Voluntarily Stopping Eating and Drinking: The End-of-Life Option That Few People Know About

Most people who contact Quiĕtus come to us asking about medical aid in dying. They have heard that New York passed a law, they want to understand whether they or their loved one might qualify, and they are hoping for a clear path forward. What many of them don't know — until we mention it — is that there is another option entirely, one that has been available in New York for years, that requires no prescription, no physician certification, and no terminal diagnosis.

It is called Voluntary Stopping of Eating and Drinking, or VSED. It is not widely discussed. It does not generate the same headlines as medical aid in dying. But for many people — including some who do not qualify for medical aid in dying — it may be the most important option on the table.

What Voluntarily Stopping Eating and Drinking Is

Voluntarily stopping eating and drinking is exactly what it sounds like: a conscious, voluntary decision by a person with intact decision-making capacity to stop consuming all food and fluids. It is not the same as a patient who has stopped eating due to illness — that is a natural part of the dying process. Stopping eating and drinking is an intentional choice, made by a person who could eat and drink but chooses not to, as a means of hastening death.

Courts and medical ethicists have consistently upheld stopping eating and drinking as a legal exercise of the right to refuse medical treatment — a right that has been recognized in the United States for decades. In New York, as elsewhere, a competent adult has the right to refuse any food or fluid, including through a feeding tube. That right is not contingent on a diagnosis, a waiting period, or a physician's approval.

Voluntarily stopping eating and drinking is a legal right that has been upheld by courts across the country. No prescription is required. No physician needs to authorize it. The decision belongs entirely to the patient.

Who Might Consider Stopping Eating and Drinking

Voluntarily stopping eating and drinking is worth knowing about for anyone navigating serious illness and end-of-life planning, but it is especially relevant for people who fall outside the eligibility criteria for medical aid in dying. The New York Medical Aid in Dying Act requires a terminal diagnosis with a prognosis of six months or less. That requirement leaves out a significant number of people who are suffering and whose quality of life has deteriorated beyond what they find tolerable.

This includes people living with dementia who express clear end-of-life wishes and still have decision-making capacity. It also includes people with serious chronic conditions such as advanced heart failure, severe neurological disease, or debilitating pain who have a longer prognosis but whose lives no longer hold meaning or comfort for them. And it includes people with ALS or similar progressive conditions who may still have months to live but whose window for self-administered aid in dying is closing.

Stopping eating and drinking is also sometimes chosen by people who are eligible for medical aid in dying but whose personal, spiritual, or religious values lead them toward a process that feels more natural — one that does not involve a prescribed medication and allows the body to die on its own terms, with the dying process gently supported rather than pharmacologically induced.

What to Expect

The timeline for voluntary stopping of eating and drinking varies depending on the person's underlying condition, current level of hydration, and overall physical state. For someone who is already seriously ill and not eating much, death may come within a week to ten days. For someone in better physical condition, the process may take two to three weeks.

The early days after stopping all intake can involve hunger, thirst, and dry mouth. These are real discomforts, and they should be addressed — not minimized. With skilled palliative care and attentive comfort measures, including careful mouth care and appropriate medication for anxiety and pain as the process progresses, most patients can be kept comfortable. This is not a process that needs to be endured in isolation or without support.

Hunger typically subsides within the first few days. The patient gradually becomes less alert, sleeps more, and drifts into unconsciousness as the body shuts down. When it is well-supported, families often describe the experience as peaceful — a natural dying process that unfolds over days, surrounded by people who love the patient.

The Role of Hospice

One of the most important things to know about stopping eating and drinking is that hospice will support it. While individual hospice organizations have their own policies, most hospice teams in New York are experienced with voluntarily stopping eating and drinking and will provide comfort-focused care throughout the process — including pain and symptom management, emotional support for the patient and family, and guidance on what to expect at each stage.

If someone is already enrolled in hospice and considering stopping eating and drinking, their hospice team is the right first call. If they are not yet on hospice, the decision to stop eating and drinking can be the basis for a hospice referral, since the decision itself signals that the person's focus has shifted entirely to comfort.

A Note on Capacity and Advance Planning

Voluntarily stopping eating and drinking requires decision-making capacity at the time the decision is made. This is a critical point for families supporting a loved one with dementia or cognitive decline — the window for a person to make and sustain this choice narrows as the illness progresses. It is important to have that conversation early, when capacity is intact, and to document the wish clearly in an advance directive.

How We Can Help

At Quiĕtus, we often talk with families about stopping eating and drinking in the same breath as aid in dying and hospice care — because none of these options exists in isolation, and the right choice depends entirely on the person, their values, their diagnosis, and what they are hoping for in the time they have left. We are not advocates for any particular path. We are advocates for informed decision-making and for people having access to the full range of options available to them.

If you or a loved one is navigating a serious illness and wondering whether stopping eating and drinking might be worth considering — or you simply want to understand what it involves before making any decisions — we are here to talk.

This post was reviewed and verified by Daniel Cogan, NP