Voluntarily Stopping Eating and Drinking by Proxy: A Long Term Care Dilemma

Abstract

In providing Patient Centered Care, the ethical principle of autonomy often helps to guide the treatment plan. The principle of non-maleficence also plays a vital role. In dementia care, the activated healthcare agent often speaks “on behalf” of the patient, but even then there's a limit to such authority. Within biomedical ethical literature, voluntary stopping eating and drinking has been a defensible decision for patients who maintain decision-making capacity and wish to exert their autonomy. However, it remains unclear whether a health care proxy may also make this decision on behalf of a patient with dementia, attempting to enforce such autonomy by proxy would be appropriate, or whether this would be an overreach.