A person who chooses to voluntarily stop eating and drinking (VSED) is choosing to forgo all forms of nutrition and hydration in order to control how and when they die.
Typically, VSED is a choice made by adults approaching life’s end who want more control over the timing and manner of their death. Most people who choose this option for dying are already 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. Because VSED is a natural process, the symptoms and timeline can vary from person to person.
If you choose VSED, you should plan carefully to be sure you receive adequate symptom management, comfort care and emotional support. Hospice services, end-of-life doulas and caregivers can help you during your process.
Research and understand VSED experiences at CompassionAndChoices.org.
Discuss with family, loved ones or caregivers
Document in an advance directive and, if possible, make a short phone video to show your well-thought-out intentions. A person must have decision-making capacity when they opt for VSED.
Secure a supportive care team
Friends and family may be hesitant to support your decision based on many factors, including a lack of understanding or knowledge about VSED and the process. Describing her partner Joan’s VSED journey, Fran Volkmann provides a helpful analogy:
One member of our core group, Audrey, distinguished between being on the outside and the inside of the situation in which we found ourselves. When people first hear of a decision like Joan’s, it comes as a bolt out of the blue and their initial reaction can be one of horror or dismay. As they learn more, they are brought into the inside, and their responses become far more nuanced, less judgmental, and in our experience, often pointedly supportive.
There may be loved ones who remain hesitant to support you or even stand against your choice. In those cases, you may choose to honor their choice and excuse them from the process. It may be worthwhile to note their exclusion from your healthcare decision-making in your advance directive.
If your healthcare proxy or alternate proxy will not support your VSED decision it is important to consider changing proxies. It’s important that your care team and loved ones who will be involved are on board with your decision and have open, ongoing conversations about how they can collaborate to achieve your wishes.
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