Palliative Podcasts: Voluntary Stopping Eating and Drinking (VSED)

This podcast is about the following JAGS article: Wax JW, MD, An AW, MD, Kosier N, MD, and Quill TE, MD Voluntary Stopping Eating and Drinking, Journal of the American Geriatrics Society, March 2018


Voluntary stopping of eating and drinking (VSED) is a deliberate, self-initiated attempt by some terminally ill patients to hasten death. Some patients explore this option in the setting of intractable suffering refractory to optimal palliative interventions or prolonged dying that a the patient finds intolerable.Data show that individuals who consider VSED tend to be older, have a serious but not always imminently terminal illness, place a high value on independence, and have significant illness burden.
In the podcast below, Dr. Periyakoil, Associate Editor of the Journal of the American Geriatrics Society and  Prof. Timothy Quill from University of Rochester (and senior author of the article) have a conversation about the practical clinical aspects of VSED.

Intended audience: Medical students, doctors-in-training and practice as well as inter-professional clinicians caring for seriously ill patients.
How to use this podcast: 
a. Read the Palliative Practice Pointer article in JAGS on VSED.
b. Listen to this podcast for further discussion about the topic, to hear about real-life situations that highlights clinical nuances. You can listen on the browser (make sure computer speaker is on and the volume is turned up) or download it into your smartphone using iTunes or a comparable program.

Experts from the domains of psychology, chaplaincy and medicine share real-life experiences.

“He does not not struggle with death. He struggles with the dying process”: Dr. Hiroto describes how she supported a veteran who had self esteem issues and how she was able to help him when he raised the issue of hastening death through VSED.

“Many religious traditions do not favor hastening death“: Chaplain Klein provides a broad overview of how to provide spiritual support to patients considering VSED, their family members and the providers caring for them.

“He was the mayor of his church”: Dr. Sandy Trieu describes her work with a Asian American patient with pancreatic cancer who asked about VSED when he could not go to church anymore.

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