Rodríguez-Prat Andrea, Monforte-Royo Cristina, Balaguer Albert
Faculty of Humanities, Universitat Internacional de Catalunya, Barcelona, Spain.
Department of Nursing, School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain.
Front Pharmacol. 2018 Mar 29;9:294. doi: 10.3389/fphar.2018.00294. eCollection 2018.
Some persons with advanced disease but no significant cognitive impairments consciously decide to stop taking food and fluids orally, even though they remain physically able to do so. The question is to what extent voluntarily stopping eating and drinking (VSED) may be considered an expression of a wish to hasten death, in the sense that the latter has been defined recently. We analyze the data reported in some studies in relation to primary care patients who died as a result of VSED and examine their results in light of the qualitative findings of patients that expressed a wish to die. In our view, VSED can be understood as a response to physical/psychological/spiritual suffering, as an expression of a loss of self, a desire to live but not in this way, a way of ending suffering, and as a kind of control over one's life. Thus, VSED is consistent with the wish to hasten death. Prior to interpreting this act as a deliberate expression of personal autonomy, it is important to explore all possible areas of suffering, including physical symptoms, psychological distress, existential suffering, and social aspects. Failure to do so will mean that we run the risk of abandoning a fellow human being to his or her suffering.
一些患有晚期疾病但无明显认知障碍的人，即使身体上仍有能力，也会有意识地决定停止经口进食和饮水。问题在于，从最近对加速死亡的定义来看，自愿停止进食和饮水（VSED）在多大程度上可被视为加速死亡愿望的一种表达。我们分析了一些关于因VSED死亡的初级护理患者的研究报告中的数据，并根据表达了死亡愿望的患者的定性研究结果来审视这些研究结果。在我们看来，VSED可被理解为对身体/心理/精神痛苦的一种回应，是自我丧失的一种表达，是一种想要活着但不愿以这种方式活着的愿望，是一种结束痛苦的方式，也是对自己生活的一种掌控。因此，VSED与加速死亡的愿望是一致的。在将这一行为解读为个人自主性的蓄意表达之前，探索所有可能的痛苦领域，包括身体症状、心理困扰、生存痛苦和社会层面，是很重要的。不这样做将意味着我们有可能让一个人独自承受痛苦。
