Your questions, answered

Some states, like Vermont, Montana, and Oregon, do not include residency as an eligibility requirement to access medical aid in dying. (Visit CandC.org/MAID for the latest information on residency requirements.) If you are unable to travel to access medical aid in dying, you have other options, including: 

• Having do not resuscitate (DNR) and allow natural death (AND) orders in place to avoid receiving CPR and other intensive resuscitative measures. Talk with your healthcare provider about creating these.
• Declining or stopping all life-sustaining treatment, such as refusing medications and procedures.
• Continuous deep sedation, also called palliative sedation, which involves medicating patients to reduce consciousness and relieve extreme pain and suffering, and usually results in death.
• Voluntarily stopping eating and drinking (VSED), which involves refusing food, liquids, or artificial feeding in order to hasten the dying process.

VSED is a lawful end-of-life option that involves forgoing all forms of nutrition and hydration in order to control the timing and manner of one’s death. Most people who choose VSED are near the end of life due to illness or advanced age, in serious or accelerated physical health decline, or facing impending cognitive decline from diseases like dementia.

Every experience of VSED is different, and the symptoms and timeline can vary. For some, it can feel like a gradual, peaceful transition. For others, it may be more physically and emotionally challenging. Age, overall health, medications, illnesses, body type, fluid retention, and even a person’s readiness to let go can influence how the process unfolds. 

If you choose VSED, plan carefully to ensure you receive adequate symptom management, comfort care, and emotional support. Hospice services, death doulas, and caregivers can help during the process. It’s also important that your care team and loved ones are on board with your decision — have open, ongoing conversations with them about how they support you. Learn more at CandC.org/VSEDguide.

If you’re finding it hard to identify someone to serve as your proxy should you be unable to advocate for yourself, be creative about your options and think outside the box. Reconnect with a friend, reach out to a neighbor, sign up to volunteer, or consider joining a virtual or in-person social club, support group, or faith community.

If you need a healthcare proxy, you can ask anyone you trust, including paid professionals. These professionals can often assist in a variety of ways including medical and financial power of attorney, executor and trustee representation, creating care plans, and connecting you with local services. Compassion & Choices’ Call Compassion helpline can point supporters like you to these resources; call us at 800.247.7421. 

Death doulas are another great resource, as they provide holistic support with planning ahead for the end of life and accompanying people through the dying process.

Death doulas, also known as end-of-life doulas, are non-medical professionals who provide comprehensive emotional, spiritual, and practical support for individuals and loved ones during the dying process or while planning ahead for the end of life. Many doulas offer both virtual and in-person support. 

The range of services provided can include guiding advance care planning conversations, providing respite care, facilitating legacy or memory projects, identifying resources, completing practical and household tasks, and offering bedside support at the end of life.

You can find a list of providers through two trusted organizations: the National End-of-Life Doula Alliance at NEDAlliance.org and the International End-of-Life Doula Association at INELDA.org. 

Learn more at CandC.org/DoulaFAQ