I have been walking towards my own line in the sand, possibly at some level since my very first breath. As I write these words, I am about three weeks away from my sixty-eighth birthday. I have an idea, knowing it will be jarring for some, that starting my own VSED (Voluntarily Stopping Eating and Drinking) process on October 5th 2027 would be an unequivocal birthday gift to myself.
That is a little over one more year.
That does feel like the right note in my blood, bones and heart.
Studying VSED - like my life depended on it - has been my focus over the last two months. I have done a self-directed micro PHD that has included reading every personal testimony I could find, and researching across the board. It is extraordinary to find so little awareness and information. The most lovely and useful resource I have found, and been so fruitfully in contact with is called talkvsed.org.uk
They are an impressive UK based organisation that raises awareness about VSED and provides information to people considering this lawful choice, those close to them and all the relevant health professionals.
I have spent much of the last decade under the impression the only option I have available to me on arriving at being done is to retreat into an empty room, having made sure no-one I know and love holds any specific time and date information about my intention.
Caroline’s broken things creations
The counterpoint to that - is everyone I know, love and am loved by - does know my intention. What’s more, all those people have continued to offer me understanding, and have declined to argue with my reasoning. That is a beautiful thing that I have leaned into over many years.
Right now, in real time, I am experiencing a profound sense of relief, of space opening up inside my chest. My breath has softened. I have wept an ocean or two, not because it feels wrong, but because seeing this alternative option that allows for a home-based death plan, being held, being accompanied, and maybe getting to fully relinquish the self-holding on that has underpinned all of my years.
I’d like to die like that.
Everyone I have talked to about this end-of-life option so far, has had an initial flinch. I think I had it myself because it is the only possible explanation for being so long standing in death literacy, yet never having walked up close to VSED and unpacked the detail.
Caroline and Leonard
That flinch is visceral in a human nervous system. The idea at first glance of death via starvation and dehydration is grim. Hence the flinch. The narrative of the flinch is something like, jeez, that sounds like a desperate last resort and gross. I agree that it does sound like that, and then on investigation it unfolds into a ritual manner of dying that is infused with connection, intimacy, agency and love. To have such a death requires a thoughtful death-plan in exactly the same way a birth-plan can hold a human being born. It is worth noting that my direct experience of being on the frontline of both a birth and a death showed me that the border between coming into embodied life with a first breath, and slipping away with the final out breath, is exactly the same place.
I am going to tell you what I’ve learned.
Firstly, the British Medical Association (BMA) published a thirty-six page document in August of this year (2026). This is written for medical professionals, but is straightforward and fully readable by lay people. If you would like to read this paper, the link below will take you to a PDF you can download.
It sets out the good practice for treating any patient wanting to either plan their own VSED, or anyone giving the option serious consideration. It is clear about the legality regarding good medical practice in taking any patient that is of sound mental capacity, both seriously and respectfully. It states that if a GP has conscientious objections that make it impossible to support such a patient, they are obliged to pass that patient to a doctor who is willing and able to work with them.
A person wishing to plan their VSED does not require a terminal illness diagnosis, nor a degenerative organic condition. It makes provision for someone such as myself, that is suffering with unspeakable pain, with nothing in terms of treatment options except for failing pain management.
I had not understood quite how lonely my end-of-life plan felt until a door opened and showed me another way. I had been completely unaware there was another option, and given the option has been sitting there all the time - this is a touch comedic. Some of the tears that have been pouring like tropical rain over these short weeks have been grief meeting relief. I don’t need to hold myself alone all the way through. I don’t need to die in an empty room with my head on my own shoulder in the silence of that. I’m saying I didn’t even know how much that pained me until VSED opened up a very different kind of room.
Some of you know how much I enjoy dreaming up a ritual, and this will be my last, so there is a quiet delight happening in my thoughts and feelings. I’ve already started interior designing my front room as a departure lounge, and, it seems that can co-exist with still hitting the walls of overwhelm from the banal and brutal pain that never lets up.
VSED is something that requires planning, collaboration with your GP at ground zero, and through that doorway to home based palliative care.
