The articles by Ian Chubb and John Ward calling for an extension of voluntary assisted dying (VAD) to cover dementia evoke the deep sadness experienced by many people confronted with this condition.

It is true that the incidence of dementia is increasing, causing great suffering, and that VAD is now legal and generally accepted in most of Australia. It is also true that for many people it seems natural to extend the availability of VAD to allow people with dementia to avoid anticipated personal indignities and painful burdens on their families.

Without diminishing our compassion for Professor Chubb’s agonising experience, however, we feel the need to point out that extending VAD in the manner proposed is not as straightforward as it seems. There are major issues regarding both VAD and dementia in relation to which extended public discussion will be needed before we would be able to take such a step.

First, the basis of VAD as established in all Australian jurisdictions is that it needs to satisfy three conditions: that the person (1) has a terminal illness with a limited prognosis, (2) is in clear consciousness, and (3) is encountering suffering that he or she considers to be intolerable (actual formulations vary slightly across the jurisdictions). It is clear that while the first may be relevant for a person with dementia at some point, the other two are unlikely to apply to people with dementia at that same........

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