Many people believe they can achieve a hastened death by VSED without anyone’s assistance or support. While it is true that people have died this way for generations without medical support, they probably endured a good deal of suffering. Palliative (or hospice) medical support for the symptoms associated with dying by dehydration can facilitate a peaceful, relatively pain-free death. Family members or close friends who understand the decision to hasten death by VSED provide important social and psychological support throughout the process. This becomes particularly important as cognitive abilities wane as death nears, and the person who has chosen VSED may “forget” their intention to forgo oral intake and their desire to hasten their death. In addition, caregiving help becomes necessary as the person loses physical strength and becomes unable to safely provide for their own physical care.

These issues ought to be anticipated and planned for while the person is still capable of making decisions and can effectively instruct their appointed health care agent, hired caregivers, and loved ones of their decision to forgo all future oral intake. They should also discuss how to respond if the person forgets their desire to hasten death and requests fluids.

It is recommended that a written advance directive be completed to inform future caregivers of this decision. Accompanying the written directive with a video recording of the person’s values and reasons for their end of life wishes is also recommended for the benefit of future caregivers who may not have known the person before capacity was lost. The person’s primary health care clinician ought to be aware of the decision to VSED, along with the reasons for that decision. The goal is to have medical (palliative) relief available for any unacceptable symptoms associated with the process. -Judy

For more information, check out our Medium article series, End of Life Options — Conversations with Judy