09/10/2026
https://www.facebook.com/share/p/19n9vcYYKd/?mibextid=wwXIfr
"๐ ๐ฐ๐ต๐ผ๐ผ๐๐ฒ ๐ป๐ผ๐ ๐๐ผ ๐๐๐ณ๐ณ๐ฒ๐ฟ."
Andrew Denton opened his National Press Club address with those words. They belonged to Margaret Radmore, a nurse of 40 years who became one of the first Australians to use Victoria's voluntary assisted dying law. She had seen too many prolonged and terrible deaths to accept the reassurance that palliative care could always keep her comfortable. "I know there are many cases where it's impossible to alleviate suffering," she said.
A decade after Andrew first stood at that podium, every state and territory has passed VAD legislation, and Go Gentle Australia's small team was at the heart of that change. In his words, at least 10,000 dying Australians have since been able to make Margaret's choice.
Anyone who believes in dignity at end of life owes Andrew an enormous debt of gratitude. Myself included.
๐ข๐ป๐ฒ ๐๐ผ๐ฟ๐ฑ ๐ธ๐ฒ๐ฝ๐ ๐ฟ๐ฒ๐๐๐ฟ๐ป๐ถ๐ป๐ด ๐ถ๐ป ๐ต๐ถ๐ ๐๐ฝ๐ฒ๐ฒ๐ฐ๐ต: ๐ถ๐ป๐ต๐๐บ๐ฎ๐ป๐ฒ.
A mother described the way her dying daughter was moved between facilities as "this inhumane treatment of my girl." A daughter described her mother on a slow morphine infusion that, in Andrew's words, prolonged her death for three days. "She kept waking up, gasping for air," she said. "It was inhumane what my mother went through."
Andrew paused on it himself. "That word again, inhumane."
It is the word I keep coming back to as well.
Humane and human share the same Latin root. To be human is a biological fact. To be humane is a moral choice.
Yet our laws demand mercy for a suffering animal and offer none to a person dying from dementia. If an animal were left to reach the condition advanced dementia forces on a human body, someone could be charged with cruelty and in all likelihood, imprisoned.
When it happens to our mothers and fathers, we call it natural.
๐ก๐ผ ๐ผ๐ป๐ฒ ๐๐ฎ๐ป๐๐ ๐๐ผ ๐๐๐ณ๐ณ๐ฒ๐ฟ. ๐ฆ๐ผ ๐๐ต๐ ๐ฑ๐ผ ๐๐ฒ ๐ฎ๐ฐ๐ฐ๐ฒ๐ฝ๐ ๐ถ๐ ๐ณ๐ผ๐ฟ ๐ฝ๐ฒ๐ผ๐ฝ๐น๐ฒ ๐ฑ๐๐ถ๐ป๐ด ๐ณ๐ฟ๐ผ๐บ ๐ฑ๐ฒ๐บ๐ฒ๐ป๐๐ถ๐ฎ?
Andrew spoke about the limits of palliative care. Now consider what those limits look like at the end of dementia.
In its final stage, dementia takes away the ability to swallow. Once that ability is permanently gone, a person can no longer take in food or water. They die of cachexia and dehydration, the slow wasting of a body that consumes its own reserves to stay alive. It can take days. Sometimes weeks.
My mother Hem died this way. It took ten days. She weighed around 24 kilograms by the end and looked like a prisoner of war. She was not comfortable.
This campaign estimates that between 9,000 and 13,000 Australians die this way every year.
Families are told that palliative medication will keep their loved one comfortable throughout this dying process. What they are rarely told is that this is not the same as other deaths.
๐๐ฒ๐บ๐ฒ๐ป๐๐ถ๐ฎ ๐ฐ๐ต๐ฎ๐ป๐ด๐ฒ๐ ๐๐ต๐ฒ ๐๐ฒ๐ฟ๐ ๐๐๐๐๐ฒ๐บ๐ ๐๐ต๐ฎ๐ ๐ฐ๐ผ๐บ๐ณ๐ผ๐ฟ๐ ๐ฑ๐ฒ๐ฝ๐ฒ๐ป๐ฑ๐ ๐ผ๐ป:
๐ธ The popular belief that the body makes its own natural comfort as it goes without food and water has never been shown to happen in dying people.
๐ธ Dementia does not simply dull pain. Brain imaging shows people with Alzheimer's still process pain, and may find it more unpleasant than people without the disease.
๐ธ People with dementia have lower levels of the body's own natural painkillers.
๐ธ Alzheimer's-related damage can impair the part of the brain that releases those painkillers and switches on the body's own pain suppression. The same damage can reduce how well pain medication works.
๐ธ The receptors that morphine and similar medications act on are measurably altered in parts of the Alzheimer's brain.
๐ธ Part of any pain relief comes from expecting it to work. In Alzheimer's, that effect can be lost, so the same treatment achieves less.
