Choices for Hastening Death
 | Voluntarily Stopping Eating and Drinking (VSED) Intentionally hastening death by stopping the intake of all food and fluids. Death is by dehydration. Time to death is variable depending on one’s health status. Average is 2 weeks. read nore about Voluntarily Stopping Eating and Drinking (VSED) | PROS: Legal in all U.S. states and socially accepted. Typically peaceful when accompanied by adequate palliative care and caregiver support. Allows time to say goodbye to family/friends. Doctor’s consent not necessary; no regulatory hurdle to overcome. CONS: Requires great willpower. Facilities may be reluctant to support. |
 | Medical Aid in Dying (MAiD) On requests of the patient, a medical professional can write a lethal drug prescription for qualified terminally ill patients. The patient must self-administer the drug, usually by drinking a bitter liquid. | PRO: A quick and peaceful death. Control over timing and place of death. CONS: Must be a terminally ill adult with less than 6 months to live. Must have legal capacity. This excludes patients with dementia because by the time they are terminal (in absence of other life-threatening disease) they do not have capacity. Not legal in many states. |
 | Refusal, Withholding or Withdrawing of Medical TreatmentMedical treatments/tests can be legally declined, stopped or withdrawn at any time, even if they prolong life. This decision can be made by patients with capacity or by their health-care agents. | PROS: Legal for adults with capacity. Patients are entitled to palliative care. CONS: May not hasten death. Could be getting difficult medical professionals to comply, Could be difficult to control pain. |
 | Inert Gas The use of a hood (or possibly a Sarco Pod) into which is pumped an inert gas, such as Nitrogen, to displace oxygen. This leads to loss of consciousness and eventual death. By decreasing oxygen levels rapidly, one avoids a sense of panic or suffocation prior to losing consciousness. | PROS: Quick and peaceful death without pain. No dependence on medical system. Conditions other than being terminal, for instance dementia, can qualify you for education in this method by the Final Exit Network. CONS: You must obtain equipment, assemble and operate it. |
 | Voluntary Assisted Dying Clinics Switzerland is the only country that allows non-citizens to use the services of their Voluntary Assisted Dying Clinics provided the person assisting does not have “selfish motives.” | PROS:: Quick and painless death. CONS:: Costly to use the service and travel there. Lots of paperwork. Must have legal capacity. |
 | Euthanasia The practice of intentionally ending the life of another to eliminate pain and suffering, | PROS: Available in Canada to those who qualify and have Canadian health insurance. CONS: Illegal throughout the U.S. |
Options that should be considered before deciding to hasten death
| Hospice A Medicare service that provides a multi-disciplinary team to improve the quality of life of the terminally ill and their family. Highly recommended even for those considering Medical Aid in Dying (MAiD). The vast majority of MAiD patients are on hospice and one is more likely to find a willing doctor if you are on hospice. | Pros: Free to those on Medicare. Pain relief is a high priority. Can provide limited caregiver relief. On death, the hospice team takes care of confirming death and completing legal paperwork and other tasks. Typically patients are at home. Bereavement services available to your family. Cons: Traditionally, patients must give up curative treatment – there have been some experimental reforms in this. Typically hospice visits are 2-3 times per week. Family/friends are responsible for day-to-day care. |
| Palliative (comfort) care Quality-of-life and comfort focused treatment for serious illness regardless of prognosis. | Pros:: You do not need to be terminal. Greater satisfaction with care and medical team. Cons:: You do not need to be terminal. Greater satisfaction with care and medical team. Limited funding and institutional capacity. |
| Palliative (or terminal) sedation Sedating a terminally ill patient to relieve intractable physical suffering when symptoms cannot be controlled by other means. | Pros: Not illegal; intent must be to relieve intractable suffering and NOT to hasten death. Cons: Not really a choice, doc has to order. Typically requires that the patient is imminently dying. Requires ongoing evaluation, often in a hospital, |
