VOLUNTARY DEATH BY DEHYDRATION
QUESTIONS & ANSWERS


1.  WHAT SAFEGUARDS SHOULD BE FULFILLED
     TO MAKE SURE THAT VDD IS THE BEST COURSE OF ACTION?

2.  HOW LONG WILL IT TAKE TO DIE?

3.  WILL I GET HUNGRY OR THIRSTY?

4.  WOULD IT BE WISE TO HAVE EMPTY INTESTINES?

5.  WHAT ABOUT MOUTH CARE DURING THE PROCESS OF VDD?

6.  IF I CHANGE MY MIND ABOUT DYING BY DEHYDRATION,
     WILL THERE BE ANY LASTING DAMAGE TO MY BODY?

7.  IS VOLUNTARY DEATH BY DEHYDRATION A LEGAL OPTION?

8.  WHERE CAN I FIND MORE INFORMATION
     ABOUT VOLUNTARY DEATH BY DEHYDRATION?



    Preliminary note for possibly-suicidal readers:

    Nothing on this portal supports committing irrational suicide.
Voluntary death by dehydration contains its own inherent safeguards to prevent irrational suicide:
Because it takes about 100 re-affirmations of the choice to die over a period of several days,
the 'reasons' for irrational suicide will often disappear before death occurs.

    If you are uncertain whether your wish to die is closer to voluntary death or to irrational suicide,
read this essay: Will this Death be an "Irrational Suicide" or a "Voluntary Death"?:
http://www.tc.umn.edu/~parkx032/CY-IS-VD.html

    And beginning to fulfill the following recommended safeguards
might prove to be a good operational method
for separating the urge toward a harmful irrational suicide
from the wish for a wise and compassionate voluntary death.
See 26 recommended safeguards for life-ending decisions:
http://www.tc.umn.edu/~parkx032/SG-A-Z.html

    Another resource specifically applies these 26 safeguards
to the the process of considering a voluntary death by dehydration:
"Voluntary Death by Dehydration:
Safeguards to Make Sure it is a Wise Choice":
http://www.tc.umn.edu/~parkx032/CY-VDD-SG.html

    Anothermore philosophicaldiscussion of the 'reasons' for suicide appears here:
"Depressed? Don't Kill Yourself!":
http://www.tc.umn.edu/~parkx032/CY-DEP-K.html

   
If you are considering voluntary death by dehydration near the end of your life,
the following essay might help you to clarify your thinking:
"Completed Life or Premature Death?":
http://www.tc.umn.edu/~parkx032/CY-CLPD.html

    You can receive instant help for any suicidal urges by calling: 1-800-SUICIDE.




VOLUNTARY DEATH BY DEHYDRATION
QUESTIONS & ANSWERS


by James Leonard Park

    Voluntary death by dehydration (VDD) is a life-ending option.
When we are near the end of our natural lives,
we can decide to shorten the process of dying
by giving up all food and water.

    The lack of water will cause death before the lack of food.
Thus, this method of choosing a voluntary death should not be called "starvation".
"Dehydration" is the most accurate description
of this means of choosing a wise and compassionate death.

    This Internet portal offers an outline for the process of choosing VDD.
When death is chosen compassionately and wisely,
it should not be difficult to find medical professionals
who will help with each element of the process of choosing death by dehydration.

    In fact, the most open-minded hospice programs
already have extensive experience with patients
who choose this means of drawing their lives to a peaceful and painless close. 
Persons who are most serious about using this method of voluntary death
should seek hospice programs nearby
that will help them along this pathway towards death.
Some of the specific problems that might arise
can best be dealt with by professionals
who know how the human body reacts to lack of water.




1.  WHAT SAFEGUARDS SHOULD BE FULFILLED
     TO MAKE SURE THAT VDD IS THE BEST COURSE OF ACTION?


    Voluntary death by dehydration is an option that can be used by anyone, anywhere.
Because it will take a week or longer to die,
this method of choosing death is not likely to be used to commit irrational suicide.
But in those cases where there might be some question
about the wisdom of dying now rather than waiting for death at some later time,
some simple safeguards can help everyone to know
that this was a truly voluntary death and not an irrational suicide.
Another way to make this point:
Wise safeguards will prevent premature death.

