Questions about consciously stopping eating and drinking

AFPCup of water

More than seven hundred people die every year due to consciously stopping eating and drinking, estimates the Central Bureau of Statistics. The impact of that choice is enormous: for the family, but also for healthcare providers. Stopping eating and drinking accelerates death, and not everyone around a patient can handle that well.

At the end of this year, the KNMG medical federation will publish a revision of ‘the guidance on stopping eating and drinking’. This is the current guidance. For people who want more information about the method, there is a brochure from the Dutch Association for a Voluntary End of Life (NVVE).

Nieuwsuur speaks to two hospice doctors for answers to the most important questions.

Is it assisted suicide?

Consciously refraining from eating and drinking can be compared to refusing treatment that results in death. This is not considered suicide, but rather as exercising someone’s self-determination: the right to refuse care. Yvonne van Ingen is a palliative care consultant at a hospice in Alkmaar: “You can refuse treatments, refuse ventilation, refuse antibiotics and refrain from eating and drinking. Then it is a case of natural death.”

The Public Prosecution Service has announced that it is not a criminal offense in the Netherlands to kill yourself. “It is also not a criminal offense to stop eating and drinking and thereby cause or hasten your own death. Forcibly feeding people against their will is only permitted in special situations.” Read the full response from the Public Prosecution Service here.

Is it a gruesome death with pain and fear?

That is a big misconception that we hear more often, says hospice doctor Annemarie den Dulk of hospice Roosdonck in Roosendaal. “That it would be an ordeal. That people get pain due to dehydration, for example, is really a misconception. If there is good medical guidance, with nursing that has experience and prepares people well for what is to come, then it can be a nice experience. trajectory.”

What does the guidance consist of? Is there no guidance?

Preparation is extremely important, the hospices say. Good agreements are made with the client, but also with the family. “We want to know why the wish is there and whether the decision was really well-considered,” says Den Dulk.

The nurse monitors the clients closely and provides medication for additional symptoms. “It is very important to see what someone is suffering from, for example pain? Then we of course provide good pain relief. But not on purpose so much that someone becomes dazed and can no longer indicate pain,” says Den Dulk.

Is there an age limit?

There is no age limit for stopping eating and drinking. But the journey is usually difficult for people under the age of 60 who are healthy. “Younger people suffer more from thirst and other complaints. It also takes a long time for younger people to die,” states the NVVE brochure, written by GP researcher Eva Bolt.

What about medication and palliative sedation?

There are guidelines for this, say the hospice doctors. “You should only give sleeping pills if people experience serious complaints that you cannot alleviate in any other way.”

“People hear stories and think that you can be anesthetized. In other words: just connect the pump and then I die gently. But of course it is not disguised palliative sedation,” says Van Ingen.

Can anyone come back to it?

The hospice doctors experience that people reach a difficult point and become confused due to the lack of food and drink. “Then they can ask for water. Then a good nurse is needed who observes carefully whether there is a confused state. If so, then we have to do something about it and then giving them something to drink is not the solution. We will then take care of it. that someone is not bothered by their thirst complaints. But they can always come back to it. If at any point they think: I don’t want this procedure, they can stop and go home.”

What are the agreements for patients with reduced capacity?

The advice given by KNMG applies to competent adults who want to hasten the end of their lives.

Are you thinking about suicide or worried about someone? Talking about suicide helps and can be done anonymously via chat at www.113.nl or by telephone on 113 or 0800-0113.

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