I'm bringing this up for discussion because I like the thoughtful responses to difficult issues by members on this forum.
My very elderly aunt passed away Friday after 8 days in a sepsis-induced coma. Hopefully, her coma remained deep enough that she did not suffer much pain or distress. Had she not predirected the support withdrawal, she probably would have continued to suffer when occasionally conscious from extreme pain, as the sepsis occurred due to spastic colitis (a truly godawful painful condition, caused by stress), creating an inflammation injury that allowed her own intestinal flora to infect her bloodstream. My last visit with her in the intensive care unit was heart wrenching, as she moaned and cried and called out for her mom, even though a dose of morphine was in the IV. She did not open her eyes again after that evening. Next day, she was transported to hospice, and all support was withdrawn, except mild pain meds.
Although I almost know for sure that she was not suffering consciously, and they think she probably had rapidly deteriorating brain function, and therefore no "real" pain, it was still a devastating thing for the family to witness. In particular, her grand daughter, who had medical power of attorney, and was the "go to" family member with the hospice team, now has a long road back to emotional balance ahead of her. And she is an RN. But that did not really shield her from the brunt of how awful it was to watch a gentle sweet old woman die so slowly, and one cannot emotionally block out the terrible thought of her possibly suffering distress from thirst and hunger sensations, on some level, no matter what medical facts one has in hand.
Ever since Dr. Jack Kevorkian was in the news decades ago, I have been strongly in favor of the medical right to die being extended to include pre-directed euthanasia. Quite a few countries now have this legal mechanism in place. But, of course, here in the US, we only condone this simple kindness of euthanasia to animals, not people. What is worse, some fundie types would like to take away even the pre-directed withdrawal of support option of the living will; "Just cuz. Holey Babble...Wut?!"