking about this.
The courts will almost never be asked to make a decision.
All of us as rational, thoughtful persons
already have all the power and authority needed
to end our lives by giving up water and other fluids.  




4.  A MEANS OF VOLUNTARY DEATH
     THAT ANYONE CAN USE


    The older methods of voluntary death
required various chemicals or other kinds of equipment.
Not everyone who made a wise and compassionate
decision to end his or her life
had easy access to the recommended methods.

    And sometimes doctors and laws stood in the way
of making an exit from life at the time one rationally chose
—not too soon and not too late.

    But death-by-dehydration is a method
within the understanding and within the capacity
of any person who knows that death will result
if the body does not have enough fluids. 

    Anyone can choose this method of dying.
And we might prefer this method
because it shows that we reaffirmed our choice again and again
over the last two weeks of our lives.

    And we realize this is a good method
because it discourages other people from committing irrational suicide.  
Lives that might otherwise be meaninglessly lost to irrational suicide
will be saved because the suicidal persons
were not encouraged to use a quick method.
If suicidal people try to die by dehydration,
the time required will almost force them to rethink their decision to die.
Approaching death very slowly will provide plenty of opportunities
to find other ways to solve their problems than by killing themselves.




5.  A MEANS OF VOLUNTARY DEATH
     THAT IS RELATIVELY PAINLESS AND PEACEFUL


    A painless and peaceful death has been the goal
of the right-to-die movement since voluntary death was first conceived.  
Death by means of chemicals was the recommended method for many years.
Drugs can certainly achieve death without pain or emotional distress.  

    But since drugs need to taken only once,
they were subject to mistakes and abuses.  
In retrospect, some of the deaths so achieved
were determined to have been premature.  

    The claim that death-by-dehydration is usually painless and peaceful
will have to be better established when more people report such cases.

    Opponents of the right-to-die will tell dire tales of suffering.
But these should not be believed.  
Some of the symptoms they describe
happen only after the patient has become unconscious.
Thus, such problems will concern others observing the dying process.
And when everyone knows what to expect ahead of time,
the changes of a body being dehydrated should not be too alarming.  

    Being very thirsty is the main symptom we will experience
if we choose this means of voluntary death.  
And there are methods of alleviating this problem.
For example, there are commercial thirst-reducing aids.

    The distress of having a dry mouth can be relieved
by rinsing the mouth with water, by small sips of water, & by ice chips.
And if the death by dehydration is taking place in a hospice
or other medical facility, then medications can be provided
that will relieve almost all of the distressing symptoms.
Seek help from the professionals who have experience
with helping people to die by means of dehydration.
With good planning, most comfort-measures can also be used at home.

    After about a week without water or other fluids,
we will probably become unconscious.
We should leave clear instructions that our life-ending decision
should not be reversed by others after we lose consciousness. 

    Our minds will shut down first, followed by other parts of our bodies,
until our hearts and lungs finally stop working.  
Then death will be declared by a doctor,
who will explain on the death-certificate
any and all underlying diseases and conditions
that led to the reasonable decision for a voluntary death
as well as the fact that we ended our lives by voluntary dehydration.  

    Once society and the medical profession
have become used to the fact that some people
are choosing to end their lived by giving up all fluids,
then some additional choices can be made,
such as the donation of organs
before they are too damaged by dehydration.

    This might require some new definitions of death,
such as permanent unconsciousness,
which would then permit the body to be used
for organ-donation and even as a living cadaver.
But such further elaboration of this method of choosing death
will have to wait until people choose this way of dying more often. 

    For example, is there a point in the process of dying by dehydration
when the patient could be certified as brain-dead?




6.  A MEANS OF VOLUNTARY DEATH
     THAT ENCOURAGES PARTICIPATION BY OTHERS


    Irrational suicides are almost always
private, secret acts committed by desperate persons.
But voluntary deaths by means of dehydration
can encourage maximum participation
by all who care to share the final days of this patient.

    In many cases, the timing of the death
can be coordinated with the plans of everyone who wants to be present.
An approximate date of death can be set well in advance.
And all the family and friends can complete their relationships
with the dying patient well before that date.  
Friends and relatives of the patient who have jobs
can take vacation time to participate in the final days of the patient
and the following funeral or memorial service.  

