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I received a very nice letter from a reader of Secondhand Smoke that I thought I would share with y’all to see what you think: She wrote in part: “I am curious to know what your stance on self-starvation is, since someone recently accused you of being a “hypocrite” (I really disagree with that judgement) for believing that self-starvation is not suicide. Unfortunately, I’m having a little trouble navigating your blog to find articles that reflect your opinion. What would you recommend I read to have your opinion best represented in this matter?”

This is the relevant part of my response: “I don’t recall ever discussing self-starvation. Unless the person means that I think people have a right to refuse tube feeding if they become incapacitated. My position is I don’t support that morally, but I would not try to prevent it legally, assuming the person has put it in writing. In that case, the person would die of natural processes, not self starvation. If an elderly person stops eating as the body shuts down due to old age and the dying process, that too is natural and not self starvation, when he or she refuses to eat. If that person does not want a feeding tube, I would respect that desire since a feeding tube is surgery, and they are not refusing to eat due to mental illness.

“Self-starvation as a form of suicide would be different. It used to be done in Roman times. This is something of a first impression for me, but if a person is depressed and wishes to self starve to death, otherwise having the capacity to eat and drink, I think that that person’s life should be saved just like we would if he or she were going to jump off a bridge. And I don’t think that would require a feeding tube or that kind of surgery. It would require a legal finding that the person is beyond a reasonable doubt a threat to themselves. Under such conditions, the state can hospitalize the suicidal person for treatment. I see no reason why that would not also apply to self starvation suicide...

“I guess your friend thinks I am a hypocrite because I am not a vitalist, that is, I don’t think that everything has to be done on every occasion, no matter how much suffering it causes, to keep people alive. I don’t see it as hypocrisy, though. People have a right to personal autonomy, that is, the right to refuse unwanted medical interventions. For example, Pope JP II did not have everything done that could be done to extend his life, and I think he was a very ethical man.” (And I should have added, that JP II certainly didn’t commit suicide.)


The floor is open to anyone who wishes to comment. Thanks.


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