By the same authors

From the same journal

Voluntary stopping of eating and drinking: is medical support ethically justified?

Research output: Contribution to journalArticlepeer-review


  • Ralf J Jox
  • Isra Black
  • Gian Domenico Borasio
  • Johanna Anneser


Publication details

JournalBMC Medicine
DateSubmitted - 5 May 2017
DateAccepted/In press - 3 Oct 2017
DatePublished (current) - 20 Oct 2017
Number of pages5
Original languageEnglish


Physician-assisted dying has been the subject of extensive discussion and legislative activity both in Europe and North America. In this context, dying by voluntary stopping of eating and drinking (VSED) is often proposed, and practiced, as an alternative method of self-determined dying, with medical support for VSED being regarded as ethically and legally justified.

In our opinion, this view is flawed. First, we argue that VSED falls within the concept of suicide, albeit with certain unique features (non-invasiveness, initial reversibility, resemblance to the natural dying process). Second, we demonstrate, on the basis of paradigmatic clinical cases, that medically supported VSED is, at least in some instances, tantamount to assisted suicide. This is especially the case if a patient’s choice of VSED depends on the physician’s assurance to provide medical support.

Thus, for many jurisdictions worldwide, medically supported VSED may fall within the legal prohibitions on suicide assistance. Physicians, lawmakers, and societies should discuss specific ways of regulating medical support for VSED in order to provide clear guidance for both patients and healthcare professionals.

Bibliographical note

© The Author(s). 2017

    Research areas

  • VSED, decision making, nutrition and hydration, palliative care, ethical analysis, medical ethics, law


  • ALS-CarE

    Project: Other projectResearch collaboration

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