    Someone who is tempted to commit irrational suicide
would almost never call a family meeting to discuss the best timing.  
The family would do their best to prevent an irrational self-killing.  
But when a rational, voluntary death is the best option,
the family can cooperate to chose the best date of death.

    When everyone is cooperating
in making the last days as meaningful as possible,
then this should be strong evidence for any distant critics
that this was a genuine voluntary death,
not a premature death coerced by others who had something to gain.  

    When the right-to-die had to be exercised in secret,
only a few people could be informed in advance
only the people who could be trusted not to tell the authorities
that a freely-chosen death was being planned.  

    But since there are no laws about giving up fluids,
everyone can be openly involved in the decision
and in the process of bringing this life to a close.
If there are differences of opinion about the wisdom of death at this time,
then these should be explored well in advance.
Perhaps some who think death is the wrong option
will be able to show another way out of the problems
that are leading to the decision to end this patient's life.  

    The secrecy and deception that was necessary
in the old ways of achieving voluntary death or merciful death
need not apply to death-by-dehydration.
And this greater openness and discussion
will prevent some premature deaths




    All in all, it seems that death-by-dehydration
achieves many values that were not possible
under other methods of choosing a voluntary death.
And the few additional burdens and problems seem tolerable,
given the number of benefits achieved. 

    What additional safeguards should be followed
to make sure that death by dehydration is the best possible death?

    Another on-line essay explores 26 suggested safeguards:
VOLUNTARY DEATH BY DEHYDRATION:
Safeguards to Make Sure it is a Wise Choice





AUTHOR: 

    James Leonard Park is an existential philosopher
and advocate of the right-to-die with careful safeguards.
Several links below lead to similar thinking.



The above analysis of the advantages of voluntary death by dehydration
is also Chapter 37 of How to Die: Safeguards Life-Ending Decisions:
"VDD: Why Giving Up Water is Better than other Means of Voluntary Death".

If you think "why hasn't anyone mentioned this before?",
you might consider joining a Facebook Seminar
revising this book for publication:
http://www.tc.umn.edu/~parkx032/ED-HTD.html

Join our Facebook Group called:
Safeguards for Life-Ending Decisions:
http://www.facebook.com/home.php#!/groups/107513822718270/




Links to further information about voluntary death by dehydration:

Go to a bibliography of books on Voluntary Death by Dehydration.

Go to an Internet portal called Voluntary Death by Dehydration
Questions and Answers.
This portal explores more details of the process of dying by dehydration.

{more links wanted}


Drafted 6-2-2003; revised 6-24-2003; 10-16-2003; 1-18-2004;
2-1-2005; 11-3-2005; 3-23-2007; 9-2-2007; 2-6-2008; 2-15-2008; 4-17-2008; 4-20-2008;
5-31-2009; 5-2-2010; 8-1-2010; 1-29-2011; 3-11-2011; 8-26-2011; 9-20-2011;
2-2-2012; 2-27-2012; 3-17-2012; 7-26-2012; 8-26-2012;
3-29-2013; 6-12-2013; 8-1-2014;


    Here are some related on-line essays and chapters:

Choosing Your Date of Death:
How to Achieve a Timely Death
Not too soon, Not too Late .

Taking Death in Stride: Practical Planning .

Losing the Marks of Personhood:
Discussing Degrees of Mental Decline
.

Advance Directives for Medical Care:
24 Important Questions to Answer
.

Fifteen Safeguards for Life-Ending Decisions .

The Number of People Reviewing a Life-Ending Decisions
Using the 26 Recommended Safeguards
.

Will this Death be an "Irrational Suicide" or a "Voluntary Death"? .

Will this Death be a "Mercy-Killing" or a "Merciful Death"? .

Four Legal Methods of Choosing Death .

VDD:
Why Giving Up Water is Better than other Means of Voluntary Death .

Voluntary Death by Dehydration:
Safeguards to Make Sure it is a Wise Choice
  .

Depressed?
Don't Kill Yourself! .



Go to the Right-to-Die Portal.



Go to the index page for Medical Ethics .



Go to other secular sermons by James Park,
organized into 10 subject-areas.



Go to the beginning of this home page:
An Existential Philosopher's Museum .




 
   

   









The views and opinions expressed in this page are strictly those of the page author.
The contents of this page have not been reviewed or approved by the University of Minnesota.