Starvation as a Voluntary End-of-Life Choice: A Compassionate Exploration

I recently became aware of a patient in the late stages of Alzheimer’s whose family explored Medical Aid in Dying (MAiD) as an option here in New Mexico. Unfortunately, due to the patient's condition, MAiD was not available to him. The family considered Voluntary Stopping of Eating and Drinking (VSED) but ultimately decided against it. Their journey and thoughtful deliberation inspired me to write this post to offer information about VSED as an end-of-life option for those seeking alternatives.

In places like New Mexico, where Medical Aid in Dying (MAiD) may not be accessible to all individuals, those seeking control over their end-of-life journey sometimes turn to voluntary cessation of eating and drinking (VSED). While this decision is deeply personal, it is important to approach the subject with compassion, understanding, and informed guidance.

What Is VSED?
Voluntary cessation of eating and drinking is a legal, nonviolent way for individuals to hasten death by choosing to stop consuming food and fluids. This choice is often made by individuals with terminal illnesses or those experiencing unbearable suffering, particularly when other forms of end-of-life care, such as MAiD, are unavailable or inaccessible.

Why Consider VSED?
For some, the desire to avoid prolonged suffering, loss of autonomy, or burdensome medical interventions leads them to consider VSED. Unlike suicide, which can be impulsive or traumatic, VSED is a deliberate, mindful choice that allows individuals to prepare for death on their terms. It can also be an act of acceptance—letting go of the body's physical needs as part of the natural process of dying.

The Process of VSED
The journey of VSED requires careful planning and support. It is not merely about "starvation" but rather a conscious decision to stop consuming both food and liquids. Without hydration, the body typically transitions into the dying process within 7–14 days.

Physical Effects: Initially, individuals may experience hunger and thirst, but these sensations often diminish after the first few days. With proper palliative care, discomfort can be managed effectively.
Mental and Emotional Effects: Preparing mentally and emotionally is crucial. Meditation, counseling, and spiritual support can provide comfort and clarity during the process.

The Role of a Death Doula
As an End-of-Life Worker, I’ve seen how vital compassionate care and informed support are during the dying process. A death doula or end-of-life guide can help facilitate a meaningful, peaceful experience for both the individual and their loved ones.

Here’s how an end-of-life-doula can help during VSED:

Emotional Support: Providing a nonjudgmental space to explore fears, hopes, and unresolved emotions.
Palliative Guidance: Working alongside healthcare providers to manage discomfort and ensure dignity.
Legacy Work: Helping individuals create meaningful memories or share their story with loved ones.
Ethical and Practical Considerations

Choosing VSED is not an easy decision. It is essential to:

Communicate with Loved Ones: Open discussions help family members understand and respect the choice.
Engage Healthcare Professionals: A hospice team or palliative care specialist can provide medical guidance.
Prepare Legally: Document wishes clearly in advance directives or living wills.
Respecting Personal Autonomy

At its core, VSED is about autonomy—giving individuals the right to make decisions about their bodies and their deaths. While it may not be the right choice for everyone, for some, it offers peace of mind and control in a situation where options may feel limited.

Individuals who chose to stop eating and drinking and document their final weeks on VSED

Meet Dr Micheal Miller

The story of Dr Michael Miller, retired surgeon and hospice patient with end-stage cancer who chose to stop eating and drinking to hasten and ease his death at www.dyingwishmedia.com

Meet Rosemary Bowen (viewer discretion advised)

At age 94, Rosemary Bowen hastened her death by voluntarily stopping eating and drinking (VSED) in 2018. For twenty years, Rosemary Bowen had told her family that she would hasten her death when she was no longer able to live independently. Several months after suffering a back injury, she decided that she was ready to die. Rosemary asked her daughter to make this video to show others that VSED could be a sensible end-of-life option.

Conclusion
The end of life is as unique as the life lived. For those in New Mexico or elsewhere without access to MAiD, VSED may provide a path to a dignified death, guided by choice and surrounded by support.

Compassion and Choices an organization dedicated to improving care, expanding options and empowering everyone to chart their end-of-life journey has a wealth of information on VSED.  You can view their website HERE

If you or a loved one are considering this option, reach out for compassionate guidance. Together, we can create a plan that honors your wishes and provides peace in life’s final chapter.

In Support - Sundara