Inthe21stcentury,peopleinthedevelopedworldarelivinglonger.Theyhopetheywillhaveahealthylongerlifeandthendierelativelyquicklyandpeacefully.Butfrequentlythatdoesnothappen.Whilepeoplearelivinghealthyalittlelonger,theytendtolivesickforalotlonger.Andattheendofbeingsickbeforedying,theyandtheirfamiliesarefrequentlyfacedwithdauntingdecisionsaboutwhethertocontinuelifeprolongingmedicaltreatmentsorwhethertofindmeaningfulandforthrightwaystodiemoreeasilyandquickly.Inthiscontext,somepeoplearesearchingformoreandbetteroptionstohastendeath.Theymaybeexperiencingunacceptablesufferinginthepresentormayfearitinthenearfuture.Buttheydonotknowthefullrangeofoptionslegallyavailabletothem.Voluntarystoppingeatinganddrinking(VSED),thoughrelativelyunknownandpoorlyunderstood,isawidelyavailableoptionforhasteningdeath.VSEDislegallypermittedinplaceswheremedicalassistanceindying(MAID)isnot.AndunlikeU.S.jurisdictionswhereMAIDislegallypermitted,VSEDisnotlimitedtoterminalillnessortothosewithcurrentdecision-makingcapacity.VSEDisacompassionateoptionthatrespectspatientchoice.Despiteitsstronglymisleadingimageofstarvation,deathbyVSEDistypicallypeacefulandmeaningfulwhenaccompaniedbyadequateclinicianand/orcaregiversupport.Moreover,thepracticeisnotlimitedtoavoidingunbearablesuffering,butmayalsobeusedbythosewhoaredeterminedtoavoidlivingwithunacceptabledeteriorationsuchasseveredementia.ButVSEDis“notforeveryone.“Thisvolumeprovidesarealistic,appropriatelycritical,yetsupportiveassessmentofthepractice.Eightillustrative,previouslyunpublishedrealcasesareincluded,receivingpragmaticanalysisineachchapter.Thevolume’sintegrated,multi-professional,multi-disciplinarycharactermakesitusefulforawiderangeofreaders:patientsconsideringpresentorfutureend-of-lifeoptionsandtheirfamilies,cliniciansofallkinds,ethicists,lawyers,andinstitutionaladministrators.Appendicesincluderecommendedelementsofanadvancedirectiveforstoppingeatinganddrinkinginone’sfutureifandwhendecisionmakingcapacityislost,andwhattorecordascauseofdeathonthedeathcertificatesofthosewhohastendeathbyVSED.
