Minimal Comfort Feeding Advance Directives

I have been collecting and discussing VSED advance directives for years. But with increasing discussion of minimal comfort feeding (MCF), we are seeing more MCF directives.   

While VSED will lead to the patient's death faster (~10 days), the incapacitated patient may not understand why she is uncomfortable. In contrast, MCF mitigates discomfort, yet still hastens the patient death (~20 days).  

One MCF directive is offered as an appendix to this book, Before I Lose My Own Mind. Note that these options below request spoon/hand feeding only in response to the patient's apparent discomfort.

C. Regarding eating and drinking once I am in any of the conditions described in Part II above:

___ If I am receptive to eating and drinking (i.e., show signs of anticipation and enjoyment), I want comfort feeding only. This means that I want the focus of eating and drinking to move away from maintaining adequate nutrition and move toward providing comfort.

___ If I seem indifferent to food or drink, I do not want to be encouraged, cajoled, harassed, or in any way forced to eat or drink. Do not spoon-feed me, meaning do not place a spoon or any other utensil or food or nutritional item into my mouth.

___ If I seem indifferent or opposed to food, solid or liquid, stop offering it.