VSED in France - Get Ready

Now that France has authorized medical aid in dying, it is appropriate to reexamine VSED for all the terminally ill and seriously ill French patients who want to hasten death but cannot access MAID. Public discussion of VSED in France was prompted six years ago with the Alain Cocq case. Now the geriatrics literature is engaging. This recent article concludes that French healthcare professionals should prepare for this option (called l’arrêt volontaire de la nutrition et de l’hydratation (AVNH) par le patient).   

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The Cheryl Hauser Effect: Story and Conversation about VSED

You are invited to a special gathering introducing The Cheryl Hauser Effect, a documentary now in its final stage of production. Come September 17, 2026 at The Lantern in Portland, Oregon. The film shares the story of Cheryl Hauser, a Minnesota woman who, after being diagnosed with Alzheimer's disease, chose to face the end of her life on her own terms through VSED (Voluntarily Stopping Eating and Drinking). At seventy-six, Cheryl became a thoughtful advocate for end-of-life autonomy, inspiring important conversations about dementia, caregiving, and personal choice. This special preview event offers an early look at The Cheryl Hauser Effect while the film is still in production. Through selected clips and conversation, we'll explore Cheryl's story and the impact this film hopes to make. During this special evening, you will: * View selected, never-before-seen clips from the documentary * Learn more about VSED and end-of-life options * Hear from those directly involved in the story and the work surrounding end-of-life autonomy A conversation will follow with: * Randi Ewing, Palliative Care Director, Eden Health * Dr. Stephanie Kaplan, Naturopathic Physician Specializing in End-of-Life Care * Dr. Pete Regan, First physician to prescribe under Oregon's Death with Dignity Act * Jamie Thrower, End-of-Life Doula and Grief Educator Join us for an evening of storytelling, education, and conversation as we share Cheryl's story and build support for the film's completion. Learn more at thecherylhausereffect.com

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Death, Dying and Disposal Conference 2027

Thee 18th Death, Dying and Disposal Conference (DDD2027) will take place at the University of Antwerp, Belgium, September 2027. The conference theme will be Death Care.

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Medical Futility in South Africa

This recent webinar nicely illustrated how medical futility conflicts are navigated differently in South Africa. The discussion referenced two sections of this guidance document from the Health Professions Council of South Africa.   "When the patient or the family request continued treatment against health advice that considers such treatment to be futile, the patient or the family must be given guidance and advice why such decision was taken and be advised regarding their choice of transferring to another institution where such treatment is available. If this option is refused and the health team considers treatment to be futile, and this is confirmed by independent health practitioner(s), The health practitioner may nevertheless, implement the decision to withhold or withdraw treatment if such is in the best interest of the patient." "All decisions should be fully and clearly documented in the health records, including the reasons for the decision and the procedure adopted in the decision-making process. Where significant disagreements arise about a patient’s best interests, the health practitioner should seek a clinical and / or ethical review, independent of the health care team. If this fails to resolve the disagreement, they must seek legal advice on whether it is necessary to apply to the court for a ruling."

dlvr.it

Dead Donor Rule - New Law Prevents Violations

The dead donor rule has been a fixture of organ transplantation for sixty years. But in light of frequent intentional and accidental breaches, some regulators have strengthened protections to mitigate DDR violations.  Notable among these is Kentucky H.B. 510, signed in April. Because the law is now effective, it has been receiving renewed attention. The Kentucky statute requires that "during any organ donation recovery, preservation, or procurement activity for a DCD or DBD, a pause in procedure shall be initiated if any [clinician or family member] reports on any of the following: * Observed or suspected change in neurological status * Observed or suspected indication of life * Uncertainty regarding the accuracy or completeness of neurological status or death declaration assessments" Triggering "indications of life" include but are not limited to: * Spontaneous movement * Vocalization or attempts to vocalize * Purposeful or reflexive responses to stimuli * Observed respiratory effort by a patient-initiated attempt at breath * Changes in heart rate or blood pressure inconsistent with a death declaration * Any neurological or physiological sign suggesting pain perception or neurological activity Reports of any of these require "immediate suspension of any organ donation recovery, preservation, or procurement activity."  

