Continuing Education — Voluntarily Stopping Eating and Drinking: A Widely Available, Lesser-Known End-of-Life Option

Completion of this class will result in the receipt of two (2) continuing education hours.

More patients are seeking to hasten their deaths by voluntarily stopping eating and drinking (VSED) than by medical aid in dying (MAID). There are two main reasons for this development. First, this end-of-life option has received significant media attention over the past few years (in books, journal articles, and obituaries). Second, MAID, which remains available in only twelve states, patients need not wait for their state legislature to authorize VSED. Patients in every U.S. jurisdiction have the right to refuse any bodily intervention, including oral nutrition and hydration.

While VSED is legal and totally within the control of the patient themselves, how should clinicians respond to requests to support the patient during this 8- to 14-day process? Which patients are eligible? Should clinicians apprise patients of this option without first being asked? And how exactly does VSED work?

This class addresses these issues as well as more complicated questions concerning VSED for incapacitated patients. Can patients request VSED in their advance directive? Can agents and surrogates request VSED for incapacitated patients without explicit direction from the patient herself? What if the incapacitated patient makes utterances or gestures indicating they now want water? How is VSED different from related approaches to nutrition and hydration such as Comfort Feed Only and Minimal Comfort Feeding?