To choose the terms of one’s own farewell is perhaps the final, most profound act of love for oneself—a declaration of agency in a chapter of life where control can so often feel lost. One such choice is Voluntarily Stopping Eating and Drinking (VSED), a path not taken in haste or despair, but often embraced with deep consideration, clarity, and the wish for a peaceful conclusion to a life fully lived.
This is not a conversation about giving up, but about defining what it means to live with intention, right up to the very end. For those who choose VSED, it is a way to navigate the closing of a life with grace and self-determination, when faced with an illness or decline that has become an unbearable burden. Understanding this choice, with compassion and without judgment, is essential for the person on the journey and for those who love them.
The Heart of the Choice
The decision to pursue VSED arises from an intimate conversation with oneself about life and its limits. It is the deeply personal answer to the question, “What makes my life meaningful?” When a progressive illness, chronic pain, or profound decline threatens to erase that meaning, VSED emerges as a way to pick up the pen and reclaim authorship of one’s final chapter.
It is a legal and accessible option for any mentally capable person, allowing them to hasten a death that is already approaching, but on their own terms1.
This choice is not a turning away from life, but a turning away from a specific kind of suffering. It is the ultimate expression of radical honesty with oneself, an acknowledgment that the quality of one’s existence is more important than its duration. It is a deliberate step toward peace—an act of profound strength, not of weakness.
Defining a Good Death on One’s Own Terms
The choice for VSED is often rooted in a profound re-evaluation of what it means to die well, a quiet refusal of the cultural script that demands we fight for every last moment, regardless of its quality. It is a courageous turn toward self-knowledge, where a person decides that a “good death” is not one that is prolonged at all costs, but one that aligns with the dignity and values of the life they have so carefully built.
After a long and full life, the focus may shift from a battle for more time to the preservation of peace. This involves making a conscious choice to avoid a future of suffering or dependency that feels alien to one’s own identity. It is the ultimate affirmation of personal values, ensuring the final chapter is as coherent and meaningful as all the ones that came before2.
Communication and Planning
A peaceful journey with VSED is paved with careful and compassionate preparation. While open communication with loved ones is ideal, for many who choose this path, estrangement from family—often due to histories of abuse or deep ideological divides—makes such conversations impossible.
In these instances, friends may offer support, but the absence of familial involvement often necessitates the presence of a coordinated team. This is not a journey that can be undertaken alone; it requires a circle of care that may include a primary caregiver, hired professionals, or the guidance of an experienced end-of-life doula to ensure comfort, dignity, and safety throughout the process.
Equally important is the practical step of documenting one’s wishes. A person choosing VSED must ensure their decision is legally protected through clear and specific advance directives. This legal documentation is the cornerstone that ensures their choice will be honored, providing peace of mind that their final wishes are understood and will be respected by all involved.
VSED vs. Other End-of-Life Options
It is helpful to understand that VSED is distinct from other end-of-life options, such as Medical Aid In Dying (MAID). While both paths are born from a desire for autonomy, MAID involves the use of prescribed medication and is legally available only under specific circumstances, including a terminal diagnosis with a prognosis of six months or less to live.
VSED, in contrast, is a non-medical process. It is a choice available to any competent adult, regardless of their specific diagnosis or prognosis, who has decided to stop taking in food and fluids. This makes it a uniquely self-directed path, guided by the individual’s own timing and resolve3.
Emotional and Spiritual Considerations
To choose VSED is to embark on a profound inner journey. While the decision is often made with resolve, the path is layered with a rich tapestry of human feeling. There may be moments of unwavering peace, punctuated by waves of fear or grief for the life being left behind. This is not a sign of doubt, but a testament to a life deeply lived and loved.
Spiritually, this can be a time of immense clarification. For some, it is a final act of surrender, a letting go of the ego’s fight and a peaceful merging with whatever lies beyond. For others, it is a return to their most essential self, a shedding of all that is not authentic until only their core truth remains.
It is a sacred, quiet time of reflection, where one can make peace with their past and approach their end with a sense of wholeness.
Supporting a Loved One’s Choice
For family and friends, walking alongside someone choosing VSED is a journey of profound love and deep emotional courage. It is a path that holds both sorrow and grace. Your own feelings may be complex—a mix of anticipatory grief for the coming loss, and a deep respect for your loved one’s autonomy. It is vital to grant yourself compassion during this time.
