The New York directive, in contrast, offers option A, which allows refusal of all oral assisted feeding. Option B permits comfort-focused feeding.
Both options would be invoked only when a patient is diagnosed with moderate or severe dementia, defined as stages 6 or 7 of a widely used test known as the Functional Assessment Staging Test (FAST). At those stages, patients would be unable to feed themselves or make health care decisions.
The new form goes further than a similar dementia directive introduced last year by another group that supports aid-in-dying, End of Life Washington. That document says that a person with dementia who accepts food or drink should receive oral nourishment until he or she is unwilling or unable to do so.
The New York document says, “My instructions are that I do NOT want to be fed by hand even if I appear to cooperate in being fed by opening my mouth.”