The Corner

Nevada Legalizes Starving Incapacitated Patients

This is stunning. Nevada has passed a law allowing competent persons to sign an advance directive instructing that all food and water be withheld if they become incapacitated by dementia. In other words, the law allows people to order their future care givers to starve and dehydrate them to death.

From the “End of Life Decisions Addendum Statement of Desires” portion of the advance directive form established in law by SB 121 (my emphasis).

(Insert name of agent) might have to decide, if you get very sick, whether to continue with your medicine or to stop your medicine, even if it means you might not live, (Insert name of agent) will talk to you to find out what you want to do, and will follow your wishes.

If you are not able to talk to (insert name of agent), you can help him or her make these decisions for you by letting your agent know what you want.

Here are your choices. Please circle yes or no to each of the following statements and sign your name below:

1. I want to take all the medicine and receive any treatment I can to keep me alive regardless of how the medicine or treatment makes me feel.
YES
NO

4. I want to get food and water even if I do not want to take medicine or receive treatment.
YES
NO

The highlighted question does not involve feeding tubes, which is a medical treatment. It isn’t about not providing nourishment when someone stops eating and drinking naturally as part of the dying process. Nor does it involve force feeding the patient. No, this provision requires withholding oral or spoon feeding.

Realize that this form could force caregivers to starve patients even when they willingly eat and drink — perhaps even if they ask for food or water. (This has happened before in a feeding tube case in Florida.) Don’t take my word for it. From an article on the Nevada law by bioethicist Thaddeus Mason Pope:

Even after we stop offering food and fluids, other problems may arise. Most problematically, the patient may make gestures or utterances that seem to contradict her prior instructions [to be starved].

Does such communication revoke the advance directive? A recent court case from the Netherlands suggests the answer is “no.” Once the patient reaches late-stage dementia, she is unable to knowingly and voluntarily revoke decisions she made with capacity. But the answer remains uncertain in the United States.

We certainly know the answer that bioethicists like Pope would urge on the courts. Besides, there is nothing in the law requiring that the provision quoted above only apply to “late stage” dementia.

Note also that the law does not require the signer to receive detailed information about the agony that starving and dehydrating entails. Symptoms can include extreme drying, seizures, mottling, and intense pain.

This law doesn’t just impact helpless patients, but also the emotional wellbeing of their caregivers. What kind of a person would presume to force anyone to do such a thing? Imagine the emotional impact! No one should have that right.

And what if doctors or nurses object? Could they be forced at the threat of being sued or professionally disciplined to starve a patient to death?

The Nevada law is silent, but medical professionals have been sued frequently for refusing to comply with advance directives. Besides, bioethicists and the medical establishment are hell-bent on destroying medical conscience by forcing healthcare professionals to engage in actions that violate their religious and/or moral beliefs as the price of licensure. Talk about a prescription for a brain drain!

One last point: The ultimate purpose behind laws such as this isn’t starvation, but rather, to gull us into allowing the aged, disabled, mentally incapacitated, and dying to be killed by lethal injection. After all, the ghouls will say, if we are going to end people’s lives, at least let’s do it humanely.

No! Let’s not do it.

Our cultural death obsession is really getting out of hand. Those with eyes to see, let them see.

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