dlvr.it

The Cheryl Hauser Effect: Story and Conversation about VSED

You are invited to a special gathering introducing The Cheryl Hauser Effect, a documentary now in its final stage of production. Come September 17, 2026 at The Lantern in Portland, Oregon. The film shares the story of Cheryl Hauser, a Minnesota woman who, after being diagnosed with Alzheimer's disease, chose to face the end of her life on her own terms through VSED (Voluntarily Stopping Eating and Drinking). At seventy-six, Cheryl became a thoughtful advocate for end-of-life autonomy, inspiring important conversations about dementia, caregiving, and personal choice. This special preview event offers an early look at The Cheryl Hauser Effect while the film is still in production. Through selected clips and conversation, we'll explore Cheryl's story and the impact this film hopes to make. During this special evening, you will: * View selected, never-before-seen clips from the documentary * Learn more about VSED and end-of-life options * Hear from those directly involved in the story and the work surrounding end-of-life autonomy A conversation will follow with: * Randi Ewing, Palliative Care Director, Eden Health * Dr. Stephanie Kaplan, Naturopathic Physician Specializing in End-of-Life Care * Dr. Pete Regan, First physician to prescribe under Oregon's Death with Dignity Act * Jamie Thrower, End-of-Life Doula and Grief Educator Join us for an evening of storytelling, education, and conversation as we share Cheryl's story and build support for the film's completion. Learn more at thecherylhausereffect.com

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VSED Bridge to MAID - Blocked in New UK Bill

VSED bridge to MAID is falling down, falling down in London. The new Terminally Ill Adults (End of Life) Bill explicitly excludes VSED as a way to qualify for MAID. In Section 2 (of 59) the Bill provides: Where— (a) a person does not eat or drink, or limits their eating or drinking, either voluntarily or because of a mental disorder, and their not eating or drinking, or limited eating or drinking, causes them to have an illness or disease, the person is not regarded for the purposes of this Act as terminally ill by virtue of the illness or disease. That this language had to be specifically included implies that VSED  otherwise legitimately makes someone terminally ill. In other word, VSED is a bridge to MAID (as in Oregon, New Mexico, and other jurisdictions) unless explicitly excluded. MP Lauren Edwards

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Reducing Variability in Brain Death Policies & Practices - Interhospital Collaboration

Nearly 20 years ago, I defended multi-institutional ethics committees. So, I was pleased to see this report in Hospital Pediatrics about collaboration among five children's hospitals in southeast Florida.  Through the South Florida Pediatric Bioethics Consortium (SFPBEC), they have reduced variability in policies regarding brain death, potentially inappropriate treatment, and other clinical ethics issues.

dlvr.it

Medical Futility in South Africa

This recent webinar nicely illustrated how medical futility conflicts are navigated differently in South Africa. The discussion referenced two sections of this guidance document from the Health Professions Council of South Africa.   "When the patient or the family request continued treatment against health advice that considers such treatment to be futile, the patient or the family must be given guidance and advice why such decision was taken and be advised regarding their choice of transferring to another institution where such treatment is available. If this option is refused and the health team considers treatment to be futile, and this is confirmed by independent health practitioner(s), The health practitioner may nevertheless, implement the decision to withhold or withdraw treatment if such is in the best interest of the patient." "All decisions should be fully and clearly documented in the health records, including the reasons for the decision and the procedure adopted in the decision-making process. Where significant disagreements arise about a patient’s best interests, the health practitioner should seek a clinical and / or ethical review, independent of the health care team. If this fails to resolve the disagreement, they must seek legal advice on whether it is necessary to apply to the court for a ruling."

dlvr.it

DNR Consent Influenced by Selective Phrasing

Even subtle differences in clinician phrasing meaningfully shape people's attitudes toward DNR.  A new study shows that selective phrasing functions as a form of nudging. The researchers also examine the ethical boundaries of linguistic selectivity in medical communication.

dlvr.it

Minimal Comfort Feeding in Advanced Dementia: Attitudes of Hospice and Palliative Care Professional