๐๐ป๐ฑ ๐ป๐ผ ๐ผ๐ป๐ฒ ๐ฐ๐ฎ๐ป ๐ฐ๐ผ๐ป๐ณ๐ถ๐ฟ๐บ ๐๐ต๐ฒ ๐ฐ๐ฎ๐ฟ๐ฒ ๐ถ๐ ๐๐ผ๐ฟ๐ธ๐ถ๐ป๐ด:
๐ธ No one has established whether medication given under or through the skin is reliably absorbed by a body that has wasted away.
๐ธ Experienced doctors and nurses don't always agree on which signs mean a person with dementia is in pain.
๐ธ With the same injury, people with advanced dementia have been given far less pain relief than people who can say they are hurting.
๐ธ Sedation can quieten the outward signs of distress, but there is still no reliable way to confirm the distress itself has ended.
When someone is dying from dementia through cachexia and dehydration, comfort cannot be guaranteed. And the one person who could tell us whether the care is working can no longer say.
In the absence of that certainty, why do we force people to endure a prolonged dying process and simply hope the care is enough?
Hemโs Law exists to give families an alternative choice, when "maybe" is the only honest answer to the question, "is she suffering?"
๐ง๐ต๐ฒ ๐ต๐ฎ๐ฟ๐ฑ๐ฒ๐๐ ๐ฐ๐ผ๐ป๐๐ฒ๐ฟ๐๐ฎ๐๐ถ๐ผ๐ป, ๐ฎ๐ป๐ฑ ๐ฎ ๐ฑ๐ถ๐ณ๐ณ๐ฒ๐ฟ๐ฒ๐ป๐ ๐ผ๐ป๐ฒ
Andrew called dementia "the hardest conversation of all," and said it is by far the most common question Go Gentle is asked. He was honest about why: "asking a doctor to end the life of someone who can't look them in the eye and say, yes, this is what I want, is enormous."
He is right. That conversation deserves the careful research Go Gentle has committed to, and I'm glad it's happening.
But there comes a point in dementia where that question is no longer the one being asked.
VAD is a person's own decision to end their life before their illness does. It is a decision about the quality of life.
Hem's Law applies only once swallowing has permanently failed, life-sustaining treatment has been withdrawn or is no longer appropriate, and two independent practitioners have certified that death is imminent and irreversible. At that point, no one is deciding whether this person will die. The disease has already settled that. The only decision left is how long the dying takes, and what the person endures along the way.
That is a decision about the quality of death.
No doctor needs to look someone in the eye and ask whether they want to die. The question in front of the family and the clinician is a different one. Must this death be prolonged when suffering cannot be reliably relieved?
๐๐ผ๐บ๐ฝ๐น๐ฒ๐บ๐ฒ๐ป๐๐ฎ๐ฟ๐, ๐ป๐ผ๐ ๐ฐ๐ผ๐บ๐ฝ๐ฒ๐๐ถ๐ป๐ด
Andrew noted that palliative care has not been weakened by VAD. Four in five people who choose VAD also benefit from palliative care, and more palliative care doctors and nurses are becoming VAD providers, "understanding it as another form of end of life care."
That is the continuum Hem's Law belongs on. Palliative care, to help people live as well as possible for as long as possible. VAD, for people who can still make that choice for themselves. And for the narrow point at the very end of dementia, where VAD cannot reach and palliative care cannot promise comfort, a lawful way to bring an imminent and irreversible death to a merciful end.
Hem's Law takes nothing from either. It sits alongside both and closes the one gap they leave.
๐ช๐ต๐ ๐๐ต๐ถ๐ ๐ฐ๐ฎ๐ป๐ป๐ผ๐ ๐๐ฎ๐ถ๐
The ethical, medical, legal and political questions around extending VAD to dementia will take years to work through. They should be worked through carefully. As Andrew said, "saying too hard is not an option."
But people are dying of cachexia and dehydration this week, in homes, hospitals and aged care across the country, with their families sitting beside them. A narrowly drawn reform for the point where death is already certain does not need to wait for the hardest conversation of all to be settled. It can move now, alongside that work, for the people who need it now.
Andrew closed with the goal Go Gentle has worked toward for ten years: for all Australians, "the chance of a good death, the choice not to suffer."
"๐๐น๐น ๐๐๐๐๐ฟ๐ฎ๐น๐ถ๐ฎ๐ป๐" ๐ต๐ฎ๐ ๐๐ผ ๐ถ๐ป๐ฐ๐น๐๐ฑ๐ฒ ๐๐ต๐ฒ ๐ผ๐ป๐ฒ๐ ๐๐ต๐ผ ๐ฐ๐ฎ๐ป ๐ป๐ผ ๐น๐ผ๐ป๐ด๐ฒ๐ฟ ๐๐ฝ๐ฒ๐ฎ๐ธ ๐ณ๐ผ๐ฟ ๐๐ต๐ฒ๐บ๐๐ฒ๐น๐๐ฒ๐
Sign the petition, share this post, together we can change the law. Andrew has proven that.
Dying with Dignity NSW Dying with Dignity ACT Inc. Dying with Dignity Queensland Dying With Dignity Victoria Voluntary Assisted Dying South Australia Dying with Dignity WA Vadanz Voluntary Assisted Dying Australia & New Zealand
