ethical concerns, hastening death, hospice guidelines, voluntarily stopping eating and drinking (VSED)



  1. Schwarz, Judith K. PhD, MS, RN


Some hospice and palliative care organizations are considering the merits of creating written policies to guide clinicians' responses to patient requests for information and support for a voluntarily stopping eating and drinking (VSED)-related hastened death. How hospice clinicians understand the meaning of a request to hasten dying and the legality and morality of the VSED option will determine their responses. Some may view a plan to intentionally hasten dying by fasting as an act of suicide that should be discouraged; others may regard VSED as an ethically appropriate decision to forego an unwanted life-prolonging measure. A discussion of the ethical and legal pros and cons of this option will be presented within the context of a case of a patient who requested hospice support for her decision to VSED. This case will illustrate a range of beliefs among team members and the potential benefit of having a written policy to help mediate interteam conflict.