Here is a Share Link for free access to our recent article "Minimal Comfort Feeding in Advanced Dementia: Attitudes of Hospice and Palliative Care Professional" in the Journal of Pain & Symptom Management.   Context. Minimal Comfort Feeding (MCF) is a new approach to providing nutrition and hydration to persons with advanced dementia who have previously indicated (or whose surrogate believes) they would not want to live with advanced dementia. The acceptability of MCF has not been studied. Objectives. To assess perceptions of hospice and palliative care (HPC) professionals toward MCF. Methods. This cross-sectional exploratory survey study of a convenience sample was conducted at a national conference of HPC professionals in February 2025. During a presentation on MCF’s definition and ethical basis, attendees engaged in audience response polling and an optional electronic survey. Descriptive results are presented. Results. Fifty-one people attended the presentation. Forty-five attendees (88%) participated in audience polling, and 22 (43%) participated in both polling and the survey. The mean age of survey respondents was 50 (standard deviation 9.58),19 (86%) identified as White, and 18 (82%) identified as women. Thirty-five of 42 respondents (83%) agreed or strongly agreed that MCF is an acceptable option for persons with advanced dementia (PWAD), and 93% (39/42) agreed or strongly agreed they would be comfortable discussing MCF with persons with early dementia or who are at risk for dementia as a potential future option. Sixty-nine percent (29/42) anticipated MCF would be somewhat or completely acceptable to families of PWAD, but respondents were divided regarding the ease of implementing MCF in clinical practice. Conclusion. While MCF was highly acceptable in this study, the sample size was small and the risk of bias was high. Further research is needed. 

dlvr.it

California Hospital Lawsuit after Using NBT/PIT Policy

In June 2025, 39-year-old Jessica Elizabeth Quijano suffered an anoxic brain injury at Providence Mission Hospital in Mission Viejo, California. On June 23, 2025, at the specific request of Quijano's attending clinician, "the Ethics Committee recommended activation of the non-beneficial treatment treatment policy and placed a DNR (Do Not Resuscitate) on JESSICA’s chart." Her husband objected but "was given 5 days to agree to turning off life support" or Quijano's  "treating doctors would disconnect the ventilator over" his objection. While Quijano was ultimately transferred to another hospital, the family is pursuing a medical malpractice action in Orange County Superior Court. 

dlvr.it

VSED Bridge to MAID - Blocked in New UK Bill

VSED bridge to MAID is falling down, falling down in London. The new Terminally Ill Adults (End of Life) Bill explicitly excludes VSED as a way to qualify for MAID. In Section 2 (of 59) the Bill provides: Where— (a) a person does not eat or drink, or limits their eating or drinking, either voluntarily or because of a mental disorder, and their not eating or drinking, or limited eating or drinking, causes them to have an illness or disease, the person is not regarded for the purposes of this Act as terminally ill by virtue of the illness or disease. That this language had to be specifically included implies that VSED  otherwise legitimately makes someone terminally ill. In other word, VSED is a bridge to MAID (as in Oregon, New Mexico, and other jurisdictions) unless explicitly excluded. MP Lauren Edwards

dlvr.it

Death, Dying and Disposal Conference 2027

Thee 18th Death, Dying and Disposal Conference (DDD2027) will take place at the University of Antwerp, Belgium, September 2027. The conference theme will be Death Care.

dlvr.it

DNR Consent Influenced by Selective Phrasing

Even subtle differences in clinician phrasing meaningfully shape people's attitudes toward DNR.  A new study shows that selective phrasing functions as a form of nudging. The researchers also examine the ethical boundaries of linguistic selectivity in medical communication.

