Information for those interested in learning more about VSED

What is VSED?

VSED stands for voluntarily stopping eating and drinking, and is also sometimes referred to as end-of-life fasting or terminal fasting. At the end of their lives, many people lose their appetites and stop eating as their body’s organs shut down. With VSED, an individual deliberately chooses to stop eating and drinking in order to hasten death. 

VSED is the oldest way to die, established eons ago when there were no antibiotics or medical interventions. Choosing to stop eating and drinking is legal because patients in the United States have a guaranteed right to refuse care, including food and hydration. VSED allows death to take place at home, where most people prefer to be at the end of their life.

The resources we have shared below are intended to help you determine if VSED might be the right choice for you or your loved one.

VSED Documents and Reading list

Common Questions about VSED
People have used VSED for eons. However, few know about this option, and misunderstandings about the process are common. This document addresses what VSED is, how it feels, and how long it takes; how to prepare and plan for VSED; what medications are involved and what appears on the death certificate; whether family members have to agree to the decision to do VSED; who helps the person dying by VSED through the process; how dying by VSED impacts life insurance payments; and how to calculate the financial cost.

How a Death Doula Helps with VSED
A death doula, sometimes called an end-of-life guide or death midwife, is a non-medical person who serves the dying person and their family. Unlike hospice staff, who have a caseload of clients to visit, a death doula has only one client. While a hospice nurse has specific time constraints and focuses on the immediate medical needs of the patient, the doula is available 24/7 to respond to family dynamics, anticipate needs for information and support, manage guest visits, and guide the family through each step of the dying process.

A Guide to Managing VSED
This document offers a thorough description of the VSED process and explains in detail how to plan for each step, from making the decision to do VSED and setting the date to begin all the way through after-death care, honoring the body, and supporting the family. The intended audience for this document is a Death Doula or end-of-life guide, but it may also be useful for family members who are either seeking to hire a Death Doula to facilitate the VSED process or are considering managing the process themselves.

VSED Preparation Checklist
This document offers a checklist to assist those preparing to begin VSED. The intended audience for this document is a Death Doula or end-of-life guide, but it may also be useful for family members who are either seeking to hire a Death Doula to facilitate the VSED process or are considering managing the process themselves.

VSED Statement of Intent
Support from family and/or friends is important for VSED as an end-of-life choice, since the process cannot be carried out on your own. This document, created by our friends at End of Life Washington (, spells out the medical choices of the person who chooses VSED. It contains space for a notary to sign, and should be shared with anyone intending to support your VSED process. 

Cue Card for Speaking with Your Provider about VSED
Not all providers have experience with VSED–or support the option. This document lists questions that might be helpful in guiding a conversation with your provider about VSED as an end-of-life choice.

Sample Letter to Your Physician about Your VSED Choice
We do not recommend beginning VSED without a promise from your physician to prescribe comfort care medications. This sample letter, developed by our friends at End of Life Washington (, provides a framework that will help guide this important conversation with your physician about your choice to carry out VSED.

FAQ for Physicians
Healthcare professionals often have questions of their own about the VSED process. This document is a one-page handout intended to augment the knowledge physicians have about VSED as an end-of-life choice.

VSED Equipment and Supplies
This document lists equipment and supplies that our team recommends assembling before the VSED process begins, such as bedside commode, shower bench, and hospital bed. Items that are available to borrow from our “lending library” are marked with an asterisk.

VSED Comfort Measures
This document lists measures that may provide comfort and pleasure while helping distract from discomfort during VSED. The list includes suggestions for things to listen to, watch, do, and wear, among others.

Reading List
An informative list of books, videos, podcasts, and articles that address the legal, ethical, medical, experiential, and spiritual aspects of VSED.

Additional resources

From personal experience with VSED, we have developed relationships with a network of related professionals such as harp therapists, our local Threshold Choir, cannabis educators, massage therapists, and acupuncturists, all of whom can deepen and ease the experience of the person who has chosen VSED and their friends and family. We also make referrals to death doulas, medical professionals, attorneys, and caregivers experienced in assisting with VSED.

We offer a free initial consultation for anyone considering VSED; for those who choose to go ahead with VSED, we offer support to family members before, during, and after VSED.  For more information, or to schedule a consultation, contact us.

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