Americans who are ill and facing unbearable suffering don’t have many legal options for hastening end of life. Those who cannot move to states like Oregon or Vermont, where laws allow medical aid in dying, have even fewer options. However, one option available to everyone that doesn’t get nearly enough attention is voluntarily stopping all eating and drinking (VSED.)
The nuts and bolts of VSED
Those who choose this option include people dealing with a chronic or incurable disease. They want to end the pain they’ve been made to endure.
Others might be diagnosed with dementia. They are determined to die before it renders them incompetent to make such a decision.
Still others might be elderly and ready to go after having lived long and full lives.
Whatever the reasons, this is a viable choice that some feel compelled to make.
It’s also legal.
Compassion & Choices, an advocacy group that supports medical aid in dying, reports: “The U.S. Supreme Court has affirmed the right of a mentally capable individual to refuse medical therapies, including food and fluids.”
What happens to our bodies when we choose this option?
Everyone is different, depending on their own unique set of emotional and physical circumstances. Many experts recommend consulting a physician for guidance and round-the-clock care before making this choice.
The process of dying from VSED is similar to a natural death.
The fasting symptoms, such as hunger pangs, usually stop after 1-2 days. At that point, the dying process follows a familiar pattern. This is true whether we’ve stopped eating and drinking deliberately or our body naturally stops digesting food at end of life.
As death approaches, some people feel at peace. They experience relief from any sadness or anxiety. At the other end of the spectrum, some might be confused or agitated. A healthy support system ensures the space is as peaceful as possible.
Dehydration can bring about feelings of euphoria. One common experience is a growing near death awareness. Visions or visits from loved ones, many of whom have already died, usually bring a great deal of comfort.
Our bodies know how to shut down. But that doesn’t mean dying is always comfortable. A medical or hospice team can provide appropriate medications to relieve discomfort.
Patients usually feel tired and sleep more often.
As death nears, a person’s breathing becomes shallow. Sometimes they might even stop breathing for a time. At this point, patients usually cannot be roused. Pauses in breathing get longer until breathing stops altogether.
The amount of time this takes depends on factors such as age, temperament, illness and so much more.
Dying could take a few days or weeks with a terminally ill patient. If someone isn’t ill, for instance a patient wishing to avoid the onset of dementia, death takes a little longer.
No indication that VSED patients suffer
We are all different when it comes to pain tolerance. That’s why a doctor’s care is important. Supportive medical teams can help with any pain relief from the original illness and keep the patient comfortable.
There are three typical symptoms from VSED, after hunger pangs subside:
- dry mouth
- dry, itchy skin
While these aren’t considered painful, they can be uncomfortable. Solutions to help alleviate these symptoms include:
- lip ointment
- glycerin or sponge swabs
- coconut oil
Continuing to drink liquids, is not recommended
Medical professionals counsel that VSED is a relatively painless way to speed up the dying process. It takes much longer if patients continue drinking. Stopping the intake of food can also be very uncomfortable.
For example, complete dehydration reduces fluid. This minimizes painful symptoms caused by conditions such as congestive heart failure or pulmonary edema. Dehydrated patients also don’t experience as much coughing, choking, or inability to breathe – side effects from many illnesses.
Drinking would mean these symptoms and side effects continue. This is why doctors argue against stopping food intake alone.
Support is vital
Patients need 24-hour care during VSED, through hospice or a family doctor. The process should begin with the patient discussing end-of-life wishes with family and caregivers as well.
Usually people add VSED plans to advance care paperwork so that everyone understands his/her/their wishes. Find out if your state requires signatures, witnesses and/or notarization.
Some patients are dealing with an illness or disease that is not terminal within the next six months. Yet they are still choosing to move forward with VSED. If that’s the case, a medical team might request a psychiatric evaluation. This ensures that the patient isn’t suffering from depression or other undiagnosed condition.
Remember, the law says this is a legal option for an adult of sound mind. A psychiatrist or therapist can rule out mental health issues that might impair someone’s right to make this informed choice.
Those who live in an assisted living facility must make the administrators aware of this decision. Since round-the-clock care is required after VSED begins, everyone in charge must be supportive and knowledgeable.
Death doulas can help
For example, whether at home or in a facility, doulas can ensure the space is peaceful and comfortable. They play favorite songs on a portable stereo or read books out loud. They also coordinate meaningful visits for friends and family. We want clients to feel supported but not overwhelmed. Doulas invite loved ones to read poetry or share personal stories. They also coordinate gentle massages if needed.
Ultimately, VSED is a legal option for those who need it. A difficult decision, but one that everyone should have the right to make.