Dementia and Voluntary Assisted Dying (VAD)
"Can I use VAD if I am diagnosed with dementia?" is the most frequently asked question at any public forum on VAD.
At present VAD is not an end of life choice for a person diagnosed with dementia in Australia. There are two reasons:
Decision making capacity: A person must request VAD themselves and have decision making capacity at every stage of the VAD process, including when the VAD substance is delivered by the pharmacists.
Prognosis: To be assessed as eligible for VAD, a person requires two doctors to confirm a prognosis of six months, or 12 months for a neurological condition, such as dementia.
The combination of these two provisions in the VAD legislation means that by the time a person living with dementia has been assessed as having less than 12 months to live, they will have usually lost decision making capacity.
In Canada and the Netherlands, VAD has always been an end of life choice for a person with dementia.
VADSA takes the view that a person with dementia should have similar access to VAD as an end of life choice as any other adult diagnosed with a terminal illness.
VADSA will use this page to post resources which support the case for VAD being an end of life choice for a person with dementia.
1. ANZ VAD Network Dementia report
Report on VAD and Dementia by the ANZ VAD network, July 2024. (download here)
2. Position Statement on VAD and Dementia
VADSA advocates for voluntary assisted dying as an end of life choice for people who have capacity, as well as those who no longer have capacity. This Position Statement explores a potential pathway for a person diagnosed with dementia and their right to VAD, before and after they lose capacity. (download here)
3. Advance Care Directive insert on dementia and loss of capacity
VAD laws in Australia do not allow advance requests for assisted dying. You must have decision making capacity to request VAD. Your ACD only comes into operation after you lose capacity. No-one - including your substitute decision maker - can request VAD on your behalf. The purpose of this ACD insert on dementia is to provide guidance on thinking through your wishes if you lose capacity for a range of reasons, including if you have dementia. There are two ways you can include your directions in relation to dementia: attach the whole document, making reference to the attachment in the body of your ACD; or copy specific sections into your ACD.
If you have already prepared an ACD, and you now wish to include the wording in this dementia insert, you will need to prepare a new ACD. You cannot add additional directions to an ACD that was signed and witnessed previously. Similar to your ACD, each page of the Dementia Insert must be signed and dated by you and your ACD witness. To attach the Dementia Insert in whole, please refer to the attachment in the body of your ACD, such as in Section 3 (a), (b) or (d). (download here)
Note: The insert on dementia was developed from the Doctors for Assisted Dying Choice document, Advance Assisted Dying Request for Dementia, available here.
4. Australian Capital Territory VAD Act definition of "advanced"
The ACT VAD Act commenced on November 3, 2025. The ACT VAD Act does not include a time limited prognosis. The criteria in the ACT are that the person is diagnosed with a condition that is "advanced, progressive and expected to cause the person's death". The Explanatory Memorandum explains how "advanced" is to be interpreted. (download here)
5. Dementia scale
In the attached scale, Levels 5 is considered as a diagnosis of "advanced dementia"; for some people, they may be assessed as having "advanced dementia" at Level 4. (download here)
6. Dementia in Australia
The Australian Institute of Health and Welfare updated its Dementia in Australia report on September 12, 2025. The report acknowledges that dementia is now the leading cause of death in Australia, accounting for 9.5% of all deaths n 2023 (17,400 people).
Address to the National Press Club, Canberra, by Professor Henry Brodaty, AO, on July 23, 2025. Professor Brodaty is Co Director, Centre for Healthy Brain Ageing, UNSW (view on youtube here)
7. Voices of VAD: needs and preferences from people living with dementia
Adrienne Matthys, from the School of Social Work and Arts, Charles Sturt University, Wagga Wagga, NSW, has recently completed research with 36 people living with dementia, and their needs and preferences in relation to VAD. Of the 36 respondents to her survey, four live in South Australia. The research is unique in Australia in that it examines the needs and preferences of people living with dementia - as opposed to the medical or legal perspective on VAD or political arguments - and highlights their right to autonomy in decision making. Article available here.