    Here is a list of 26 recommended safeguards:
http://www.tc.umn.edu/~parkx032/SG-A-Z.html

    Each of these should be considered at least briefly
in any process of choosing a voluntary death.
Some will seem more appropriate and relevant to the situation at hand.
And if the time is short until natural death in any case,
then only a few of these safeguard would be useful.

    See an on-line essay explaining how these 26 recommended safeguards
apply to voluntary death by dehydration:
Voluntary Death by Dehydration:
Safeguards to Make Sure it is a Wise Choice
:
http://www.tc.umn.edu/~parkx032/CY-VDD-SG.html




2.  HOW LONG WILL IT TAKE TO DIE?


    Voluntary death by dehydration will normally take a week or longer.
The exact length of time between taking the decision to die
and when your body finally gives out
will depend on the amount of stored water in your tissues
and on how much water you use to prevent the worst symptoms of dying by dehydration.

    You are probably considering voluntary death by dehydration
because you have some terminal illness or fatal condition.
And when some parts of your body are already beginning to shut down,
this will shorten the process of dying by dehydration.
Your death-certificate will probably record
your terminal illness as the cause of your death
rather than the fact that you chose to shorten the process by giving up food and water.
A complete explanation of your death could include all the relevant facts.




3.  WILL I GET HUNGRY OR THIRSTY?


    Yes, there will be a period, especially at the beginning,
when your body will declare that it needs water and food.
But this period of time should last only 1-3 days.
After a while, the body adjusts to the fact of not getting any more food.
It begins to use fat cells to maintain itself.
And these fat cells also contain lots of water,
which will be used by your body to maintain itself for as long as possible.
This is how camels can live for long periods of time in the desert without food or water:
They live on the fat stored in their humps and elsewhere.
But the human body does not have as much storage capacity.

    According to people who have tried this method of voluntary death
and according to others who have observed such deaths,
the period of hunger and thirst passes relatively peacefully.

    And if you are receiving medical help
as in a hospice program
the medical professionals will be able to help you control
all undesirable side-effects of your choice to die by dehydration.
And if you would rather be asleep most of the last few days,
sedatives can be provided in whatever pattern works best for you.




4.  WOULD IT BE WISE TO HAVE EMPTY INTESTINES?


    Yes.  Some experts recommend that the patient
begin with some effective means of bowel-cleansing
before beginning the process of voluntary death by dehydration.
Because you will not be taking in any more food or water,
your suffering will be less if you have a clean digestive tract.
There will be no particles of food turning into gas in your intestines.

    Any laxative would be helpful in this process.
But the kind of bowel cleansing used before a colonoscopy would be ideal.
However, if you are already in such a fragile condition
that rigorous bowel preparation might be difficult,
you might choose just to follow a liquid diet for four days,
followed by a laxative of your choice.
Then you could begin your period of dying by dehydration.

    And psychologically, this period of bowel-cleansing
would also be a period of time to think more clearly and deeply
about your choice of voluntary death by dehydration.
No damage will be done to your body if you change your mind
and start eating and drinking again after any period of cleaning your intestines.
Other people will probably know about your plans to die by dehydration.
And they will help you with the process.
Their involvement will be an additional 'reality-check' on your reasons for wanting to die.




5.  WHAT ABOUT MOUTH CARE DURING THE PROCESS OF VDD?

    Mouth care is a very important element of any plan to die by dehydration.
Your mouth will suffer drying and cracking unless some effective methods are employed.
One simple method is to use ice chips to keep your mouth moist.
Or you could rinse your month with water as often as you please
and spit out the water instead of swallowing it.
Drinking small amounts of water will slightly delay the process of dying.

    And perhaps during your last days of life, you will value each additional day.
On balance, extending your dying process might not be a bad choice.
While you are still conscious and able to decide,
you can control your precise glide-path towards death,
by controlling the exact amount of water you drink.

    If you are enrolled in a hospice program while you are dying,
the professional care-givers will have even more methods of taking care of your mouth.
Since they have helped others to die by dehydration before,
they know exactly what to expect
and how best to deal with each problem as it arises.

    Other physically-painful and psychologically-distressing symptoms of dehydration might occur.
There are medical methods for dealing with all of these if they arise.
What forms of sedation would you find acceptable?

