Voluntary stopping of eating and drinking, or VSED, is one way people around the world choose to end their life prematurely. It’s a conscious choice most often made to end unbearable suffering that cannot be alleviated by modern medicine.
In Switzerland, VSED has entered the collective consciousness of healthcare professionals. In 2018, the Swiss Academy of Medical Sciences included the practice as part of its guidelines on “Dealing with Dying and Death”. Even so, the depth of the issue across the nation is largely unknown. How many deaths does VSED account for annually? How do healthcare professionals view the practice of VSED?
A recent survey of heads of Swiss nursing homes set out to answer these and other questions. The results suggest ample room for improvement in how VSED is understood and managed.
The researchers behind the study tailored their questionnaire to long-term care nurses, asking questions such as whether VSED is compatible with their worldview or religion, whether professionals are burdened by the practice, and whether special care should be dedicated to residents choosing VSED.
The results show that every other institution among those participating in the survey has experienced at least one VSED case. Additionally, among all persons who died in Swiss nursing homes in 2016, 1.7% were due to VSED.
Participants’ views on VSED were very positive overall—even if slightly flawed in some cases. The majority of participants, for example, assumed that VSED, whether spoken or unspoken, is a phenomenon that occurs almost exclusively at older age, above the age of 75. That assumption overlooks the fact that, though small, a significant number of people 65 and younger choose VSED.
Such findings could be skewed by the respondents’ focus on elderly care, but they are still instructive. Addressing this and other knowledge gaps with more targeted training could help clinicians deliver better care to patients who choose VSED.