Elderly patients at risk of forced starvation in Oregon

Health | New bill would give family and doctors the ability to withhold food and water without a patient’s consent
by Samantha Gobba
Posted 2/07/17, 10:46 am

Oregon pro-lifers are fighting a bill in their state’s Senate that could allow the starvation or dehydration of patients with dementia or mental illness—without their prior written consent.

S.B. 494, introduced by a judiciary committee, appears at first simply to update the state’s advance directive laws. But it allows a patient’s representative to remove undefined “life-sustaining procedures” if the patient has “a progressive illness,” has stopped talking, and cannot recognize family members.

The bill would allow an authorized guardian, spouse, a majority of their children, their parents, a friend, or if none is available, an attending physician to order the withdrawal of “life-sustaining procedures” that could include food and water, even if the advance directive did not give explicit permission or if the patient had no advance directive at all. 

A spokeswoman for the Senate committee said about 50 people worked on the legislation for the last two years. Authors of the bill did not respond to questions about its content.

“S.B. 494 has as its goal to give surrogates the ability to withdraw food and fluids from Alzheimer’s patients, dementia patients, and mentally ill patients,” Gayle Atteberry, director of Oregon Right to Life, told me. “It does it in very sneaky and crafty ways, but it does it.”

Atteberry said lawmakers kept the bill’s wording intentionally vague in order “to make everything very unclear and subject to whatever the people surrounding the patient want to do.”

The bill removes the definitions of tube feeding, life support, and dementia, along with all references to power of attorney from current Oregon advance directive law. But it leaves the definitions of tube feeding and life support in the advance directive form patients would fill out.

“You can say, ‘I don’t want tube feeding,’ but unless tube feeding is defined in the statute, it’s just words,” Atteberry said.

The bill also leaves room to stop spoon-feeding patients who can and still want to eat, Atteberry said. Last year, Oregon courts considered the case of a man who wanted nursing home workers to stop spoon-feeding his wife, Nora Harris, who had Alzheimer’s. He argued her advance directive against life support included spoon-feeding. A judge disagreed, ruling Oregon law requires nursing home workers to provide assistance with eating, including offering food on utensils.

Alex Schadenberg, director of the Euthanasia Prevention Coalition, said the bill would not force people to choose death by dehydration, “but it’s so highly suggestive it’s ridiculous.”

Most advance directive forms allow people to choose death by dehydration, he said, but he’s never seen an advance directive bill so focused on withdrawing food and water.

“This is dressed up as a normal advance directive bill, but for some reason, someone has a fetish for dehydration,” he said. ”It’s the priority of this bill to get people to say, ‘yes’ to dehydration. I will tell you that that is the gateway to euthanasia.”

Since death by dehydration, even softened by morphine, is a death prolonged over roughly nine days, he said people will begin “clamoring for death by euthanasia,” which is faster and appears more compassionate: “Who wants to watch Mom dehydrating to death? No one.”

Oregon Right to Life members are working to inform legislators, both Republicans and Democrats, of every facet of the bill. Pro-life senators, Atteberry said, oppose the bill, while even pro-choice senators act surprised at its contents.

“We are hopeful,” Atteberry said. “We are praying. The only one who can really stop this bill is God.”

Samantha Gobba

Samantha reports on the pro-life movement for WORLD Digital.

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  • My Two Cents
    Posted: Tue, 02/07/2017 11:26 am

    This is so horrifying. There is a fine line between "allowing" natural death by withholding basic sustenance, and an obligation to get out of the way quickly once age sets in. 

  • Janet B
    Posted: Tue, 02/07/2017 11:47 am

    My mom has dementia, so I understand the difficulties of the disease.  But I can assure you that the difficulties are more on us children as we care for her.

    This bill is designed to alleviate the trouble caused to the caregivers.  It promotes selfishness and greed.  Make no mistake; the folks who promote this care nothing for the life of the one they are so eager to help to die. 

