Why we’ve created clear, accessible information about voluntary stopping eating and drinking (VSED)
People regularly contact our nurse-led helpline with questions about some of the most difficult decisions they may ever face.
Sometimes they want to know how to make an advance decision. Sometimes they’re supporting a family member who is seriously ill. And increasingly, people are asking us about voluntary stopping eating and drinking (VSED) – what it is, whether it is lawful, and what support might be available if they are considering this process.
These aren’t easy conversations. They involve deeply personal decisions, complex legal and clinical issues, and emotions that can be difficult to navigate. But avoiding those conversations doesn’t stop people having questions.
At Compassion in Dying, we help people understand their rights and choices when it comes to end-of-life decision making. That means explaining what the law says, sharing relevant professional guidance, and helping people navigate what can often be complex healthcare systems and conversations.
What is VSED?
Voluntary stopping eating and drinking (VSED) describes a decision by a person with mental capacity to refuse food and fluids, with the understanding that this will hasten their death.
In the UK, adults with capacity have the right to refuse medical treatment and to refuse food and fluids. VSED is therefore not a “legal grey area” as I’ve often heard it described; it is a lawful option available to adults who have decision-making capacity.
However, lawful does not mean straightforward.
People’s experiences can vary significantly, and those considering this option may encounter a range of practical, clinical and emotional challenges. In fact, I would say it’s likely they will.
Why we are publishing information about VSED
Over recent years, we’ve seen a growing number of enquiries about VSED. Between 2021 to 2025, the proportion of contacts to our information line mentioning VSED increased seven-fold, and enquiries about VSED have continued to rise. In the first five months of 2026 we had more contacts about VSED than we did in the whole of 2022.
As with any end-of-life topic people ask us about, our role is not to tell people what they should do. Our role is to provide accurate, balanced information that is available within the law and within the scope of our service, so people can make informed decisions and understand what support may be available.
We know this is a sensitive subject. We also know that avoiding conversations about difficult end-of-life decisions does not stop people having questions about them.
People contact our helpline because they are looking for clear, honest and evidence-based information. Many of the people who contact us are trying to understand what choices are legally available to them.
Our role is not to encourage any particular option, whether it’s completing an advance decision or choosing VSED. Our role is to support informed and truly person-centred decision-making within existing legal boundaries.
That means when someone asks us about VSED, we will listen without judgement.
We will explain:
- what the law says
- what the British Medical Association says
- the importance of decision making capacity for this decision
- how decision making capacity is assessed
- how conscientious objection from professionals may arise
- where appropriate, the kind of clinical and carer support that may be needed
- and questions they may wish to ask their GP or healthcare team
We are also realistic with people about the barriers they may face and the preparation time often required.
Being honest about the complexities of this process
We’ve heard such a broad range of experiences from the people we’ve supported and who have chosen to pursue VSED over recent years. Some family members describe peaceful and well-supported deaths. Others describe difficult and distressing experiences.
Whilst it’s central to our approach anyway, we’re very upfront with people considering VSED that:
- their capacity to make this decision may be questioned even if this has never happened before,
- mental health teams may be involved,
- some healthcare professionals may feel unable to participate because of conscientious objection,
- and arranging appropriate support can take time.
In some situations, people who begin VSED without appropriate clinical support in place may become vulnerable or unsafe. Our nurses may have concerns where somebody appears isolated, unsupported or at risk, and safeguarding processes may occasionally be necessary.
This reflects the reality that VSED is not simply an individual act; it is often a process that requires careful discussion, assessment and clinical support.
The limits of our service
It is also important to be clear about what our service does and does not do.
We do:
- provide information about the law and professional guidance,
- support people to understand their rights and options,
- help people prepare questions for healthcare professionals,
- encourage involvement from relevant inpatient or community based health care professionals, e.g. GPs, district nurses and palliative care teams.
We do not:
- recommend or suggest VSED to the people who contact us,
- assess a person’s mental capacity,
- provide hands-on clinical care or in-person support,
- or make decisions on behalf of healthcare professionals.
At Compassion in Dying, we believe people are best supported to make informed decisions when they have access to clear, accurate and balanced information about their choices – even when those conversations are difficult.
In 2022, we published a policy report calling for national guidance for healthcare professionals on VSED, as no such documentation then existed. In its absence, clinicians, individuals and those caring for them were forced to make complex and deeply personal decisions about a process that is generally little understood, without the support of clear, nationally recognised information. We are pleased that the BMA has listened and recognised this need for clarity for clinicians. In response, it has developed guidance for healthcare professionals supporting people who choose VSED.
Our policy reports are not written with the public audience in mind. However, in the absence of anything else, this is what people have been reading when trying to learn more about VSED. So, as we are an organisation focused on helping people understand their rights and choices, we have developed new public-facing website content, informed by legal and healthcare expertise and designed specifically for people rather than policy-makers or healthcare professionals.
Avoiding conversations doesn’t stop people having questions – we therefore believe that clear, accessible content is essential to ensure that people seeking this information can make informed decisions.