How we vet professionals

Finding the right support near the end of life matters deeply, and we take that seriously. We also want to be honest with you about what a directory like ours can and cannot do.

A few words first, so we are talking about the same thing

Many families come here while considering VSED, which stands for voluntarily stopping eating and drinking. VSED is a choice a person makes for themselves, while they still have the capacity to understand the decision and what follows, to stop taking food and fluids so that a natural death can come. It is a recognized way of declining food, fluids, and treatment, and across the United States it generally does not require a special law, a particular diagnosis, or a prescription. Even so, the details can vary by state and by hospice, so this is something to confirm with your own physician, hospice team, or attorney.

VSED is not the same as medical aid in dying, where a clinician prescribes medication that a terminally ill, decisionally capable adult may choose to take themselves. Medical aid in dying is available only in some states and the District of Columbia, each with its own eligibility rules, so families must confirm what applies where they live. Both of these are different again from a situation where another person administers something to cause death, which is not legal anywhere in the United States. In both VSED and medical aid in dying, the person decides and acts for themselves.

What we review before listing a professional

Before a doula or end-of-life professional appears in this directory, we ask them to share information about their background. As a guide to what we look at, we ask about training or coursework in end-of-life care, any professional affiliations or memberships they hold, their direct experience supporting families through a VSED process, and at least one professional reference. We review what they share and follow up when something is unclear.

Doula support is not medical care

End-of-life doulas are companions and guides. They do not diagnose, prescribe, give medication, or complete any form that requires a clinical license. For medical decisions, comfort medications, and clinical documentation, your family will need a physician, nurse practitioner, or hospice team.

In a VSED process, a physician can confirm capacity, help manage comfort, and document. Comfort medications come from clinicians, and as the process goes on they are generally not taken by mouth. Hospice is comfort-focused care delivered by a team, and it does not cause death. Many hospices can support a VSED plan, though not all will do so formally, so it is worth confirming early.

Doula support is generally not covered by insurance or the Medicare hospice benefit. It is worth asking any professional directly about their fees and how they work alongside a hospice or medical team.

Our conflict-of-interest stance

Professionals listed here do not pay to appear. We do not accept fees for placement, ranking, or promotion. If that ever changes, we will say so plainly on this page.

We have no financial relationship with any professional in the directory. We do not receive referral fees or commissions if you hire someone you found here.

What this means for your family

We encourage you to speak with any professional before hiring them. Ask about their specific experience with VSED. Ask how they work with hospice teams and physicians. Ask for a reference. Trust your own sense of the relationship.

If you have a concern about someone listed here, please reach out to us. We take those reports seriously, and we will review them.

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