Suicide postpones and intensifies karma. Dharma ethics do not condone euthanasia or assisted suicide: deliberately causing the death of a patient at his/her request by any lethal means. If requested by the patient, Dharma practitioners may describe —but never recommend— voluntary fasting unto death as a viable means to abbreviate prolonged suffering.
The patient making the decision to fast unto death must declare it publicly, to distinguish the act from suicide committed privately in traumatic emotional states of anguish and despair, and to allow for family and Dharma community intervention.
Voluntary fasting is allowed when death appears imminent, the patient is unable to perform normal bodily purification, and pain and suffering are extreme (such that mitigating them would entail loss of consciousness).
After due deliberation, voluntary fasting unto death should be undertaken as spiritual practice, with the support of a community of faith. Voluntary fasting is gradual, and allows the patient to reflect and reconsider his/her decision, while intensifying Dharma practice.