dlvr.it

Dead Donor Rule - New Law Prevents Violations

The dead donor rule has been a fixture of organ transplantation for sixty years. But in light of frequent intentional and accidental breaches, some regulators have strengthened protections to mitigate DDR violations.  Notable among these is Kentucky H.B. 510, signed in April. Because the law is now effective, it has been receiving renewed attention. The Kentucky statute requires that "during any organ donation recovery, preservation, or procurement activity for a DCD or DBD, a pause in procedure shall be initiated if any [clinician or family member] reports on any of the following: * Observed or suspected change in neurological status * Observed or suspected indication of life * Uncertainty regarding the accuracy or completeness of neurological status or death declaration assessments" Triggering "indications of life" include but are not limited to: * Spontaneous movement * Vocalization or attempts to vocalize * Purposeful or reflexive responses to stimuli * Observed respiratory effort by a patient-initiated attempt at breath * Changes in heart rate or blood pressure inconsistent with a death declaration * Any neurological or physiological sign suggesting pain perception or neurological activity Reports of any of these require "immediate suspension of any organ donation recovery, preservation, or procurement activity."  

dlvr.it

VSED - New Book "As She Chose"

More than a dozen authors have published books about their  family member's using VSED to hasten death. The latest by Oliver Christen is As She Chose: A Memoir about his 86-year-old mother. He has been discussing the book in radio and podcast interviews. 

dlvr.it

Reducing Variability in Brain Death Policies & Practices - Interhospital Collaboration

Nearly 20 years ago, I defended multi-institutional ethics committees. So, I was pleased to see this report in Hospital Pediatrics about collaboration among five children's hospitals in southeast Florida.  Through the South Florida Pediatric Bioethics Consortium (SFPBEC), they have reduced variability in policies regarding brain death, potentially inappropriate treatment, and other clinical ethics issues.

dlvr.it

Death, Dying and Disposal Conference 2027

Thee 18th Death, Dying and Disposal Conference (DDD2027) will take place at the University of Antwerp, Belgium, September 2027. The conference theme will be Death Care.

dlvr.it

Midwestern Medical Humanities Conference

The 16th Annual Midwestern Medical Humanities Conference will be on Friday, October 2, 2026. The theme of this year’s meeting is Medical Technologies. Abstracts are accepted until August 1, 2026. 

dlvr.it

Dead Donor Rule - New Law Prevents Violations

The dead donor rule has been a fixture of organ transplantation for sixty years. But in light of frequent intentional and accidental breaches, some regulators have strengthened protections to mitigate DDR violations.  Notable among these is Kentucky H.B. 510, signed in April. Because the law is now effective, it has been receiving renewed attention. The Kentucky statute requires that "during any organ donation recovery, preservation, or procurement activity for a DCD or DBD, a pause in procedure shall be initiated if any [clinician or family member] reports on any of the following: * Observed or suspected change in neurological status * Observed or suspected indication of life * Uncertainty regarding the accuracy or completeness of neurological status or death declaration assessments" Triggering "indications of life" include but are not limited to: * Spontaneous movement * Vocalization or attempts to vocalize * Purposeful or reflexive responses to stimuli * Observed respiratory effort by a patient-initiated attempt at breath * Changes in heart rate or blood pressure inconsistent with a death declaration * Any neurological or physiological sign suggesting pain perception or neurological activity Reports of any of these require "immediate suspension of any organ donation recovery, preservation, or procurement activity."  

dlvr.it

Minimal Comfort Feeding in Advanced Dementia: Attitudes of Hospice and Palliative Care Professional

Here is a Share Link for free access to our recent article "Minimal Comfort Feeding in Advanced Dementia: Attitudes of Hospice and Palliative Care Professional" in the Journal of Pain & Symptom Management.   Context. Minimal Comfort Feeding (MCF) is a new approach to providing nutrition and hydration to persons with advanced dementia who have previously indicated (or whose surrogate believes) they would not want to live with advanced dementia. The acceptability of MCF has not been studied. Objectives. To assess perceptions of hospice and palliative care (HPC) professionals toward MCF. Methods. This cross-sectional exploratory survey study of a convenience sample was conducted at a national conference of HPC professionals in February 2025. During a presentation on MCF’s definition and ethical basis, attendees engaged in audience response polling and an optional electronic survey. Descriptive results are presented. Results. Fifty-one people attended the presentation. Forty-five attendees (88%) participated in audience polling, and 22 (43%) participated in both polling and the survey. The mean age of survey respondents was 50 (standard deviation 9.58),19 (86%) identified as White, and 18 (82%) identified as women. Thirty-five of 42 respondents (83%) agreed or strongly agreed that MCF is an acceptable option for persons with advanced dementia (PWAD), and 93% (39/42) agreed or strongly agreed they would be comfortable discussing MCF with persons with early dementia or who are at risk for dementia as a potential future option. Sixty-nine percent (29/42) anticipated MCF would be somewhat or completely acceptable to families of PWAD, but respondents were divided regarding the ease of implementing MCF in clinical practice. Conclusion. While MCF was highly acceptable in this study, the sample size was small and the risk of bias was high. Further research is needed. 

