Response to Resolution A19 Regarding “Stopping Eating and Drinking by Advance Directives”

In March 2019, the Society for Post-Acute and Long-Term Care Medicine’s (AMDA’s) House of Delegates adopted Resolution A19 as policy, which AMDA’s Ethics Committee had proposed.1 We appreciate their effort to address a difficult issue. But we disagree both with their categorical rejection of “Stopping Eating and Drinking by Advanced Directives” (SED by AD) and with their categorical insistence that feeding must continue for all advanced dementia patients until their behavior manifests refusal or distress.