Sallekhana and the End-of-Life Option of Voluntary Stopping of Eating and Drinking: An Ethical Argument to Consider the Jain Practice of Fasting to Death as Different from Suicide

This article brings sallekhana, the Jain practice of fasting to death, into conversation with the practice of ‘voluntary stopping of eating and drinking’ (VSED), an end-of-life option, available in various countries for competent adults, to hasten the end of life by consciously choosing to not eat and drink. From a medical and legal point of view sallekhana can be considered a form of VSED. Although differing in terms of intent and historical context, the two practices are similar insofar that they relate to capable and sound individuals who voluntarily forego food and water until death. Showing the critical similarity between VSED and sallekhana, I argue that the grounds put forward by major medical associations and legal societies to differentiate VSED from suicide are equally applicable to the case of sallekhana. I contend that the Jain fast needs to be disentangled from the concept of suicide based on the quality of intent, but also because the process is, in theory and for some time at least, reversible, supported by loved ones and members of the larger Jain community, and dependent on the individual’s continuous and prolonged will of renouncing food and water. I also show how medical and legal authorities defend an individual’s right to VSED based on the principles of self-determination, bodily integrity, self-ownership, and respect for persons. I put forward the view to take these ethical principles into account to legally protect a Jain’s right to take the vow of sallekhana.