What is a good death?
Voluntary Assisted Dying laws in Australia were passed with the intention of providing choice and preventing intolerable suffering at the end of life.
However, families of people who have used the laws say the benefits go even further.
They use words such as “peaceful”, “comforting” and “a gift” to describe their loved ones' VAD deaths.
David Levitt, a Queensland paediatrician, was diagnosed with an aggressive brain tumour, glioblastoma multiforme, and chose VAD in 2023. His wife Pauline McGrath told the inaugural VAD conference in Sydney about the experience of his death.
“[It] was as gentle as you could imagine,” she said.
“But it wasn’t only gentle for David. It was gentle for us. And we’re the ones who have to actually move through life now, having had this experience.”
What is a good death?
A ‘good death’ seems a subjective concept but it was the focus of a systematic review published in The Lancet in 2021.
The review found there were 11 conditions for a good death including: dying at the preferred place, relief from pain and psychological distress, emotional support from loved ones, autonomous treatment decision making, avoidance of futile life-prolonging interventions and of being a burden to others.
The authors reflected that many of these conditions were not met because of a “growing medicalisation of life at its very end”.
They said a right to end one’s life was deliberately included as one of the 11 conditions. It was identified as a separate theme, "important to enabling the dying person to remain in control, as a way to escape or abandon a medicalised dying process, or to control one’s fate while facing the inevitable end."
The idea of a ‘good death’ was also examined in the 2014 Grattan Institute report Dying Well.
The report found 70 per cent of Australians want to die at home yet only 14 per cent do so. The report also found dying in Australia was increasingly institutionalised and medicalised, with about half of people dying in hospital and a third in residential care.
Assisted deaths represent a small proportion of all deaths because of strict eligibility requirements; between 0.5 per cent and 4 per cent of all deaths in countries where it is legal. However, data collected by oversight bodies shows that more than 50 per cent of VAD deaths happen at home.
It is clear that VAD is not just preventing intolerable suffering, it is meeting many, if not all, the conditions for a ‘good death’; it is allowing people to die at home, offering relief from pain and psychological distress, enabling emotional support from loved ones, and empowering autonomous decision making.
A death he wanted
Professor Arnold Gillespie was a driving force behind the push for a voluntary assisted dying law in South Australia. When he became terminally ill, he applied for VAD.
His wife Debra described his death: “With most of his family around him, we hugged, kissed and then held hands… As he was telling us how much he loved us all he slipped away to the peace that he so desperately craved. It was a beautiful death. It was a death he wanted, and he never wavered in his decision.”
Voluntary Assisted Dying in Australia
VAD laws allowing eligible terminally ill adults to seek medical assitance to die have been passed and are operating in all six Australian states. The Northern Territory and the ACT are in the process of introducing their own legislation.
Find out about the law in your jurisdiction.