VAD & Dementia: Do our laws need to change?
Australia's voluntary assisted dying laws rule out access for people living with dementia. Researchers from QUT are exploring if that could change.
Voluntary assisted dying (VAD) laws are operating in all Australian jurisdictions except the Northern Territory. However, access is limited to adults with a medical condition that will cause their death who:
- possess decision‑making capacity with respect to VAD throughout the process; and
- are approaching the end of their life (usually with death expected within 6 or 12 months, with the exception of the Australian Capital Territory, where no specific timeframe is prescribed).
These requirements together mean people living with dementia are effectively excluded. By the time a person’s dementia is advanced enough to be considered to be at the end‑of‑life, they are unlikely to possess decision‑making capacity.
In response, there have been growing public calls for VAD laws to be changed to accommodate dementia as an eligible terminal condition.
To look at whether this is feasible, academics from QUT's Australian Centre for Health Law Research undertook a multi-stage project to review international and relevant domestic laws and policies, and canvass the opinions of people living with dementia, their carers, and medical practitioners.
Writing in MJA Insight, the researchers reported these discussions revealed that "while some participants supported reform that would permit people living with dementia to access VAD, views varied regarding the circumstances under which this should be permitted".
Importantly, the discussions did not address the broader ethical issue of whether VAD for dementia should be permitted. "However, participants were able to identify desirable features of such a framework that would enable this, including potential safeguards, should such a policy decision be made."
Go Gentle's position
Dementia, including Alzheimer's disease, is now the leading cause of death in Australia.
Whether people with dementia can access voluntary assisted dying (VAD) is the question the community most often approaches us about. People are genuinely surprised and disappointed that dementia is excluded from our existing VAD laws.
We understand these concerns. Dementia is a devastating, progressive and terminal illness. It can involve the loss of memory, cognition, communication, independence, identity and the ability to make decisions. It is a disease that causes profound distress for indivdiuals, their families, friends and carers.
Like Dementia Australia, Go Gentle supports the right of people living with terminal cognitive decline to exercise autonomy and choice over their end-of-life care.