Some hospices are willing to support an in-house VSED, and in theory it should be able to happen in a hospital, though for obvious reasons that is the setting that lends itself least to such a particular ritual.
Mostly people want to do this at home.
I want to do this at home.
I have had my closing appointment with my GP of 35 years. There were tears. There was also an opportunity for me to tell this very dear person, who has heard me over many years speak about my ‘when I’m done’ plan, that I had fallen through a doorway that had been there all the time. I asked her to put my intention and the (BMA) document front and centre into my impeccable handover. I have my first appointment with Doctor A in several weeks, and will bring VSED in as the start point. I have no idea what her views will be, but I trust myself as a skilful communicator, and if she has reservations, I will not take an adversarial position. I’ll do my utmost to help her understand my position and ask her to support me.
Filmmaker, Andrew is one of her village
I don’t have a main person in my life. I have a village that actually spans the globe. Sometimes, as a very happy occupant of both my internal and external home address, that is just me, a three-legged black panther called Bebe, and the infamous Leonard the Dog - sometimes, particularly as pain and disability has become more hardcore, I have felt lonely in the simple nuts and bolts of having to manage all the logistics on my own. That does not mean I wish I had a housemate or a partner. I am simply not built for that much proximity. I love depth contact and then space between. No problem to solve here.
However in the death-planning - I realise I don’t have a singular person I can ask to hold the frame of a ritual, that while being deeply curated and created by me, will at some point in the process become the thing that holds me, rather than something I can keep on holding.
This is my cradle, and I am going to find two death-wives to hold it for me. I haven’t worked that out yet, but shape is coming into focus not through applying thought; much more as creative process has always shown itself, if cooking, making poems, or playing with broken things in my shed.
I think I need two people. I think it is a job-share.
VSED usually takes 10 - 14 days. It does depend somewhat on how organically well or unwell you are at the start point. One thing that is crucial throughout will be mouth - care. Spraying the inside of the mouth, the use of sponge mouth swabs, damp, soft flannels and small ice chips can all help. Lip salves, as well as gentle moisturising creams for drying skin is a kindness. All the little details that in my reading the personal stories of those that have helped a loved one with their VSED, are both illuminating and touching.
My intention is to be well prepared before I step into this ritual. I stand here on the shoreline of holding the whimsy of my sixty-ninth birthday in my open palms. That is just over a year away. I want to begin to prepare my body from here, so it is gentle and kind, taking the slow road that is always my road. My eating is disordered because my medication killed my appetite. Eating has become a chore that I’m currently not doing very well at and I want to get better. I have generous time to get better.
In the month before my start date - I will take expert advice on how to help my body prepare to stop eating and drinking. I imagine a light and clean menu for those weeks, and I am already clear about ceasing to eat solid food several days in advance. This is in part to ease in, and equally because I want an empty colon up front. I am not going to be filling my departure lounge with medical equipment. I know how it goes with pads and diapers, and I’m okay with that. I’m just clear I don’t want any poo in the equation. I’ve done the reading, and if you go in empty of anything solid requiring digesting, it can be very simple at the gastrointestinal level.
As you can see - I am both in the poetry and the nitty-gritty of building my death plan.
I will make my room beautiful.
I will find two earthbound angels to hold me so I can lay my head down.
I will have a fully functioning collaboration with any medical support I need.
That is the structure and form.
Alongside that is my open door and invitation to anyone at all that wants to pass through my ritual.
An unequivocal invite with no conditions - come by, stay for a moment or a while, bring anything at all that lives in you (obviously no food, vino or normative guest type offerings!). Just your presence, your irreverence, your comedy, your heart… it will be a room where it is literally impossible to get it wrong or even right, and that translates as freedom and infinite space. Even though the actual physical room has walls, the ritual itself has none.
Painting by Peter Judge or Asanga Judge which appears at the back of Caroline’s book, Postcards from a Little Life
That is phenomenal. I have subscribed so that I can watch your progress in the next twelve months.
Thank you, Caroline, for researching and bringing forth this topic. After a lifetime of chronic pain, this is a sensible alternative!