    See more details about mouth-care and dealing with thirst here:
http://www.thirstcontrol.com/




6.  IF I CHANGE MY MIND ABOUT DYING BY DEHYDRATION,
     WILL THERE BE ANY LASTING DAMAGE TO MY BODY?


    The first few days without food or water will not do any permanent damage to your body.
If you change your mind about dying by dehydration,
you can carefully resume eating and drinking.
And you body will be able to assimilate water and food once again.
People have come back from experimental fasts without harm.
And others have survived unavoidable deprivation of food and water for several days.

    Each day you must decide again to continue your chosen method of dying.
This is one of the strongest, built-in safeguards of VDD.
When you choose to die by dehydration,
this is a choice you must make over and over again,
perhaps as many as 100 times during the process of dying.

    After 4 or 5 days, your mind might not be working as well as normal.
So it would be important to have helpers
who will assist you in choosing death by dehydration.
You certainly should not put yourself into a situation
in which care-givers might reverse your decision to die
once you become unconscious.

    This method of drawing life to a close is clearly a voluntary choice at the beginning.
You are expressing your settled values in this decision to die by dehydration.
But you must make sure that other people around you also agree with your decision.
This will usually have been worked out in great detail
when you are fulfilling the safeguards
intended to prevent irrational suicide or any other form of premature death.
{See the first questionabout safeguards.}

    But after you become unable to express your settled values
in this case your determination to die by dehydration
then continuing the process of dying by refusing food and water
will be controlled by others around you.
We might say that the process has shifted
from being a voluntary death to being a merciful death
because other persons are the primary agents for continuing the process.

    For example, you would certainly not want to be in a hospital
where the default medical choice is always to give fluids artificially
once a patient has become unconscious or otherwise unresponsive.
That would defeat the whole process of dying by dehydration.
You might be kept 'alive' by tubes indefinitely.




7.  IS VOLUNTARY DEATH BY DEHYDRATION A LEGAL OPTION?


    Yes, everywhere on the Earth you have a legal choice to give up eating and drinking.
The only exceptions to this would be situations
in which the patient has been declared incompetent to make medical decisions
(including decisions that would lead to death)
and the decision-making power has passed to others.
The process of declaring you not capable of making medical decisions
will probably involve an evaluation by a psychiatrist.
So you could head off any such attempts to block your plan for death
by seeking your own psychological evaluation before you stop eating and drinking.

    You can prevent any such intervention by relatives or medical authorities
by having fulfilled strong safeguards before beginning the process of dying.
These safeguards are intended to make sure that you are making a wise decision for death.
The opinions of several other people are collected
in creating your death-planning record.
If there is going to be any legal challenge to your capacity to make life-ending decisions,
such questions will arise at several places in the process of fulfilling safeguards.

    In short, you should prove that you are making a wise and competent choice
to end your life by dehydration before you begin the process.

    Even in societies without complex legal systems,
the right to discontinue eating and drinking is universally recognized.
Some societies have traditions that honor this choice to die by giving up food and water.
Only under the most exceptional circumstances
would others have the legal power to force you to eat and drink against your will.




8.  WHERE CAN I FIND MORE INFORMATION
     ABOUT VOLUNTARY DEATH BY DEHYDRATION?

This life-ending choice has been discussed under a number of names:
VSED
Voluntary Stopping Eating & Drinking
VFRR
Voluntary Refusal of Food & Fluid
VTD
Voluntary Terminal Dehydration
VDD
Voluntary Death by Dehydration
MDD
Merciful Death by Dehydration
STED
Stopping Eating & Drinking
SED
Stopping Eating & Drinking
PRNHPatient Refusal of Nutrition & Hydration
MD
Medical Dehydration
TD
Terminal Dehydration
VTD
Voluntary Terminal Dehydration

    ARTICLES ON THE INTERNET:
(These on-line articles are organized by quality, beginning with the best.)

Voluntary Death:
A Comparison of Terminal Dehydration
and Physician-Assisted Suicide

a medical-journal article supporting the option of terminal dehydration
by Franklin G. Miller & Diane E. Meier.

VDD:
Why Giving Up Water is Better than other Means of Voluntary Death
a short article by James Leonard Park,
exploring the advantages of this form of exercising the right-to-die over all others methods.

VOLUNTARY DEATH BY DEHYDRATION:
Safeguards to Make Sure it is a Wise Choice

an on-line article exploring 26 recommended safeguards to fulfill
by James Leonard Park.


