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Some call this the last resort option – for whose who live in a state without a medical aid in dying law – or for those with conditions that do not qualify them for medical  or physician aid in dying.  This option requires tremendous will power to carry out.  

VSED Resources Northwest

4 Important Determinants with Voluntarily Stopping Eating and Drinking (VSED)

(1) The state of nutrition of the patient--if someone has already lost weight due to a chronic ailment and is emaciated, the process may take only a few days. If the patient is well nourished, it will take two weeks if no liquid is ingested — or longer depending on fluids taken.

(2) The key determinant is hydration. People can go weeks or months without eating, but only about 10 days without hydration. If the patient gets supplemental fluids, or a lot of ice chips frequently, it takes much longer. Within 3 days of no (none) hydration the daily urine output should be below 50 ml, and renal shutdown begins.

(3) Supplemental medical therapy is necessary. This method is not good if the patient cannot get good palliative care–adequate morphine or lorazepam to alleviate hunger and, especially, thirst.

(4) If the patient is in hospice, and stops food and fluids, after a day or two the hospice nurses almost always become sympathetic and administer the meds necessary to eliminate virtually all symptoms, and commonly give enough to sedate the patient. When done optimally, with a patient who is not well hydrated or nourished to begin with, it usually is over in a week or less.

Avoiding late-stage dementia with advance directives for stopping eating and drinking. Also known as Stopping Eating and Drinking by Advance Directive (SED by AD).

As of March, 2020, only one state (Nevada) has a statute that specifically recognizes advance directives that instruct health care providers to stop hand feeding food and fluid by mouth.

As Tadd Pope, JD, PhD. points out, here the legality of such a directive may extend to other states through reciprocity rules common in advance directive statutes. He also points out there are currently no established protocols for how to implement VSED for a patient in late-stage dementia, which likely could cause stumbling blocks for having one’s advance plans fulfilled.

More on Voluntarily Stopping Eating and Drinking: (VSED)

  • New Book: Voluntarily Stopping Eating and Drinking edited by Timothy E. Quill, Paul T. Menzel, Thaddeus Pope, and Judith K. Schwarz.  June 11, 2021

    Available for pre-order and will ship July July 27, 2021.

  • Rosemary Bowen’s Self-Directed Death by Voluntarily Stopping Eating and Drinking (VSED) January 24, 2020

    94-year old Rosemary Bowen experienced a loss of independence after a spinal compression fracture. She was clear throughout her life and after the compression fracture that once she was unable to care for herself she wanted to end her life. Rosemary wanted to …get out of life while the “getting was good.” The below video ...

  • It’s My Right: The Handmade Death of Herta Sturmann December 30, 2019

    This video shows a woman with congestive heart failure who chose to die by Voluntarily Stopping Eating and Drinking (VSED), or Sterbefasten or Death Fast, as known in Germany. She died at home after 10 days, with round-the-clock care from her sons and support of hospice. Her sons built her coffin ...

  • Voluntarily Stopping Eating and Drinking Is Legal—and Ethical—for Terminally Ill Patients Looking to Hasten Death July 14, 2019

    by Thaddeus Mason Pope, J.D. The Asco Post, June 25, 2018 Attorney and law professor Thad Pope discusses the fact that Voluntarily Stopping Eating and Drinking (VSED) is legally more accessible to terminally ill patients than Medical or Physician Aid in Dying and that it is becoming more accepted by physicians as a legitimate way to ...

  • Preparing for Dementia and Avoiding Medically Futile Care November 18, 2018

    Video of HSSD general meeting. A world-renowned expert (ThadPope) on many areas of health law & bioethics speaks about options and limitations for persons suffering from dementia.

  • Voluntarily Stopping Eating and Drinking (VSED) September 19, 2018

    Sept. 16, 2018 Speaker: Dr. Bob Uslander Dying Wish, the award winning 20-minute documentary was shown. It chronicles the journey of an eighty-year old retired surgeon with end-stage cancer, on hospice, who chooses to stop eating and drinking with the support of his friend and fellow physician.

  • Diane Rehm: Do Americans Have A Right To Die? April 9, 2016

    NPR Host Diane Rehm discusses her book, On My Own and about how the death of her husband inspired her to take up a controversial cause: the right to die in America. She is fierce advocate for the right to choose. See the video (Length: 58:56 min) of Diane Rehm talking about her ...

  • Diane Rehm shares the painful story of her husband’s death March 3, 2016

    PBS News Hour. March 3, 2016 Diane Rehm’s husband, who had Parkinson’s, was not eligible medical aid dying. He chose to voluntarily stop eating and drinking in order to end his life. “I rage at a system that wouldn’t allow John to be helped toward his own death.” Read the interview with Diane Rehm and ...

  • Dying WishDying Wish August 16, 2014

    Documentary of the process of dying by Voluntarily Stopping Eating and Drinking. It follows a retired surgeon with end-stage cancer on hospice who chose this method to end his life. Click here for information from the producers about the film “Dying Wish.”