Can someone with dementia access VAD?
Dementia does not automatically rule VAD in or out, but the person must meet all legal criteria and have decision-making capacity throughout the required steps.
Sometimes, but it is uncommon and legally complex. A person with dementia can only access voluntary assisted dying (VAD) if they meet all criteria in their state or territory. They must also have decision-making capacity for VAD at the required times.
Dementia often affects memory, communication, understanding and judgement. As it progresses, it may make the person unable to complete the VAD process.
General information: This page gives general information for people in Australia. VAD and decision-making laws differ between states and territories. Dementia and capacity questions need individual medical and legal assessment through the relevant VAD service and treating team.
Capacity is central
For VAD, the person must be able to understand the relevant information, weigh it, make a voluntary decision, and communicate that decision in a way the law accepts. A diagnosis of dementia does not automatically mean a person lacks capacity. Capacity is decision-specific and time-specific.
The harder question is whether the person still understands their illness, VAD, other care options, and the likely result of taking the VAD substance.
Dementia alone may not be enough
VAD laws usually require an advanced and progressive condition expected to cause death, with suffering the person finds intolerable. Some laws use prognosis periods. Some treat neurodegenerative disease differently.
A person with early dementia may not yet be near enough to death. A person with advanced dementia may no longer have capacity. This can leave a narrow and uncertain window.
A family member cannot request it for them
Family, an enduring guardian, medical treatment decision maker or attorney cannot request VAD on the person's behalf. They can support the person, help arrange appointments if the person wants that, and share information with the team. They cannot make the VAD decision.
You may also want to read
- What is an advance care directive?
- At what stage might someone with early dementia still be able to access VAD?
- Can I request VAD in an advance care directive?
- What does dying from dementia look like?