Voluntary stopping of eating and drinking in advance directives for adults with late-stage dementia

Australas J Ageing. 2020 Jun;39(2):142-147. doi: 10.1111/ajag.12737. Epub 2019 Nov 19.

Abstract

Objective: The objective of this paper is to explore the ethical and legal validity of advance directives that request the voluntary stopping of eating and drinking against a backdrop of late-stage dementia.

Method: Doctrinal research and analysis of primary and secondary materials including Australian legislation, Australian case law and journal articles was undertaken.

Results: There is legal uncertainty in Australia around whether an advance directive to voluntarily stop eating and drinking will be followed should the adult become incompetent.

Conclusion: Voluntary stopping of eating and drinking should be viewed in law as a form of "treatment" that competent adults can nominate in advance directives, thereby providing dementia patients with the opportunity to choose in advance, if they wish, to end their life legally, with dignity and comfort, and in a manner that does not implicate others in criminal behaviour such as assisted suicide, acceleration of death or euthanasia.

Keywords: advance care planning; advance directive; dementia; withholding treatment.

MeSH terms

  • Advance Directives*
  • Australia
  • Dementia* / diagnosis
  • Dementia* / therapy
  • Drinking
  • Eating
  • Humans
  • Suicide, Assisted*