Friday, November 30, 2018

ABOUT VSED: Voluntarily Stopping Eating and Drinking

By Katie Ortlip, LCSW 
Co-author of Living With Dying: A Complete Guide for Caregivers

At this moment, six (USA)states have “Death With Dignity” laws that allow patients who are close to dying to take medication to end their lives. 

As a 26-year hospice social worker, I have had the privilege to attend a number of those deaths. 

But even in my state of Oregon, that option is not always available or some people don’t feel comfortable with it, and so some patients make the decision to hasten their death by not eating or drinking. 

Usually people do this when they feel that their body is starting to fail, their quality of life is not acceptable to them anymore, and they are just done. 

Not eating or drinking hastens the dying process by shutting down the kidneys. 

Stopping eating isn’t that difficult because most people at this stage in their illness don’t feel that hungry. 

It’s the thirst that can be the most uncomfortable. People can suck on ice chips and moisten their mouth with sips of water but they have to realize that if they want to go quickly, they should drink as little water as possible. 

And, of course, medication for pain, anxiety and other symptoms can be given and can help make the process easier.

The process generally takes from ten days to two weeks for a person to die once they stop eating and drinking depending on how hydrated the person is. 

The first few days are the most difficult, again because of the thirst and maybe some hunger pangs. 

The closer one is to a natural death, the easier VSED is, as the patient most likely already stopped eating and is partially dehydrated. 

After the first 3 days or so, the person gets sleepier and the process should get easier, as the kidneys start to shut down, and a gentle euphoria can occur.

I had a patient last year who was at the end stage of his esophageal cancer and there was a chance that the cancer would cause extreme bleeding and pain in his throat as it progressed.  

He was beginning to dread getting up in the morning and had nothing to look forward to but worsening symptoms. 

Rather than wait for the tumor to get bigger and make things awful for him, he said, “I am ready to go and I want to know how to make it happen sooner.” 

After a discussion with him and his family, who gave him their blessings, he decided to proceed with VSED.

He stopped eating and drinking, took regular doses of pain and anxiety medication to be more comfortable, and to help him sleep. We provided them with swabs and mouth moisturizers, and instructed them on good mouth care. 

I had told him and his wife that sometimes, as the kidneys start to shut down, people feel a mild euphoria. On my last visit his wife reported, “He’s doing pretty well, but he’s waiting for the euphoria.” 

She gave him his medication and we chatted a while. When I said good-bye, I bent to give him a kiss and he smiled. 

I asked, “Are you feeling euphoric?” And he nodded dreamily and answered, “Yes.” 

He died peacefully a few days later.

Katie Ortlip, LCSW, former RN, is a Hospice Expert on SHARECARE, Dr. Ahmet Oz’s online health and wellness platform. Katie is co-author of Spiritual Tools for the Dying, a booklet distributed by Asante Health Care of Oregon to all patients on hospice. She received her nursing degree in 1982 and spent three years working in neonatology at St. Luke’s-Roosevelt Hospital in New York City and Mary Dartmouth-Hitchcock Hospital in Hanover, New Hampshire. Katie earned a BS in Psychology and Masters of Social Work at SUNY-Albany. She has worked as a social worker for Asante Hospice for the past twenty-five years.

Find more about their book and mission of she and her partner Jahanna Beecham HERE


  1. Please note that, rather than 13, it is six states (CA, CO, HI, OR, VT, WA) and Washington, D.C. that have death with dignity laws on the books.

  2. Hi Peter, Thank you for that correction. We will correct in the article!
    (Blame the typist, not Katie Ortlip!)