Comprehensive Clinical Guidelines for Voluntarily Stopping Eating and Drinking (VSED) Published in the United States

On June 21, 2023, the Journal of Pain and Symptom Management (JPSM) released the first published comprehensive clinical guidelines for Voluntarily Stopping Eating and Drinking (VSED) in the United States. VRNW co-founder and director Nancy Simmers was a member of the working group that drafted the guidelines. What follows is the text of a news release written by members of the working group.

VSED has become a topic of growing interest among patients facing a decline in their quality of life. While VSED is a legal option for individuals with serious illnesses in every state across the country, there is a significant lack of published comprehensive guidelines, especially specific to the American medical system. This void has left many individuals contemplating this end-of-life choice without adequate support.

In response to this crucial gap, a diverse and multi-disciplinary group, consisting of professionals from the fields of medicine, nursing, ethics, theology, spiritual care, law, and even death doula expertise, collaborated over the past eighteen months. Their collective effort resulted in the formulation of practical counsel for patients considering VSED, as well as guidance for clinicians and agencies who may offer support in this context.

Apart from the ethical considerations inherent in the practice and support of VSED, clinicians also encounter various clinical, logistical, institutional, social, religious, spiritual, and administrative factors when responding to patients’ inquiries and discussing this option within the realm of end-of-life care.

These newly published clinical guidelines provide practical recommendations for clinicians who are considering supporting their patients contemplating and/or undertaking VSED as a means to hasten death. The guidelines address the complex array of challenges that arise and offer valuable insights into navigating this sensitive area of care.

The writers of these guidelines can be reached for further information and conversation. They are also available for presentations to share their findings and contribute to professional discourse surrounding this important topic.

For media and presentation inquiries, please contact: Hope Wechkin, MD, FAAHPM HMDC, Medical Director, EvergreenHealth Home Care (Hospice and Home Health), at

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