Is palliative sedation just VAD by another name?

Australia · 29 August 2026 · 3 min read · Reviewed by Dr Kane Treble

No.

General information: This page gives general information for people in Australia. It cannot give medical or legal advice about one person's care. VAD rules differ between states and territories and can change. Confirm current rules with the relevant official VAD service, treating team or legal adviser.

No. Palliative sedation is not VAD by another name. They are different in purpose, process and law.

Palliative sedation aims to relieve severe symptoms by reducing awareness. Voluntary assisted dying, or VAD, is a legal process where an eligible person chooses medical assistance to end their life. Both may be discussed near the end of life, but they are not the same thing.

The purpose is different

In palliative sedation, the clinical goal is to relieve suffering from symptoms that cannot be controlled in another reasonable way. The sedating medicine is adjusted to the level needed for comfort. The person dies from the underlying illness.

In VAD, the person seeks medical assistance to end their life. A VAD substance is prescribed or administered under the relevant state or territory law after eligibility and process safeguards are met.

The person and timing can be different

Palliative sedation is usually considered when a person is close to death and has severe refractory symptoms. A person may or may not still be able to take part in the decision, depending on their condition. If they cannot, the team must follow consent law, any advance care directive, and the role of the legally authorised substitute decision-maker.

VAD requires the person to have decision-making capacity for VAD and to make their own voluntary request. A family member cannot request VAD for them. VAD cannot be requested through an advance care directive after the person has lost capacity.

Why people confuse them

The confusion is understandable. With continuous deep palliative sedation, the person may remain asleep until they die. To a family member, this can look similar to "being put to sleep". But the medical and legal meaning is different.

Palliative sedation should involve assessment, discussion, consent, documentation and review. It should not be used to cause death or to avoid hard conversations about VAD, stopping treatment or family conflict.

What to ask the team

Ask:

Are you recommending palliative sedation, VAD, stopping treatment, or something else?
What symptom is being treated?
Is the symptom refractory?
Is the person expected to die soon from their illness?
What level of sedation is planned?
How will comfort be checked?
Who has legal authority to consent if the person cannot?

When to get help now

Ask for urgent senior review if you believe sedation is being used without proper explanation, if symptoms remain uncontrolled, or if family members think the plan is really VAD but no VAD process has occurred.

If the person is in severe distress and you cannot reach the treating team, seek urgent medical help or call 000, unless there is a clear expected-death plan with different instructions.