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Understanding VSED (webinar)

Could you choose to stop eating and drinking at the end of life? For many people, the answer is yes—but few understand how Voluntary Stopping Eating and Drinking (VSED) works, when it is appropriate, or how it can be made as comfortable as possible. Join the Hemlock Society of San Diego for a thoughtful discussion featuring three unique perspectives. Guest Speakers:   * Laura Carroll shares her story of assisting her 86-year-old father's VSED end-of-life choice. With support of a doctor, hospice, and concierge nursing care he was able to end his life on his own terms. * Dr. Brian Graham, Medical Director of Topkare Hospice * Nicole Soares, founder of EcoLove Transitions, who works with Dr. Graham to guide patients and families through the VSED process. They'll explain the medical, practical, and emotional support that can help ensure a peaceful and dignified end-of-life experience. Whether you're planning ahead for yourself, supporting a loved one, or simply want to understand all of the legal end-of-life options available, this program will provide practical information, compassionate guidance, and an opportunity to ask questions.

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ASBH-St. Jude Bioethics Tournament 2026

ASBH has announced a new Bioethics Tournament at the 2026 Annual Conference, in partnership with St. Jude Children's Research Hospital. This tournament will feature two teams in a debate style format on Friday, October 16, 4:00–5:15 PM ET.    The aim of the event is to bring together ethics professionals, trainees, and students with diverse interests and backgrounds in friendly competition. ASBH strongly encourages participation across the career spectrum from students, trainees, early career, and late career professionals.  ASBH is currently recruiting teams, case writers, and judges. Teams will have the opportunity to highlight their argumentation and speaking skills; case writers will have the opportunity to contribute fresh ideas for public engagement, and judges will have the opportunity to foster responsive and critical thinking while moderating a session.  Teams: ASBH is recruiting two teams. Teams may consist of 3-5 members and must include at least one student or trainee. The interest form includes a statement of commitment and space to include team structure. ASBH is accepting applications for entire teams and for individuals who wish to be placed on a team. If you are applying on behalf of a team, please include the credentials, role, and institution for all team members.  Case Writers: ASBH uis recruiting up to 4 case writers to write a one-page case and questions to be used in competition. Teams will receive cases in advance and use them to prepare their arguments for use in the tournament. The interest form includes a statement of commitment and a summary of your proposed case, including background and questions for team consideration.  Judges: ASBH is recruiting up to 3 judges to evaluate the session. As part of the application, judges will be asked to include relevant experience in ethics or in participation of similar events. 

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California Hospital Lawsuit after Using NBT/PIT Policy

In June 2025, 39-year-old Jessica Elizabeth Quijano suffered an anoxic brain injury at Providence Mission Hospital in Mission Viejo, California. On June 23, 2025, at the specific request of Quijano's attending clinician, "the Ethics Committee recommended activation of the non-beneficial treatment treatment policy and placed a DNR (Do Not Resuscitate) on JESSICA’s chart." Her husband objected but "was given 5 days to agree to turning off life support" or Quijano's  "treating doctors would disconnect the ventilator over" his objection. While Quijano was ultimately transferred to another hospital, the family is pursuing a medical malpractice action in Orange County Superior Court. 

dlvr.it

Reducing Variability in Brain Death Policies & Practices - Interhospital Collaboration

