Quaker Universalist Voice

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Hastened Death Preparations: A New/Old Means for Providing a Healthy and Peaceful Death

A Book Review of T. Quill et al, Voluntarily Stopping Eating and Drinking: A Compassionate, Widely Available Option for Hastening Death (2021)

Thanks to medicine, nutrition, sanitation, good government, trade, and peace, human life expectancy has grown longer. But, we all die. For most of human history, life expectancy was about 30 years and people died of accidents primarily. About 10,000 years ago, humans discovered agriculture, which brought both significant labor intensity and concentration and new diseases that crossed the species barriers from animals to humans in dense settlements. It took generations for natural resistance to evolve and spread. 

Progress in addressing infectious disease changed 250 years ago in Europe and North America. These new diseases included bubonic plague, flu, measles, smallpox, typhoid, and cholera. Humans also began to apply reason to their understanding of illnesses, producing clinical trials, vaccination, epidemiology, and hygiene.  Today, we face the global looming specter of dementia as the global number of elderly people is rising.  Alzheimer’s Disease and Parkinson’s Disease are the leading disabilities as we head for a world of elderly people with healthy bodies and demented minds.

In the 21st-century, people are living longer, hoping for a healthy longer life followed by a quick and peaceful death. But frequently, this does not happen. Humans are exploring ways to manage death in light of increasing human longevity in healthy bodies.  People are living healthy a little longer, but they tend to live sick for much longer.  This situation leaves seniors and their families round the earth facing difficult decisions regarding prolonging medical treatments and death.

As options are being explored to avoid unacceptable suffering, more people are looking to voluntary stopping eating and drinking (VSED), which can be used legally anywhere on earth. VSED is not limited to people with a terminal illness or to those people with current legal decision-making capacity.  VSED is an option that respects choice and is typically peaceful and meaningful with the company of medical and caregiver support.  It is not limited to those persons with unbearable suffering.  VSED is a choice available to all.

A major, new, compassionate, and comprehensive resource on VSED in the United States has just been published:  Timothy E, Quill et al, Voluntary Stopping Eating and Drinking: A Compassionate, Widely Available Option for Hastening Death (2021). The book’s title is an accurate reflection of the book’s subject and contents.

This book is structured in two parts, addressing VSED for those persons with legal decision-making capacity and addressing, separately VSED for those persons without legal decision-making capacity.  The book is organized around a group of cases, with commentaries from several representative perspective.  The authors are multidisciplinary (medicine, nursing, legal, ethics, care facilities, and hospice) The reader leaves this book confident in the comprehensive treatment of this important subject.  The authors reflect diverse perspectives in disciplines including clinical, legal, ethical and institutional. 

This book is thorough on the VSED subject, provides a full bibliography, an adequate index, and a clear and helpful table of contents. The appendices include helpful advanced directive elements, and resources for personal testimonies.

VSED is not easy, but it is doable and is one of the free, legal, and compassionate available alternatives from all perspectives for many.

The focus is on clarification of legal decision-making capacity and non-capacity to make decisions at the end of life, including suggested best practices at the bedside, including documentation, talk, inclusive understanding with the family and candor.

All humanity is affected by the increased life expectancy and they recognize the growing group of elders who are physically healthy elderly people.  There are several ways of managing death in the legislative process, but VSED is available to all persons universally.

This book is now the standard introduction and reference on VSED.  The book provides realistic and nuanced understanding of this important tool available to us all.  This book is the fullest review of VSED, with particular exploration of VSED in the circumstance when the person no longer has legal capacity to make decisions.

Quakers: There is no reference to Quakers in this book. Currently, Quakers understand and address the subject of death much like other groups in their cultures. Quaker organizations have no clear, public position on voluntary stopping eating and drinking, despite historic Quaker leadership in the development of elder care in the 20th century. Quakers are compassionate and silent on this issue of VSED. Quakers, like hospice, often cooperate and assist with VSED, but are not public on the subject.


  1. How do Quakers explain the management of the final chapter of life with Quaker testimonies?
  2. What do Quakers have to contribute that is potentially distinctive to discussion of VSED?
  3. If VSED is not selected, what can Quakers say about useful alternatives for accomplishing a peaceful death?


  • T. Quill et al, Voluntary Stopping Eating and Drinking: A Compassionate, Widely Available Option for Hastening Death (2021)
  • A. Doig, This Mortal Coil (2021)


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