Fasting to stop suffering in advanced dementia

Alzheimers Dement (Amst). 2024 Mar 15;16(1):e12532. doi: 10.1002/dad2.12532. eCollection 2024 Jan-Mar.


Many healthcare providers think withholding food and fluids from advance dementia patients, even if those patients requested that when competent, is immoral. This means such patients suffer unnecessarily long. Patients have the ethical right when capacitated to specify that they want assistance with food and drink stopped when they have advanced dementia. Physicians should implement these patient choices when advance dementia patients can no longer feed themselves. In some states there may be legal barriers to this practice. The perpetual placement of food and drink within reach of patients who are unable to feed themselves is futile, so there is no need for it. The best way for persons concerned about suffering in advanced dementia is to add a supplement to one's advance directive specifying under what circumstances one wants food and fluids assistance stopped.

Keywords: advance directive supplements for refusal of feeding assistance; advanced dementia; causation of death; ceasing assisted feeding and drinking; euthanasia; hasten death; placing food and fluids in reach; proving inability to feed oneself is not reversible.