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PCPs can help patients who intend to die by voluntarily stopping eating, drinking

Primary care providers can provide counseling and palliative care to patients who choose to hasten death by voluntarily stopping eating and drinking, according to research published in the Annals of Family Medicine.

Eva E. Bolt, MD, and colleagues, surveyed a national sample of family physicians in the Netherlands to investigate their role in managing patients who voluntarily stop eating and drinking (VSED) and the process of VSED.

The first survey was mailed to 1,100 family physicians and 708 replied. Based on those responses, Bolt and colleagues sent out an additional survey on individual VSED cases to 500 of the initial respondents. They received 285 responses to the second questionnaire. The responders reported on 99 cases of VSED.

Eva E. Bolt

The results demonstrated 46% of family physicians had experienced a case of VSED at some point in their career and 9% had experienced a case of VSED in the last year. Half of the physicians were informed of the VSED beforehand, and of those, 62% were involved in the VSED.

Researchers also reported that 70% of patients who used VSED to hasten death were older, with a median age of 83 years, 76% had severe disease and 77% depended on others for everyday care. Additionally, the most common symptoms were pain (14%), fatigue (9%), impaired cognitive functioning (8%) and thirst or dry throat (7%). The median time until death was 7 days.

Bolt and colleagues detailed the role that physicians can play with these patients.

"In the preparatory phase, physicians can provide information to patients and proxies and can coordinate care," they wrote. "Specific treatments are available for many symptoms described in this study (pain, thirst or dry throat, dyspnea, delirium, and agitation. Palliative sedation can be indicated in cases of severe refractory symptoms." – by Chelsea Frajerman Pardes

Disclosures: The authors report no relevant financial disclosures.