OPTIONS FOR A CHOSEN DEATH 

VOLUNTARILY STOPPING EATING AND DRINKING (VSED)

VSED is a decision made by a competent adult to stop further intake of food and fluids with the goal of hastening death. It is an intentional and voluntary (non-coerced) choice to hasten death by a decision-capable person who suffers intolerably from an incurable and progressive, or terminal illness. A successful VSED ‘outcome’ is understood as a peaceful death that occurs with a minimum of discomfort and with this method, death occurs within a predictable period of days or weeks following the start of the fast. The person using VSED will need total care during the process, which should be done with medical support.

VSED for Individuals, Families and Caregivers:

Things to Consider (Compassionate Choices) 

 Voluntarily Stopping Eating and Drinking (End of Life Choices Oregon)

MEDICAL AID IN DYING (MAID)

Medical Aid in Dying (MAID) is an end-of-life option that allows people with a terminal diagnosis and a prognosis of less than six months to end their lives through the self-administration of lethal medications. On October 27, 1997, Oregon’s Death With Dignity Act was implemented. Oregon thus became the first state in the US to pass end-of-life legislation. 

Under the current law in Oregon, and in all other US jurisdictions that have end-of-life laws, people with dementia or other progressive neurological conditions cannot qualify for MAID.

Eligibility Requirements:

● Age: The patient must be at least 18 years of age.

● Residency: Residency in Oregon is no longer required.

● Capacity: The patient must be capable of making and communicating their own healthcare decisions.

● Terminal Illness: The patient must have a terminal illness that is expected to result in death within six months.

● Self-Administration: The patient must be able to self-administer the medication without help.

Additional Information:

● Two physicians must confirm the diagnosis and prognosis.

● The patient must make an informed decision, understanding the alternatives, and voluntarily express their wish to die.

● At least 15 days must pass between the initial oral request and the written request, and at least 48 hours must pass between the written request and the writing of the prescription. (Starting January 1, 2020, patients are exempt from any waiting period that exceeds their life expectancy. Patients with less than 15 days to live are exempt from the 15-day waiting period between the first and second oral requests for medication. Patients with less than 48 hours to live are exempt from the 48-hour waiting period between the patient’s written request and the writing of the DWDA prescription.)

Medical  Aid in Dying slide show - Dr. Blanke, Medical Oncologist 5/10/2025

 Internationally known for his cancer research, but also a leader in developing choices for those at the end of life, Dr. Blanke provided an update on how the Oregon Death with Dignity Act functions at present, as well as his thoughts as to how this act may be improved.  (Introductory comments by Dane Moseson, M.D.). 

FINAL EXIT NETWORK

Presentation 10/16/2025 by Brian Ruder, President of Final Exit Network (FEN) Navigating Dementia 

 The Final Exit Network (FEN) holds that mentally competent adults who suffer from terminal illness, intractable physical pain, chronic or progressive physical disabilities, or who face loss of autonomy and selfhood through dementia, have a basic human right to choose to end their lives when they judge their quality of life to be unacceptable. Their mission is to educate and support those who want choice in dying. Fen offers an Exit Guide Program where volunteer coordinators respond to calls and website contacts about end-of-life options and the Exit Guide Program. The coordinators answer questions, discuss options, and direct callers to appropriate resources.  

 Mr. Ruder recommended 2 Books 

1.The Inevitable by Katie Engelhart

2.There at the End by Jim Van Buskirk

Final Exit Network: An Introduction (5-minute video)

Final Exit Network (Homepage) 

Exit Guide Process

 
Discussing Death

OTHER RESOURCES RE: DEMENTIA AND END OF LIFE CHOICES

End-of-Life Decisions (Alzheimer’s Association)

Advance Directives for Dementia (Final Exit Network)

RESOURCES FOR ASSISTED DEATH IN SWITZERLAND

Traveling to Switzerland to access an assisted death is an option for choice in dying that has been getting increased attention in the US. Swiss laws are much more compassionate in whom they serve than US MAID laws, which are very restrictive.

Swiss law only requires that 1) anyone assisting in a chosen death must not have selfish motives, 2) the individual choosing to die must have decision-making capacity, and 3) the individual choosing to die must perform the final action that will bring about death. Importantly, Switzerland is the only country that will provide an assisted death for non-citizens and allows non-Swiss citizens to come to Switzerland to

receive medical support to aid their death.

 The Switzerland Alternative  - While primarily for people in the UK (it was put together by a British former lawyer and MP) there’s a lot of useful information, and a supplement for US citizens.

Assisted Dying in Switzerland and Swiss Option Advisor (Final Exit Network)

Link to  article on using Pegasos by Ruth Dixon Mueller (article in the Summer 2023 FEN Newsletter)

A Visit to Pegasos for Assisted Dying (40-minute video from the Hemlock Society of San Diego) 

PEGASOS (Swiss Organization)

DIGNITAS (Swiss Organization) 

ATHANASIOS (Swiss Organization)

Phönix Care [Phoenix Care] (Swiss Organization)