Voluntary Terminal Dehydration
a chapter by Alan D. Lieberson, an author who is both a doctor and a lawyer,
summarizing the literature exploring the medical, legal, & ethical dimensions
of voluntarily giving up eating and drinking as a reasonable means of choosing death.
The on-line book is entitled: Treatment of Pain and Suffering in the Terminally Ill.

Will this Death be an "Irrational Suicide" or a "Voluntary Death"?

Is the death helpful, rational, well-planned, & admirable?
a short article by James Park.

Will this Death be a "Mercy-Killing" or a "Merciful Death"?
Is the death harmful, irrational, capricious, & regrettable?
a short article by James Park.

Stopping Eating and Drinking
an excellent article by Judith K. Schwartz, PhD, RN
especially written for nurses, about all aspects of VDD,
with reference to a specific 100-year-old women
who chose to give up eating and drinking
even tho her various forms of physical deterioration
did not yet constitute 'terminal illness'.
This article appears at a few places on the Internet,
the URL's of which are too long.
So find it by searching for the exact title:
"Stopping Eating and Drinking".
As a side-benefit, such a search will lead you to similar articles.

Four Legal Methods of Choosing Death
Voluntary death by dehydration is one of these methods.
The others are: increasing pain medication, terminal sedation, & withdrawing life-supports.
a short article by James Park.

The Decision to Stop Eating at the End of Life:
Many Stop Eating to Regain Control

a short article by Angela Morrow, RN.

Choosing to Stop Eating & Drinking at the End of Life (VSED)
a short article by Robert J Webb, MD.

Tube Feeding Options at the End of Life
This comprehensive website explores the medical, ethical, legal, & religious dimensions
of the decision to use, forgo, or withdraw various forms of tube-feeding at the end of life.
The assumed context for these decisions is a patient in a hospital, nursing home, or hospice.
The decision about tubes is taken by the doctors, the patient, and/or proxies for the patient.

    DVD:

Dying Wish: A Dying Doctor's Decision to Stop Eating and Drinking and Die
This is a 29-minute DVD documentary of the last month of Dr. Michael Miller.
Because he was dying of cancer,
he decided his best pathway towards death was to give up eating and drinking.
This DVD shows the whole process,
including the participation of family, doctors, & hospice workers.
It took Dr. Miller almost two weeks to die after he stopped all liquid intake.
    The link above takes you to the bookstore of Compassion & Choices.
Scroll down to to near the end of the list. Retail price: $18.
This DVD is also available from Amazon.com.




BOOKS SUPPORTING VOLUNTARY DEATH BY DEHYDRATION:

The Best Way to Say Goodbye:
A Legal Peaceful Choice at the End of Life
by Stanley Terman

Taking Control of your Death by Stopping Eating and Drinking
by Boudewijn Chabot

both of these books are reviewed in the First Books on Voluntary Death by Dehydration.



    BEST BOOKS ON VOLUNTARY DEATH

This bibliography reviews several books about people who have chosen voluntary death.


 
OTHER WEBSITES SUPPORTING VOLUNTARY DEATH BY DEHYDRATION:

    COMPASSION AND CHOICES
Frequently Asked Questions about VSED.
This is another attempt to explain Voluntary Stopping Eating and Drinking.

    DEATH WITH DIGNITY, CANADA  
Voluntary Stopping Eating and Drinking
2 pages of questions and answers.





    Further Questions and Answers will be added to this website
as they are suggested by readers.
Additional links will also be added, connecting to similar websites.
Send all comments to the webmaster: James Park,
e-mail: PARKx032@TC.UMN.EDU


Created January 30, 2009; Revised 2-15-2009; 2-18-2009; 3-6-2009; 6-15-2009; 11-27-2009;
1-4-2010; 1-6-2010; 1-9-2010; 5-17-2010; 7-11-2010;10-17-2010; 8-24-2011; 8-25-2011; 8-27-2011;
5-17-2012; 3-19-2014;



Go to the Right-to-Die Portal.
This portal leads to many additional resources, including several bibliographies.



Go to the opening page for this website:
An Existential Philosopher's Museum
















The views and opinions expressed in this page are strictly those of the page author.
The contents of this page have not been reviewed or approved by the University of Minnesota.