Nearly 20 years ago, I defended multi-institutional ethics committees. So, I was pleased to see this report in Hospital Pediatrics about collaboration among five children's hospitals in southeast Florida.  Through the South Florida Pediatric Bioethics Consortium (SFPBEC), they have reduced variability in policies regarding brain death, potentially inappropriate treatment, and other clinical ethics issues.

dlvr.it

France Authorizes Assisted Dying

Today, France enacted a law authorizing assisted dying (loi relative au droit à l'aide à mourir).  Like most Australian states, the medication must be self-administered. But clinician administration is permitted when the patient cannot self-administer. France joins nearly 20 other countries:   * Australia (all states and territories but NT) * Austria * Belgium * Canada * Colombia  * Cuba * Ecuador * Estonia * Italy * Germany * Luxembourg * Netherlands * New Zealand * Portugal * Spain * Switzerland * United States (14 states)  

dlvr.it

Minimal Comfort Feeding in Advanced Dementia: Attitudes of Hospice and Palliative Care Professional

Here is a Share Link for free access to our recent article "Minimal Comfort Feeding in Advanced Dementia: Attitudes of Hospice and Palliative Care Professional" in the Journal of Pain & Symptom Management.   Context. Minimal Comfort Feeding (MCF) is a new approach to providing nutrition and hydration to persons with advanced dementia who have previously indicated (or whose surrogate believes) they would not want to live with advanced dementia. The acceptability of MCF has not been studied. Objectives. To assess perceptions of hospice and palliative care (HPC) professionals toward MCF. Methods. This cross-sectional exploratory survey study of a convenience sample was conducted at a national conference of HPC professionals in February 2025. During a presentation on MCF’s definition and ethical basis, attendees engaged in audience response polling and an optional electronic survey. Descriptive results are presented. Results. Fifty-one people attended the presentation. Forty-five attendees (88%) participated in audience polling, and 22 (43%) participated in both polling and the survey. The mean age of survey respondents was 50 (standard deviation 9.58),19 (86%) identified as White, and 18 (82%) identified as women. Thirty-five of 42 respondents (83%) agreed or strongly agreed that MCF is an acceptable option for persons with advanced dementia (PWAD), and 93% (39/42) agreed or strongly agreed they would be comfortable discussing MCF with persons with early dementia or who are at risk for dementia as a potential future option. Sixty-nine percent (29/42) anticipated MCF would be somewhat or completely acceptable to families of PWAD, but respondents were divided regarding the ease of implementing MCF in clinical practice. Conclusion. While MCF was highly acceptable in this study, the sample size was small and the risk of bias was high. Further research is needed. 

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Texas Republicans Oppose Brain Death & TADA

Last month, the Texas Republicans voted on legislative agenda items, including on "life-affirming patient protection." This is a material expansion of opposition to dispute resolution of brain death and medical futility disputes. Here is the full text of proposal 163:   We call for the Texas Legislature to secure due process and the rights of vulnerable Texas patients by continuing to reform Chapter 166 of the Health and Safety Code (Texas Advance Directives Act) by: a) Repealing the unethical, unconstitutional, unprecedented, and anti-life 25-Day Rule in Section 166.046, Health and Safety Code, and replacing it with a truly life-affirming law that requires physicians to adhere to a patient’s or surrogate’s medical decision about life-sustaining treatment, and that provides for physicians who disagree with the patient’s decision to transfer the patient to another physician or facility that will honor the decision to continue life-sustaining treatment. b) Improving language that protects Texas patients with disabilities to clarify and strengthen that disability should not be a considered factor. c) Guaranteeing judicial review, ensuring the ability to appeal a hospital committee’s decision and provide impartial legal recourse over life and death medical decisions. d) Protecting patients' rights to opt out of the dangerous apnea test to declare brain death, receive an independent second opinion and to have their beliefs about brain death to be respected.

dlvr.it

VSED - New Book "As She Chose"

More than a dozen authors have published books about their  family member's using VSED to hasten death. The latest by Oliver Christen is As She Chose: A Memoir about his 86-year-old mother. He has been discussing the book in radio and podcast interviews. 

dlvr.it