{"id":5964,"date":"2023-12-15T20:20:35","date_gmt":"2023-12-15T20:20:35","guid":{"rendered":"https:\/\/finalexodus.org\/EndOfLife\/?page_id=5964"},"modified":"2025-07-11T03:28:17","modified_gmt":"2025-07-11T03:28:17","slug":"deep-dive","status":"publish","type":"page","link":"https:\/\/finalexodus.org\/EndOfLife\/deep-dive\/","title":{"rendered":"Deep Dive"},"content":{"rendered":"\t\t
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DEEP DIVE: ADVANCE DIRECTIVES AND DEMENTIA<\/h1>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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This page is created to supplement other pages, primarlily the Advance Directive page, but also the one dealing with Dementia. Those pages have links to here.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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ADVANCE DIRECTIVES THAT CALL FOR STOPPING EATING & DRINKING (SED) AFTER INCAPACITY<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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In the informative book, Voluntarily<\/em> Stopping Eating and Drinking<\/em>\u00a0by Timothy E. Quill, Paul T. Menzel, et al., the authors devote Part II to “Stopping Eating and Drinking by Advance Directive (SED by AD) for Persons Without Decision Making Capacity<\/em>.” SED by AD raises a legal issue, are food and fluids medical treatments? If they are, then the agent has the authority to carry out SED by AD. If they aren’t, then the agent doesn’t. In other words, does the agent have authority to cause the death of the principal? If s\/he doesn’t, then the agent is committing a felony, assisting suicide or murder.<\/p>

If the agent’s medical decision isn’t expected or designed to cause death, but does so unexpectedly, there is no such crime; the agent is merely carrying out her or his authorized responsibilities. But is it the same if the intent is, based on the SED directive, to cause death? The answer probably depends, according to the VSED book, on whether food and drink are medical treatments. There is no answer from the courts on this issue. As far as this author knows, the issue has yet to be pursued in the courts.<\/p>

Here is the background.\u00a0 The Supreme Court of the United States has held that people have a right not only to obtain medical treatment, but to deny or terminate medical treatment, even if such denial or termination leads to death.\u00a0\u00a0 Doctors\u2019 wishes and opinions must stand aside for the individual\u2019s own decision.<\/p>

The states have determined that when a person is incapacitated, his or her agent, with a durable power of attorney for health care, can make the same decisions the patient\/principal could have made had s\/he not lost capacity.\u00a0 Thus we have advance directives.<\/p>

The question of whether food and fluids are medical treatments has become a major issue in the right-to-die movement.<\/p>

Largely because of this issue the final choices in this website’s directive, giving the agent authority to institute SED by AD, creates the opportunity for this to be litigated. Of course litigation is not the best way to go.<\/p>

Legislation would be better. This has been done in Nevada, Vermont and Arizona.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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THE BURDEN OF CHOOSING STOPPING EATING & DRINKING (SED) IN THE ADVANCE DIRECTIVE FORM<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Principals who direct SED by AD are\u00a0 asking their agent to intentionally oversee their death.<\/strong>\u00a0 That is placing a very heavy burden on the agent and others involved.\u00a0 The agent must be willing to accept this burden.\u00a0 Again, a conversation is essential.<\/p>

In this website there are two forms that allow one to choose SED by AD. \u00a0The general form and the special form for people with early dementia. For more information on the latter, see the instructions to the Early Dementia Directive form.\u00a0 What\u00a0 follows below is information for the general form.<\/p>

In this website’s general form, page 2, the four choices under #5 create this burden, unless the prior sentence, #5, is chosen too.<\/p>

Choosing the four without also choosing the preceeding sentence, #5, could well mean that the agent must go to court to assert the principal\u2019s right to end her or his life this way \u2013 an expensive and very time consuming process. Be very careful about putting your agent and family in this situation.\u00a0 In Nevada, this shouldn’t be a problem.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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OTHER DEMENTIAS<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Here are three prevalent dementias:<\/p>

Vascular<\/a> \u2013 hardening of the arteries in the brain., Huntington\u2019s<\/a> \u2013 a break down in the brain\u2019s nerve cells. Lewy Body<\/a> \u2013 abnormal deposits of the brain protein alpha-synuclein.\u00a0 In Alzheimer\u2019s, lewy body and tau proteins become twisted. \u00a0In this link you will find the details of the dementias listed above and the names and details of many other dementias.<\/a><\/p>

Furthermore, dementia can arise secondarily in the late stages of other diseases, namely Parkinson\u2019s, HIV, multiple sclerosis and alcoholism.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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OTHER ADVANCE DIRECTIVE FORMS<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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The main sources of free forms are each state’s statutory forms, which can be found here<\/a>. Another free form is the Veterans\u2019 Administration<\/a> version.\u00a0<\/p>

Two for-fee forms, the first of which is very popular (with a slight religious bias), are: Five Wishes<\/a>, and Formswift\u2019s Living Will\/Advance Directive<\/a>.\u00a0\u00a0<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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PREVENTING ALZHEIMER\u2019S DISEASE<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Some research progress is being made on reversing Alzheimer\u2019s in its very early stage.<\/p>\n\n

Extensive recent medical research clearly indicates that with a healthy lifestyle one has a good chance of preventing Alzheimer's disease.<\/p>\nWhat life style changes? (As many as you can do; the more, the better.)\n