VSED with Hospice: Clinical Course, Symptom Management, and Patient Demographics

Voluntarily stopping eating and drinking (VSED) is an increasingly recognized option for capacitated adults at the end of life who wish to hasten death due to persistent, unacceptable suffering [1, 2, 3]. This decision often stems from a desire for control over the dying process, a perception of life as pointless, or a wish to avoid prolonged decline [4, 5, 6]. While VSED is legally and ethically distinct from medical aid in dying, it frequently necessitates significant support from caregivers and healthcare professionals, raising complex considerations and highlighting the need for clear guidelines [7, 8, 9]. Despite growing discussion around this topic, comprehensive clinical descriptions of the patient experience and care requirements during VSED, particularly within the context of hospice support in the United States, have been scarce [10, 1].