Dying of Thirst is Excruciating Agony

Original Article

Health writer Larry Bernstein of the Washington Post has written an excruciating column about how awful and painful it is to die by thirst. The article laments–as any civilized person would–the potential mass deaths by dehydration of the Yazidi at the hand of the butchers of ISIS in Iraq.

Dying of dehydration is an awful death. From the piece:

I’m not about to start ranking the horrors visited on the human body this summer, from Ebola in West Africa to bombs and bullets in Gaza and Israel. But thousands of particularly excruciating deaths may soon be added to the list by the Sunni extremists of the Islamic State of Iraq and Syria, the terrorist group that is sweeping through parts of Iraq and establishing its own state. As this barbarism continues.

Bernstein did some research:

I asked Jeffrey Berns, president-elect of the National Kidney Foundation and a nephrologist at the University of Pennsylvania, what these children may be going through. “Thirst, as you probably know, is one of the most potent drives for behavior we have. It may be the most potent we have, more than even hunger,” he said. “People are going to be miserable.”

The body is about 60 percent water, and under normal conditions, he said…If it’s not replaced over time and dehydration becomes severe, cells throughout the body will begin to shrink as water moves out of them and into the blood stream, part of the body’s efforts to keep the organs in fluid. “All the cells will shrink,” he said, “but the ones that count are the brain cells. They don’t operate normally when they’re’ shrinking.”

Changes in mental status will follow, including confusion and ultimately coma, he said. As the brain becomes smaller, it takes up less room in the skull and blood vessels connecting it to the inside of the cranium can pull away and rupture. Without water, blood volume will decline and all the organs will start to fail, he said. Kidney failure will soon lead to disastrous consequences and ultimately death as blood volume continues to fall and waste products that should be eliminated from the body remain.

Yes, an awful, horrific death.

Except when inflicted on people like Terri Schiavo? That can’t be right.

This is a biological process–yet conscious and unconscious disabled and elderly alike are made to die of thirst throughout the country and much of the Western world through removal of tube-supplied sustenance.

How many times have we seen advocates for removing feeding tubes from the cognitively disabled sooooothingly assure us it is a peaceful, painless way to die? From a 2005 Chicago Tribune story about the pending death of Schiavo:

One of the main rationales of religious advocates and lawmakers seeking to keep Terri Schiavo alive through a feeding tube has been that removing her only source of nutrition and liquid would be cruel, leading to a “horrible and painful death,” in the words of one activist.

But many of the doctors and nurses who witness the consequences of removing such treatment from patients say withholding nourishment is a common—and largely painless—way of letting nature take its course for ill patients. They say many people near death actually choose to have their feeding tubes removed, which typically leads to a calm, peaceful death.

Yes, IF PEOPLE ARE ON THE VERGE OF DEATH BY CANCER or some other disease.In those cases, the death is not from thirst!

But the people we are discussing here are not dying other than having their water and food taken away. That’s a huge difference. The same process described in Bernstein’s piece happens to them.

Oh, and notice what Berns said about the size of the brain after dehydration: Terri’s shrunken brain was touted as proof she could feel nothing. Remember?

People in cognitively disabled conditions may not be able to cry out and beg for food–although I know of at least one case where that happened–because they don’t have the ability. But that doesn’t mean on the inside, unless given powerful drugs–Terri Schiavo wasn’t given that courtesy–they aren’t feeling the same pain as those poor people on the Iraq mountain.

And now Compassion and Choices and other assisted suicide organizations push suicide by thirst and starvation (VSED). From the C & C book, “Voluntary Stop Eating and Drinking:

Some call us because they feel overwhelmed by the symptoms of chronic and progressive illnesses that fill their days with misery and suffering. There are also those who may not be seriously ill but are simply “done.” After eight or nine decades of life, they want information about ways to gently slip away in a peaceful and dignified manner.


Add to that advocacy now for VSED-by-proxy that would force nursing homes to withhold oral sustenance to Alzheimer’s patients who asked to be starved and dehydrated to death in an advance directive–even if they willingly drink water and juices and eat food.

The elderly, the profoundly disabled, babies born with Down syndrome that have intestinal blockage, etc. are not a different species. They are people. Making them die of thirst is agonizing too. Those who push these kinds of deaths as merely “medical ethics:” Own it!

Wesley J. Smith

Chair and Senior Fellow, Center on Human Exceptionalism
Wesley J. Smith is Chair and Senior Fellow at the Discovery Institute’s Center on Human Exceptionalism. Wesley is a contributor to National Review and is the author of 14 books, in recent years focusing on human dignity, liberty, and equality. Wesley has been recognized as one of America’s premier public intellectuals on bioethics by National Journal and has been honored by the Human Life Foundation as a “Great Defender of Life” for his work against suicide and euthanasia. Wesley’s most recent book is Culture of Death: The Age of “Do Harm” Medicine, a warning about the dangers to patients of the modern bioethics movement.