Journal of Bioethical Inquiry

, Volume 12, Issue 3, pp 389–394 | Cite as

Decision-Making: At the End of Life and the Provision of Pretreatment Advice

  • Thaddeus Mason Pope
  • Bernadette J. RichardsEmail author
Recent Developments

Prospective Autonomy and Dementia: Ulysses Contracts for VSED


Despite a dearth of affirmative judicial or legislative guidance, it is generally accepted that a capacitated individual may legally and ethically hasten his or her death by voluntarily stopping eating and drinking (VSED) (Pope and Anderson 2011). In contrast, it is far more controversial whether an individual can VSED when s/he lacks capacity to do so contemporaneously (Menzel and Chandler-Cramer 2014). It remains unsettled whether an individual may use an advance directive or surrogate decision-maker to restrain caregivers from offering food and fluids when s/he later reaches a pre-defined state of advanced dementia. Two new court decisions from the Canadian province of British Columbia are among the few in the world to address the legitimacy of advance VSED (Bentley v. Maplewood Seniors Care Society, 2014 BCSC 165; Bentley v. Maplewood Seniors Care Society, 2015 BCCA 91).

Factual Background: Margaret Bentley



Cerebral Palsy Advance Directive Severe Dementia Shoulder Dystocia Trial Court 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. Menzel, P.T., and M.C. Chandler-Cramer. 2014. Advance directives, dementia, and withholding food and water by mouth. The Hastings Center Report 44(3): 23–37.CrossRefPubMedGoogle Scholar
  2. Pope, T.M., and L. Anderson. 2011. Voluntarily stopping eating and drinking: A legal treatment option at the end of life. Widener Law Review 17(2): 363–427.Google Scholar
  3. Pope, T.M., and A. West. 2014. Legal briefing: Voluntarily stopping eating and drinking. The Journal of Clinical Ethics 25(1): 68–80.PubMedGoogle Scholar
  4. Terman, S.A. 2007. The best way to say goodbye: A legal peaceful choice at the end of life. Carlsbad, CA: Life Transitions Publications.Google Scholar
  5. White, D.W., and T.M. Pope. 2012. The courts, futility, and the ends of medicine. The Journal of the American Medical Association 307(2): 151–152.CrossRefPubMedGoogle Scholar

Copyright information

© Journal of Bioethical Inquiry Pty Ltd. 2015

Authors and Affiliations

  1. 1.Hamline University School of LawSaint PaulUSA
  2. 2.Law SchoolUniversity of AdelaideAdelaideAustralia

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