  • grateful2
    Posted: Tue, 02/07/2017 05:16 pm

    My mother had an advanced directive that said not to insert a nasogastric tube if she was unable to eat. She later got Progressive Supranuclear Palsy and eventually became unable to eat.  A stomach tube was suggested to be inserted.  She was no longer able to communicate, having lost the ability to move any of her voluntary  muscles, but she was still conscious and aware.  I am embarassed to admit that I, the one daughter who wasn't involved in her daily care due to living 1,000 miles away, encouraged them not to have the stomach tube inserted.  I didn't want her to suffer for a long time in that condition, but my two sisters who were involved in her daily care couldn't imagine withholding sustenance and I'm thankful they did go ahead and have the feeding tube inserted.  It would have been wrong to dehydrate her to death.  I was able to tell her how sorry I was that I was such a difficult teenager and she was still able to cry and we cried together.  Words from her weren't necessary.  I knew I was understood. She lived another 7 years or so, finally passing away from pneumonia.  She was kept in her own home and had hired caregivers who helped my Dad and at times my sisters care for her.  He had purchased Long Term Care Insurance before she got Progressive Supranuclear Palsy and that helped pay for her care.  We know where she is and look forward to a glad reunion.

  • Fani's picture
    Posted: Sat, 02/18/2017 12:43 pm

    Dear Grateful2,

    Thank you so much for taking the time to write this. It could not have been easy.

    I'm glad to know of your sisters' determination and selflessness, and to know you were able to have that moment of forgiveness with your mom. On this side of Heaven, we will never know all the ways that God, in His infinite wisdom, used your mom and her needs in those final years for His glory. 

    I remember a woman explaining to me why she had aborted her third child. In detail she explained that the amniocentisis test had revealed Down syndrome. In detail she explained all the hardships in her life (not financial, but in my view the regular difficulties in raising two children). Horrified, all I could think was, Wow. You murdered your own child, and now you're rationalizing this to me—twenty years after the fact.

    Who knows how God could have used this dear baby to bring blessings to her life?

    We humans are far too flawed to have the legal means to take away life in our hands.


  • Kiwi's picture
    Posted: Tue, 02/07/2017 06:09 pm

    Utterly and totally horrendous.  I have witnessed many people starve and dehydrate to death because they were physically unable to swallow.  It is incumbent upon us in the command to 'love our neighbours as ourselves' to assist those who are hungry and thirsty, but who cannot speak or remember, to eat and drink.  This is what I do everyday for my autistic son when I prepare food for him. This is what I do when I go to work and spend hours each day spooning food into the mouths of those who do not speak, and have forgotten how to use a spoon.  I enjoy concocting new flavour mixes of milkshakes and floats for a man who hardly ever speaks, is in his 90s, and does not eat much.  He gives me huge grins when I try a new flavour.  This is joy, this is a bright spot in his final days.  Who knows how long he has left on this earth?  He will not dehydrate to death on my watch - I would risk being fired to give him his 'special shakes'.  I say this knowing full well that that time will come to all nursing home workers - kill your residents or lose the ability to support your family. There are already so many in the nursing home industry who complain of the hassle and bother of caring for people who need to be spoon fed, and even those who have feeding tubes. Yes, it's hard work, but it is a privilege. I find that even my residents with advanced dementia have great value and worth, I love them, and try to encourage fellow workers to see their value also. I try to get the other workers to take the time to give the residents food and drink when I am not there. They know I am a follower of Jesus, and is a testimony to them.

  •  Deb O's picture
    Deb O
    Posted: Wed, 02/08/2017 02:17 pm

    God bless your beautiful and loving heart, Kiwi.  You have allowed your Savior to turn sorrow into joy in your life, your son's life and all of the residents under your care.  Yes, that day will come where all nursing home workers will be forced to kill and doctors will be forced to prescribe lethal doses of medication.  It's what is done in the vet's office for dogs and cats, and they seem to be more revered than throwaway people. 

