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  • Writer's pictureZhoujie Wang

When Memory Fades, What Should Happen to Our Lives?

880 people have accessed Voluntarily Assisted Death since the law came into force in Victoria in 2019. None of them are individually autonomous, and they should not be.

By the end of this year, euthanasia will be made legal in all states across Australia. Euthanasia, also called Voluntarily Assisted Death (VAD), is defined by the Australian Human Rights Commission as the process of intentionally terminating one’s life in order to reduce pain and suffering from catastrophic injuries and incurable diseases. The legalization of euthanasia, along with who should have access to it, has been discussed over the years.

And as I read, I heard a strong voice in my head insisting that people with neurological diseases such as dementia should be included in the legalization of euthanasia. It’s usually the patient’s family members who appear in the news interview, airing their misery of seeing their loved ones suffering while they are too powerless to help. They have made their claims very clear that dementia is a progressive disease; it severely influences a person’s daily routines and causes extreme pain in the last part of a person’s life. They lose autonomy. And no one deserves a death like that.

However, the legislation was drafted with specific considerations in mind. Dementia does not fulfill VAD requirements by its nature. Victoria, the first state in Australia that legalized VAD, has specified in the Voluntarily Assisted Dying Act 2017 that only those who have decision-making capacity and have been diagnosed with incurable diseases are eligible for VAD. The Act also offers a precise explanation of what decision-making capacity based on the following four points:

“Understand the information relevant to the decision relating to access to voluntary assisted dying and the effect of the decision; retain that information to the extent necessary to make the decision; and use or weigh that information as part of the process of making the decision; and communicate the decision and the person’s views and needs as to the decision in some way, including by speech, gestures or other means.”

Dementia, in this case, is not included. And it shouldn’t be. Symptoms of dementia may include loss of proper judgment and difficulty in understanding and expressing thoughts, according to Dementia Australia. This undoubtedly makes people with dementia fall out of the range of VAD requirements. Then, how should people treat dementia when it brings extreme pain to patients and their carers?

The solution for dementia patients should be better dementia care rather than VAD. Alzheimer’s Society states that relationships usually change when people suffer from dementia. They can easily feel isolated from or be avoided by people around them. Therefore, dementia carers matter in supporting their relationships and encouraging them to remain involved in social activities. However, dementia patients are supported mainly by their family members and close friends who are not professionals. How could such an important role be taken by someone who possesses no knowledge of dementia? That’s one primary reason that causes misery to both dementia patients and their carers. People are too unfamiliar with dementia to know how to deal with it, and it’s too much responsibility and pressure for one to bear.

Dementia Australia's post on X (22/09/2023)

This can be improved by proper training provided by relevant organizations and the support offered by society. In 2023, an estimated 400,000 Australians are living with dementia, and more than 1.5 million people are involved in their care, according to Dementia Australia. Dementia Support Australia has supported more than 50,000 clients since 2016. This effort should not be made alone but by the joint endeavor of the whole society. As the carers support dementia patients, the rest of us should support the carers. As Dementia Australia posted on X: “We want our staff and the community to develop greater understanding and compassion towards people living with dementia.”

This is not just a battle between patients and the disease but between humans and the irreversible natural law. Dementia has its appropriate solutions, and it’s by no means VAD but people’s effort to build a dementia-friendly future.

While news and information about VAD are frequently associated with dementia, what is underlying it is an even more significant question: Do diseases and age make a person worthless? In Canada, the range of euthanasia-qualified people has expanded to those who have either physical or mental illness or just those who have suicidal thoughts. This is severely against humanity as all lives are equal and deserve to be cherished. Diseases and age don’t devalue lives. Instead, all conditions and aging symptoms have their corresponding suitable treatments. Having VAD as a solution is likely to become a stumbling block to medical progress. We have already conquered some deadly diseases that are incurable to humans in the past; we shouldn’t simply stop and take VAD as the easy way out. The pain of disease should be our motivation to overcome it, not to convince people that death is the better option.

But with so many incurable diseases currently troubling human beings, I guess VAD is and will remain to be a better option for some groups of people. So, our task is to strictly regulate it, including its process and availability.

VAD has liberated 880 people in Victoria from pain so far, but in terms of its regulation, there’s still a long way to go. Though there are some advocates demanding VAD to be made available to dementia patients, the current legislation should still stick to its stand on decision-making capacity. The solution to dementia should be better dementia care rather than VAD, and VAD shouldn’t quickly expand its range without careful consideration and practice. Canada’s assisted death program has set an ill-considered example for us. Hopefully, Australia will maintain its right track and let euthanasia make contributions, not chaos.

Written by Zhoujie Wang.

Cover photo by David Matos.



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