HARBORVIEW ETHICS FORUM | VOLUNTARILY STOP EATING AND DRINKING (VSED)
An Option of Last Resort Near the End of Life
Speaker:
David Gruenewald, MD, FACP
Section Chief, Palliative Care & Hospice Service
Geriatrics/Extended Care Service Line
VA Puget Sound Health Care System
Associate Professor of Medicine
Co-Director, Palliative Medicine Fellowship
Division of Gerontology & Geriatric Medicine
University of Washington
Dr. Gruenewald is Section Chief of the Palliative Care and Hospice Service at VA Puget Sound Health Care System. He is Co-Director of the Palliative Medicine Fellowship and Associate Professor of Medicine in the Division of Gerontology and Geriatric Medicine at the University of Washington School of Medicine.
His varied clinical interests in patient care near the end of life include the management of symptoms, especially difficult pain management problems; palliative treatments of “last resort” including palliative sedation and voluntarily stopping eating and drinking (VSED); conducting goals of care conversations; and communication skills. He co-founded the Palliative Care & Hospice Service at VA Puget Sound in 2004 and the UW Palliative Medicine Fellowship in 2008. He was project leader of a Dept. of Veterans Affairs initiative to improve family meetings in intensive care units, and co-chairs the national Hospice-Palliative Care Workgroup for the VA Electronic Health Record Modernization program.
Objectives:
- Describe ethical arguments for and against VSED near the end of life
- Identify reasons patients near the end of life may choose VSED
- Discuss steps health care providers should take in evaluating requests for hastened death, including VSED
- Discuss management of symptoms during VSED