Why You Might Want To Know About VSED

VSED stands for voluntarily stopping eating and drinking, and it’s something people can choose when they wish to hasten the dying process at the end of their life.

As someone living in Mexico (who therefore might die there), you might want to know about VSED as a potential end of life choice. VSED is legal in all of Mexico. People might choose VSED to avoid suffering at the end of life, to avoid living with advanced cognitive or neurological disorders, or to avoid long-term dependency on others.

The knowledge that VSED is available can be comforting to some, even if they never do it.

What Is VSED?

VSED, voluntarily stopping eating and drinking, is a legal way to hasten death. People naturally lose interest in eating and drinking at the end of life as the body’s organs slow down and nutrition and hydration is no longer needed. Sometimes referred to as end-of-life fasting, VSED accelerates the natural process of dehydration that occurs when we die. People who choose VSED tend to die within 9-15 days of initiating the fast.

Human beings have been practicing VSED at the end of life since - perhaps - the beginning of time. It is relatively new in our culture (and some may say mistaken) to continue feeding and hydrating people whose bodies are in the process of dying. People who have chosen VSED are said to have died a natural death, as the final stages of VSED are no different from the natural dying phase of advanced age or illness.

Is VSED Legal In Mexico?

You may have heard of people choosing MAID, Medically Assisted Dying, at the end of their life. People who choose MAID do so with the hope of avoiding suffering, to feel in control, to save themselves and their loved ones from living longer with poor quality of life, or for other personal reasons. Although it’s currently being debated in the Senate, as of September 2026, medically assisted dying, or euthanasia, is illegal in all of Mexico.

VSED, while not the same as MAID, may offer people living in Mexico with a life-limiting illness a safe, legal means of hastening death.

VSED, much like green burial in Mexico, has not been made explicitly legal, but neither is it illegal. In Mexico, you have the right to refuse medical treatment - including nutrition and hydration - at the end of your life. This is codified by Mexico’s law of advance directive and considered a basic human right.

Unlike MAID, VSED has no outside cause of death. It is the patient’s choice to refuse care (versus introducing an outside substance) that leads to natural decline. 

Still, refusing medical treatment in Mexico is not always easy to do. Having a robust advance medical directive and a courageous proxy who knows your end-of-life preferences is highly recommended.

While it may be common to indicate on an advance directive that we don’t want tube feeding or intravenous hydration at the end of our lives, it is less understood that we can also refuse to be fed by mouth when we can no longer feed ourselves. Further, we can choose to stop feeding or hydrating ourselves, even if we’re still physically or cognitively capable of eating and drinking on our own.

Can People With Dementia Choose VSED?

A meta-analysis of people who chose VSED in Europe found that more than half of those who chose VSED had dementia. This appears to be reflective of worldwide trends, as more people with dementia diagnoses grapple with the choice of whether or not to live longer with advancing cognitive impairment.

In Mexico, if VSED (the refusal of nutrition and hydration) is to be part of your legal advance directive, it is a decision that must be made while you still have decision-making ability. Consider the milestones of disease that might trigger you to start the VSED process.

Consider also, how to address the challenge of assigning your medical proxy the task of refusing you food or drink at a future date when you may not fully remember your original choice.

An “in-between” measure sometimes chosen by people with dementia is “minimal comfort feeding,” or MCF. Although MCF will prolong life, it emphasizes hand feeding only when the person with dementia asks for it, and not, for example, three times daily on a meal schedule. 

Is VSED Painful? 

It is common to be curious about pain at the end of life and how to avoid it, as we have grown up with the narrative that death is painful and frightening (perhaps especially if we grew up in the US). Remember that pain is subjective and not a given at the end of life.

VSED, like other forms of fasting, promotes the production of ketones, which some people register as a pleasant experience. Although there may be an initial uncomfortable period of hunger or thirst, this typically resolves itself after 1-3 days as the body’s hormones respond to the lack of food and water.

When we allow for dehydration as part of the natural dying process it triggers the release of several ‘feel-good’ hormones and endorphins. These can provide an analgesic or euphoric effect, described in studies as ‘more powerful than morphine.’

What Type Of Support Is Needed For VSED?

Voluntarily stopping eating and drinking leads to a natural death. Still, it is best done with the support of someone who is trained and experienced in the process. In Mexico, you might find such expertise in a death doula or a trained hospice provider. They can help with symptom management and provide comfort care.

In the United States, it is recommended that you undergo VSED with the buy-in of a medical hospice team, who can provide medical supervision. This might be harder to come by in Mexico, where doctors could be more hesitant to get involved due to the legal grey area VSED occupies. One main benefit of VSED, however, is that medical support is not necessary. Especially, if you have caregivers who are well educated in VSED and the dying process. 

Education, for the dying person and for all who will accompany them, is key. People should understand that VSED is not assisted suicide, nor is it starving to death. It is merely the hastening of the natural process that is already occurring in the dying person’s body. 

How Do I Learn More About VSED?

VSED is a complex topic and we’ve barely introduced it here. If you’d like to explore this option further, I recommend the resources below for more information about VSED, what it is, what the process looks like, and what type of support is recommended.

• WEBSITE: Compassion and Choices: FAQs for patients and families

• BOOK: The VSED Handbook by Kate Christie

• PODCAST: Palliative care physician Tim Quill on VSED

• WEBSITE: Articles on VSED by Professor Thadeus Mason Pope’s Medical Futility Blog

• BOOK: Choosing to Die: A Personal Story by Phyllis Schacter

• PODCAST: Episode 10 of The Sandwich Generation Pod on Choosing VSED with Alzheimer’s

The information provided on this website is for general informational and educational purposes only. It is not intended as, and should not be considered, legal, medical, financial, or professional advice. See our full disclaimer.

Are you considering VSED in Mexico or have you accompanied someone on this journey? If you have a story that could benefit others, I invite you to share it in the comments below or in our private Facebook group.