Background: A competent patient has the right to refuse foods and fluids even if the patient will die. The exercise of this right, known as voluntarily stopping eating and drinking (VSED), is sometimes proposed as an alternative to physician assisted suicide. In earlier work on this issue, we claimed that even if we classify VSED as a form of suicide, there are good grounds for rejecting the view that doctors making a patient comfortable are assisting suicide.
Methods: In this presentation, we will focus instead on the different issue about whether VSED really is a form of suicide. We approach this question by looking first at how the refusal of artificial nutrition and hydration has been held, both in medical ethics and the law, not to be a form of suicide and then we ask whether the same arguments apply to VSED.
Results: We claim that the only ground for resisting the classification of VSED as a form of suicide is a normative one to do with avoiding certain connotations associated with the word ‘suicide’. These include connotations of mental illness or depression, the stigma attached to the expression ‘committing suicide’ and, possibly, claims made by some stakeholders that the legalisation of assisted suicide is incompatible with policies aimed at reducing the rates of suicide in many jurisdictions. We examine whether these connotations provide a sufficiently robust reason for refusing to classify VSED as a form of suicide. We then examine whether there are alternative grounds for the distinction.