VSED: Death With Dignity or Without?

Conceivably, in an ideal world, all patients with a life–limiting illness would receive optimal hospice and palliative care so that no one would ever wish to hasten their own death. The reality, however, is that despite provision of optimal hospice and palliative care, individuals with terminal illness experience suffering, loss of meaning, or deterioration in quality of life to the extent where they express the desire to expedite the dying process. While there has been extensive discussion surrounding physician–assisted death (PAD), there has been less attention paid to the practice of voluntary stopping eating and drinking (VSED) near the end of life. These twelve compelling narratives represent a dramatic groundswell of attention to the practice of VSED. Through my review of these narratives, numerous statements of significance emerged along with common ethical themes which bring to light matters that might otherwise remain idle. As such, integrity and autonomy become paramount while, unfortunately, logical fallacies like that of the slippery slope argument are asserted. Ultimately, the suffering that leads people to embrace VSED is compelling and must not be minimized. Therefore, this paper, while not comprehensive, is an attempt to dissect these major themes and offer recommendations for addressing concerns regarding end–of–life care that have surfaced during the VSED debate. It is through this endeavor that I will hopefully challenge prevailing assumptions and misconceptions that can only exist in an ideal world.