Natural Dying is the alternative to Physician-Assisted Dying (Medical Aid in Dying) for patients who want to avoid prolonging dying with suffering in Advanced Dementia and other terminal illnesses.
A) Natural Dying does not actively cause patients' dying. Instead, patients die of their underlying disease. Example: patients die from severe impairment of mental functioning due to their brain disease, Advanced Dementia. (The physician orders for Natural Dying include stop assisting hand-feeding and hand-hydrating, but always offer food and fluid by placing them in front of patients and within patients’ reach.)
B) Natural Dying does not require alert patients to make a one–time, irreversible decision. Instead, they can change their mind after fasting for a few days;
C) Natural Dying and VSED (Voluntarily Stopping Eating and Drinking) are legal almost everywhere and do not necessarily depend on finding
a physician who is willing;
D) MAiD—even where legal—cannot let patients die after they reach Advanced Dementia. Why? Two reasons: Patients usually live longer than 6 months, and their
minds are not sound enough to make this extremely important decision: Do they want to continue to live in the face of severe suffering?
Strategic Advance Care Planning lets you express your end-of-life requests based on your values in a way that is clear, comprehensive, consistent, convincing, and compelling.
The Natural Dying Living Will is Unique:
Compelling: Severe enough suffering is the single criterion used to determine
when patients want to die of their underlying disease.
(or their proxies/agents) judge over four dozen conditions that include what people dread most about prolonged dying in advanced
dementia and other terminal illnesses.
Easy to complete: Illustrated and written
at the 4th grade of reading comprehension, My Way Cards can be used by many patients in early dementia
to make judgments about future possible conditions.
Straightforward to interpret:
Physicians do NOT need to assess patients’ current suffering. Instead, physicians only need to determine if patients have reached a clinical condition that patients
had previously judged would cause SEVERE ENOUGH SUFFERING for them to be allowed to die of their underlying disease.
Acceptable: The intervention “Natural Dying” (as explained) aspires to
be accepted by authorities who view it as legal, ethical, moral, and consistent with the teachings of conservative religions.
Respectful: Avoids conflict that could lead to either prolonged or premature dying by:
(A) The interpretation of observed feeding behavior can lead to mistakes and either premature or prolonged dying;
(B) Use of “stage of disease” can be arbitrary and/or irrelevant;
(C) Physicians imposing what they believe is in patients’ “Best Interest” can be paternalistic and not reflect patients’ values; and,
(D) Relying on such vague terms as “indignity” and “quality of life” could be ambiguous and lead to prolonged conflict, or worse: it could begin a dangerous
slippery slope where one group of people assumes they have the right to judge if the lives of other people are worth living.
can be added that strive to overcome more than 14 common challenges, rather than assuming—or hoping—that others will honor patients‘ clear and specific wishes.