ArticleBMC nursing2018
Voluntary stopping of eating and drinking (VSED) as an unknown challenge in a long-term care institution: an embedded single case study.
Article in BMC nursing, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The experience of nurses when providing care across acts that may be perceived as death hastening: A qualitative evidence synthesis.Palliative medicine · 2025Pooled it
- Dying as a 'normal', 'ordinary' or 'natural' process in palliative care: a systematic scoping review and narrative synthesis.BMC palliative care · 2026Article
- Carers' Perspective on Voluntary Stopping of Eating and Drinking: A Systematic Mixed-Methods Review of Motives and Attitudes.Healthcare (Basel, Switzerland) · 2025Review
- Caring for patients during voluntarily stopping of eating and drinking (VSED): experiences of a palliative care team in Germany.BMC palliative care · 2023Article
- "Discussion or silent accompaniment: a grounded theory study about voluntary stopping of eating and drinking in Switzerland".BMC palliative care · 2022Article
- Family caregivers' advocacy in voluntary stopping of eating and drinking: A holistic multiple case study.Nursing open · 2022Article
- Family physicians' perspective on voluntary stopping of eating and drinking: a cross-sectional study.The Journal of international medical research · 2020Article
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundChronically ill persons experience conditions of life that can become unbearable, resulting in the wish to end their life prematurely. Relatives confronted with this wish experience ambivalence between loyalty to the person's desire to die and the fear of losing this person. Caring for a person during the premature dying process can be morally challenging for nurses. One way to end one's life prematurely is Voluntary Stopping of Eating and Drinking (VSED).
methodsThis embedded single case study explored the experiences of registered nurses (embedded units of analysis: ward manager, nursing manager, nursing expert) and relatives who accompanied a 49-year-old woman suffering from multiple sclerosis during VSED in a Swiss long-term care institution (main unit of analysis). By means of a within-analysis, we performed an in-depth analysis of every embedded unit of analysis and elaborated a central phenomenon for each unit. Afterwards, we searched for common patterns in a cross-analysis of the embedded units of analysis in order to develop a central model.
resultsThe following central concept emerged from cross-analysis of the embedded units of analysis: As a way of ending one's life prematurely, VSED represents an unfamiliar challenge to nurses and relatives in the field of tension between one's personal attitude and the agents' concerns, fears and uncertainties. Particularly significant is the personal attitude, influenced on the one hand by one's own experiences, prior knowledge, role and faith, on the other hand by the VSED-performing person's age, disease and deliberate communication of the decision. Depending on the intention of VSED as either suicide or natural dying, an accepting or dismissing attitude evolves on an institutional and personal level.
conclusionsTo deal professionally with VSED in an institution, it is necessary to develop an attitude on the institutional and personal level. Educational measures and quality controls are required to ensure that VSED systematically becomes an option to hasten death. As VSED is a complex phenomenon, it is necessary to include palliative care in practice development early on and comprehensively. There is a high need of further research on this topic. Particularly, qualitative studies and hypothesis-testing approaches are required.
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