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Some people want to die without food or fluids. They are accompanied by the family doctor more often than expected. This was the result of a study by the Zurich University of Applied Sciences (ZHAW).
(sda)
On average, doctors had to deal with eleven cases of death, as the ZHAW announced Thursday. “We would not have expected such a high value,” said Sabrina Stängle, study co-author and research assistant in the ZHAW Department of Health’s Nursing Science Research Center.
Stängle sees a possible explanation for the high rate of fasting death cases in the reliability of general practitioners. In the representative survey, about 750 doctors were interviewed. In medical jargon, fasting until death is called “voluntary renunciation of food and liquids (FVNF).”
Inconsistent handling
Although a large proportion of general practitioners have already accompanied patients during the fast, there has been a lack of standardized management of them, the ZHAW wrote.
“A consensus is needed for a professional and standardized management of FVNF,” explained Stängle. In addition, more opportunities are needed for general practitioners, those affected and their families to learn more about the fasting process, for example about its physical symptoms such as acute confusion (delirium) or pain. “It can be devastating if those affected and their families are not properly informed and instructed.”
According to Daniel Büche, chief physician at the palliative center at St. Gallen Cantonal Hospital and a co-author of the study, people who want to end their lives by fasting often don’t know what they are getting into. “The process can be cumbersome and tedious; people often don’t realize that.” And general practitioners sometimes lack knowledge of how to deal with patients’ wishes to end life through fasting.
A natural process of death for most
A good 60 percent of the surveyed doctors see fasting death as a natural death process that is accompanied by nurses or doctors. 32 percent defined FVNF as a form of passive euthanasia, around six percent view an FVNF accompanied by nurses or doctors as assisted suicide.
For more than two-thirds (73 percent) of those surveyed, the death fast is compatible with their worldview or religion, and for 58 percent with their professional ethics. A good half of the doctors described accompanying a death fast as a stressful situation for them.
Large number of unreported cases
The study also recorded how many deaths at home or in the elderly and nursing homes were due to the death fast. Research with figures from 2017 found that 1.1 percent of cases announced that fasting was the cause of death. In absolute numbers, 458 people ended their lives with FVNF in 2017.
However, researchers suspect that the number of unreported cases is higher. They estimate that there are definitely two or more cases of announced death fasts in which those affected did not communicate their decision to abstain from eating and drinking.