  • My Two Cents
    Posted: Wed, 02/08/2017 03:32 pm

    Kiwi, may God bless you. I worked as a nurses' aid in a nursing home when I was in high school and home for breaks during college. I remember vividly when I was 17 and I was feeding "Donna" her pureed dinner. Donna couldn't speak, she was spastic with severe cerebral palsy but oh, she loved watching cartoons on tv and would wiggle with anticipation whenever the food tray came. As I was feeding her, another aide was feeding her roommate, another young woman with Down syndrome and sever epileptic seizures. This nurse went on and on about quality of life, and how it was a waste of time to sustain these two people when it was obvious they'd never get better, blah blah. I was growing more furious and found myself stuffing spoonfuls into Donna's mouth. Finally this woman left and I was left alone with Donna. I don't remember what I said exactly, but I told her not to pay any attention, that her life was worth more than that woman's, and Jesus loved her and created her. I watched this tear fall down her cheek. We cried together. Donna couldn't speak, but she could hear. After that it was like she and I shared this secret and I'd always joke around and do silly dances to amuse her. I only regret that with my young age I didn't stand up against the bully NA. And I told Donna of my regret, and she wiggled and shrieked with delight. I imagine Donna eventually died in her state of happy bliss, and is with Jesus.


  • Cmakowski
    Posted: Tue, 02/07/2017 10:19 pm

    This is stunning! How could anyone even seriously consider starving a patient to death! Or dehydrating one to death! Don't these people understand what those words mean?! So we can't waterboard terrorists because it's torture, but hey, torture away the helpless??!!!

    Apparently these people and unborn people have no right to life if someone deems them inconvenient!! Is that going to be the future defense for cold blooded murder?! What? You think that unlikely? Let me ask you this: what's the difference?! 

  • Janet S
    Posted: Wed, 02/08/2017 10:52 am

    The problem with going down a slippery slope is that you usually do not stop until you reach the bottom.  Romans 1:28 "And because they did not think it worthwhile to acknowledge God, God delivered them over to a worthless mind to do what is morally wrong."  We have been silent for too long.  It is time to wake from our slumber and reach our nation for God.  Let our voices be heard.  It is possible to stop on the slope, but how many "inconvenient" lives will be sacrified before we stand for justice and mercy.

  • VT
    Posted: Wed, 02/08/2017 12:41 pm

    This is terrifying, if I had dementia, I would still want to eat.

  • JennyBeth
    Posted: Mon, 02/13/2017 09:30 pm

    We should never withdraw life-sustaining care just because care is too tiresome or difficult, etc., and I don't support euthanasia to end suffering, but I have seen cases where declining a feeding tube was justifiable. Alzheimer's runs in my family, and when the oldest of my great-aunts reached the point of not being able to eat even from a spoon, the doctors urged the family to put a feeding tube in. After watching her go on for years unable to get up or communicate, scarcely conscious, and yet kept alive, the siblings began to regret that decision; it seemed more like uselessly prolonging death than sustaining life. The next time one of them was in that position, the siblings (who, again, all knew they were likely headed to the same condition someday) agreed it would not be the best thing for her. I really can't say where the line is; all we can do is pray for God's grace and wisdom :(

  • WM
    Posted: Mon, 02/27/2017 11:10 pm

    I live in Oregon.  I had to face similar issues with my mother quite a few years ago.  She developed increasingly severe systemic infections near the end of her life.  At one point, her own doctor took upon himself the decision to 'code' her as 'do not resusitate' without consulting her or any of us siblings.  At another time, ER attendants (doctors and nurses) said that she had had suffered severe brain seizures and would be in a 'vegetative' state permanently, and we were being unreasonable by not authorizing them to pulll the plug.  Not true!  Some important times remained for us, as a family.  Underhanded euthanasia is going on now, and has been for a long time.  I watched another family member, in a different state, be deprived of food and water until his death.  He had been resusitated after a heart attack, against his declared wishes, so perhaps caregivers felt justified in some way by this fact.  I am ashamed that I did nothing to try to keep him fed and hydrated, and allowed the deliberate decision to take the rest of his life from him to stand, unchallenged.

    Once we allow this very basic boundary to be erased (treating food and water as if they were a form of artificial llife support), there will be a flood of such deaths, whether the patient - or even family members - wish it.  This stealth-euthanasia seems to blur or cross another foundational line - from euthanasia to homicide.  Medically sanctioned murder.  I believe that we in Oregon will be watched closely, and if the bill is allowed to pass, similar legislation will be introduced in other parts of the country.  

    We seemingly no longer have any compelling reason to cherish and protect life in our culture of free-falling morality.  May God have mercy on us and send us an awakening.