Supporting this choice is not about being free of sadness; it is about holding that sadness alongside your love. By honoring their final, most personal decision, you are offering a final, powerful gift: the peace of being seen, heard, and respected to the very end. This act of bearing witness can be a deeply healing and connecting experience, an affirmation of a bond that love, not time, defines.
Creating a Legacy in the Final Days
The time afforded by the VSED process offers a unique and sacred window for connection and meaning-making. This is not just a time of letting go, but a time of intentional creation. A legacy is not only what is left behind, but what is actively shared in these final days. This can be as simple as telling stories, sharing unheard memories, or listening to music that has shaped a life.
It can also involve more tangible legacy projects, such as writing letters to loved ones, recording messages, or compiling a scrapbook of cherished moments. These acts of creation are a powerful way to affirm a life’s meaning and to give a final, lasting gift of love and wisdom to those who will carry the memory forward4.
The Doula’s Role as a Sanctuary of Support
The path of VSED is not meant to be walked alone. It calls for a circle of unwavering, non-judgmental support, where the role of an end-of-life doula becomes profoundly important. A doula does not guide the decision but honors it, creating a sanctuary where the dying person’s choice is the central, guiding principle.
This support is a gentle weaving of the practical and the sacred. The doula stands as a compassionate companion, helping to manage the physical environment to ensure comfort and peace. More importantly, they hold space for the emotional and spiritual journey unfolding for both the individual and their family.
Part of this preparation may also involve a medical professional who can prescribe palliative medications—often in liquid or sublingual form—before the process begins. These may include anti-anxiety medications, sedatives, or agents to ease the sensations of thirst and hunger, helping to ensure that the individual remains as comfortable and calm as possible in the early days of the journey.
As the process continues and the active dying phase approaches, it is advisable to identify a local hospice willing to step in. Their involvement can provide not only medical oversight but essential emotional and logistical support to caregivers and the surrounding team. The doula, in concert with hospice and medical professionals, helps sustain a space of dignity and care—one where the individual is held with intention, and those around them are supported with guidance, empathy, and respect.
They become a calm, steady presence in a time of immense change, facilitating conversations, honoring memories, and ensuring the person feels seen, heard, and respected until their last breath. And for the loved ones, the doula offers reassurance and direction, helping them understand the process and find meaningful ways to offer their love.
The Journey of Connection and Release
While the idea of VSED may sound difficult, the process itself is a natural shutting down of the body that can be managed with gentle, attentive care. The journey, which often lasts from one to three weeks, can become a time of unexpected intimacy and connection.
As the demands of the world fall away, what remains is the profound importance of presence. Comfort is key, as the primary physical challenge is often a dry mouth, not hunger or thirst. Attentive mouth care—using misting sprays, gentle mouth rinses, and lip balm—can offer significant relief. A cool cloth to wipe the face or the use of a cool mist humidifier in the room may also bring comfort.
These methods support the individual’s ease without prolonging the natural process, as even small amounts of water, such as from ice chips, can unintentionally extend dehydration by days or weeks.
The simple act of sitting together in quiet companionship can be the most powerful form of support; your calm presence is a language of love that needs no words. This time can be filled with honoring the moment through legacy-making, storytelling, listening to favorite music, or simply holding a hand.
The goal is to create moments that feel authentic and loving, honoring the wishes of the person at the center of this sacred time.
You Are Not Alone on This Path
To bear witness to a loved one’s final, courageous choice is a sacred responsibility, but it is not a journey you must undertake without support. The path of VSED can be emotionally demanding and complex to navigate. As an end-of-life doula, my role is to provide steady, compassionate companionship for both you and your loved one.
I help hold the space for this profound transition, offering practical guidance, emotional grounding, and a non-judgmental presence so that you can focus on what matters most: connection, love, and peace.
If you feel called to have a knowledgeable guide by your side, I invite you to connect with me. Let us schedule a complimentary discovery call to explore how I can support your family through this deeply personal journey.
- Terman, Stanley A. The Best Way to Say Goodbye: A Legal Peaceful Choice at the End of Life. Life Transitions Publications, 2007. ↩︎
- Harrington, Samuel. At Peace: Choosing a Good Death After a Long Life. Hachette Go, 2021. ↩︎
- Butler, Katy. The Art of Dying Well: A Practical Guide to a Good End of Life. Scribner, 2019. ↩︎
- Quill, Timothy E., Menzel, Paul T., Pope, Thaddeus Mason, & Schwarz, Judith K. Voluntarily Stopping Eating and Drinking: A Compassionate, Widely Available Option for Hastening Death. Pegasus Books, 2021. ↩︎
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