Will VAD hurt?

Australia · 29 August 2026 · 6 min read · Reviewed by Dr Kane Treble

Voluntary assisted dying (VAD) is intended to cause death after the person takes or is given a prescribed VAD substance.

General information: This page gives general information for people in Australia. It cannot tell you exactly what will happen in one person's situation. If you have concerns about a symptom, medicine, treatment decision or change in someone's condition, contact their doctor, palliative care team, nurse or other treating health professional. VAD laws, forms and service pathways differ by state and territory, so confirm the current rules with the person's VAD practitioner or official VAD care navigator service.

Voluntary assisted dying (VAD) is intended to cause death after the person takes or is given a prescribed VAD substance. The usual expectation is that the person becomes unconscious before they die. It would not be honest, though, to promise that VAD is always completely painless or that nothing distressing can happen.

The best person to answer this for an individual is the VAD practitioner or pharmacist involved in that person's care. They can explain the expected effects, possible risks, what the person may feel before losing consciousness, and what support can be arranged.

VAD is operating in Victoria, New South Wales, Queensland, Western Australia, South Australia, Tasmania and the Australian Capital Territory. News reports said the Northern Territory Parliament passed VAD laws on 27 August 2026, with implementation to follow. At 29 August 2026, an official operational commencement source for the Northern Territory was not verified for these pages, so the Northern Territory is treated here as not yet operational.

What "hurt" can mean

People may mean different things when they ask this question.

They may be asking whether swallowing the medication is painful, whether an injection or tube will hurt, whether the person will feel panic, whether they will choke, whether they will be aware while dying, or whether family will see signs that look distressing.

These are fair questions. They should be asked before the planned day, while there is time to adjust the plan, arrange symptom medicines, organise who will be present, or choose a different legal administration method if available.

What usually happens

The common aim is for the medication to lead to sleepiness, loss of consciousness and death. A Victorian study of 572 self-administered VAD deaths reported that most people lost consciousness within 10 minutes. Most died within an hour, but some took more than two hours and a small number took much longer.

That study looked at reported experience after self-administration in Victoria. It does not prove that every person in every jurisdiction will have the same experience. It does show why families should be prepared for timing to vary.

Some people may have brief discomfort from the taste, the amount to swallow, nausea, a line or injection, positioning, breathlessness, anxiety, dry mouth, weakness, or symptoms from their illness. The VAD team can often plan for these problems.

What the VAD team can do

Before prescribing or supplying the VAD medication, official processes commonly require practitioners or pharmacists to give information about the medication, how it is stored, how it is taken or administered, and its expected effects and risks.

The person should ask:

What might I feel before I lose consciousness?
How quickly do people usually become unconscious?
What symptoms would be unusual?
Who should be in the room?
Can a nurse, doctor or other health professional be present?
What comfort medicines or palliative care supports should be ready?
What should family do if death takes longer than expected?

For self-administration, a health professional may be present only if arranged and if they agree. In Victoria, official guidance says a doctor or other health practitioner who is present cannot help the person take the medication, but can help make sure the person is comfortable during the dying process.

For practitioner administration, the authorised practitioner has a more direct role and must follow that jurisdiction's legal steps.

What if the person already has pain or breathlessness?

VAD is not a substitute for good symptom control. A person who is considering VAD can still receive palliative care. Pain, breathlessness, nausea, anxiety and agitation should be assessed and treated whether or not the person goes ahead with VAD.

If symptoms are poorly controlled before the planned day, contact the palliative care team, treating doctor or VAD practitioner. The plan may need to change. The person may also decide to pause or stop the VAD process.

What family may see

Family may find the moment emotionally painful even if the person appears physically comfortable. Breathing can change. The person may become still. There may be sounds, colour changes or a longer wait than expected. These signs can be hard to watch.

Ask the VAD practitioner what signs are expected and what signs would need action. If a health professional is present, ask what they can do if there are symptoms or complications.

When to get help now

Before the medication is used, contact the VAD practitioner, palliative care team or official care navigator service if the person has new pain, severe breathlessness, panic, vomiting, confusion, pressure from others, or doubt about going ahead.

Call 000 if there is an immediate life-threatening emergency outside the agreed VAD or expected-death plan. If the person is expected to die at home, follow the written plan from the treating team.