Other end-of-life choices

Every adult in Australia has the legal right to refuse any medical treatment — including treatment that would keep them alive. This includes chemotherapy, dialysis, ventilation, CPR, antibiotics, feeding tubes, and hospital admission.

This is not VAD. It is not suicide. It is a person deciding that the treatment is no longer worth the suffering it brings, and choosing to let the illness take its natural course with comfort care only.

• This right is protected by law in every Australian state and territory
• It can be exercised at any time, for any reason
• Doctors must respect the decision, even if they disagree
• An Advance Care Directive can record this choice in advance
• The palliative care team will ensure the person remains comfortable

Some people at the end of life choose to stop eating and drinking as a way to hasten death naturally. This is sometimes called VSED. It is legal, and it has been practised for centuries. It is not the same as VAD.

• The person must make this choice themselves, with full understanding
• It typically takes 1–3 weeks, though this varies
• Palliative care should be involved to manage comfort — especially mouth care, pain relief, and sedation if needed
• The person usually becomes drowsy within a few days and sleeps more and more
• It can be a peaceful process when properly supported

This is not starvation in the way most people imagine. As the body shuts down, hunger and thirst typically diminish. Good mouth care (swabbing lips, moistening the mouth) keeps the person comfortable.

When a dying person has symptoms that cannot be controlled by any other means — extreme pain, agitation, breathlessness, or distress — palliative sedation may be offered. This means using medication to reduce consciousness so the person is no longer aware of their suffering.

• It is used only when all other comfort measures have failed
• It does not hasten death — it manages suffering
• It can be light (drowsy) or deep (unconscious), depending on need
• The person typically dies from their underlying illness while sedated
• It is a standard part of palliative care, not a controversial intervention

If someone you love is considering any of these options, the most important thing is to listen. Ask them what matters most to them. Ask what they are afraid of. Ask what a good death looks like to them.

You don't have to agree. You don't have to understand. But they need to know you heard them.