February 15, 2026
Voluntary Stopping Eating/Drinking – New Study
Every year, thousands of elderly people die because they consciously stop eating and drinking
According to research by Erasmus MC, an estimated 5,800 people in the Netherlands end their lives each year by consciously stopping eating and drinking.
That is 3.5% of all deaths. In most cases, a previous request for euthanasia had been rejected.
People often do this at home, but it also happens in hospices and nursing homes. The study shows that many of them initially preferred euthanasia: two-thirds had previously requested euthanasia, which was rejected by their doctor.
One-third explicitly cite this rejection as the reason for stopping eating and drinking.
The researchers looked at the two best-known methods of ending one’s life without the direct assistance of a doctor.
The second method, taking a lethal combination of (sleeping) pills, is estimated to be used by two thousand people annually: 1.2% of deaths. A quarter of them choose Middel X (sodium azide)
By comparison, nearly ten thousand people undergo euthanasia by a doctor each year: 5.8 per cent of all deaths.
Increase
The study, which focuses on the period 2019-2023, is a repeat of the study conducted in 1999-2003 by the renowned psychiatrist Boudewijn Chabot.
The data in both studies was obtained from relatives who were well aware of the termination of life and had also discussed it with the deceased.
At the time, Chabot’s study provided the first insight into dying on one’s own terms.
Recent figures show that the proportion of people who consciously stop eating and drinking has increased in twenty years: from 2.1 to 3.5 per cent of all deaths.
The proportion of people who took lethal substances remained roughly the same.
Doctors and family members are allowed to assist patients who wish to stop eating and drinking. This is not a criminal offence. This method is not legally classified as suicide and is registered afterwards as a “natural death”.
Dehydration
“We hear from people that doctors sometimes deliberately encourage this,” says Fransien van ter Beek, director of the Dutch Association for Voluntary Euthanasia (NVVE), one of the three clients who commissioned the study.
“Especially when it comes to complex cases. Some doctors don’t want to get their hands dirty with euthanasia.”
People who choose to stop eating and drinking ultimately die from dehydration. In half of the cases, they died within ten days. Sometimes this is accompanied by “thirst, a dry mouth, constipation, restlessness or confusion”.
A doctor can administer pain relief and family members can care for the mouth to make it more bearable. Many patients are put to sleep during the process through palliative sedation.
No prospect of improvement
Two-thirds of the people who stopped eating and drinking were over 80, according to the study, but there were also younger people. Those who took medication or Substance X were mostly between 30 and 70 years old. They often had mental health problems and had made multiple suicide attempts.
In both groups, more than 90 per cent told their confidants that they were suffering unbearably. Most saw no prospect of improvement.
The main reasons for people choosing to die on their own terms were the feeling of being “done” with life, loss of dignity or a feeling of meaninglessness, pain and dependence. For some, it was mainly about retaining control over their own lives.
Becoming more popular
“I think that consciously stopping eating and drinking can be a dignified way to die,” concludes researcher Fenne Bosma of Erasmus MC. “Provided you prepare well and receive good support from loved ones and a doctor. I would say: don’t start this on your own, don’t start it if you haven’t discussed it with your family.”
Critics, including the then director of the NVVE, Petra de Jong, labelled stopping eating and drinking in 2015 as “barbaric” and “medieval” for healthy people and said that people sometimes “screamed” for water. She argued that this was only possible if people were very old and frail.
Nevertheless, the method became more popular.
For example, the KNMG medical association embraced the method by publishing a “guide” for doctors in 2014 to assist people over the age of 60. Later, this age limit was even dropped.
Mixed experiences
The NVVE also revised its opinion. “We now know that it can be a dignified death, but only with good care,” says director Van ter Beek. “We provide factual information about it; ultimately, it is up to the individuals themselves.
Some say: I do not want to experience the deterioration of my body. There are also people, although this group is considerably smaller, who say: I find it an interesting process, I want to experience it.”
But without proper guidance, it can be “horrific”, she says.
The researchers also conducted dozens of in-depth interviews with confidants. Their opinions on stopping eating and drinking varied greatly: some called it peaceful, dignified and “a gentle death”.
One of them said that the deceased “suffered relatively little”.
Others found it intense to see their loved one lying there “skin and bones”, called it “inhumane” and an “ordeal”, and wondered why someone should have to die “so difficultly”.
Van ter Beek calls it “extremely sad” that some people stop eating and drinking because their request for euthanasia was refused. “That should not be necessary.
People who have thought it through carefully and want to die should be able to get help from a doctor or a terminal care counsellor.”
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