Heavenly Healing Centre

"𝗜 𝗰𝗵𝗼𝗼𝘀𝗲 𝗻𝗼𝘁 𝘁𝗼 𝘀𝘂𝗳𝗳𝗲𝗿."

Andrew Denton opened his National Press Club address with those words. They belonged to Margaret Radmore, a nurse of 40 years who became one of the first Australians to use Victoria's voluntary assisted dying law. She had seen too many prolonged and terrible deaths to accept the reassurance that palliative care could always keep her comfortable. "I know there are many cases where it's impossible to alleviate suffering," she said.

A decade after Andrew first stood at that podium, every state and territory has passed VAD legislation, and Go Gentle Australia's small team was at the heart of that change. In his words, at least 10,000 dying Australians have since been able to make Margaret's choice.

Anyone who believes in dignity at end of life owes Andrew an enormous debt of gratitude. Myself included.

𝗢𝗻𝗲 𝘄𝗼𝗿𝗱 𝗸𝗲𝗽𝘁 𝗿𝗲𝘁𝘂𝗿𝗻𝗶𝗻𝗴 𝗶𝗻 𝗵𝗶𝘀 𝘀𝗽𝗲𝗲𝗰𝗵: 𝗶𝗻𝗵𝘂𝗺𝗮𝗻𝗲.

A mother described the way her dying daughter was moved between facilities as "this inhumane treatment of my girl." A daughter described her mother on a slow morphine infusion that, in Andrew's words, prolonged her death for three days. "She kept waking up, gasping for air," she said. "It was inhumane what my mother went through."

Andrew paused on it himself. "That word again, inhumane."

It is the word I keep coming back to as well.

Humane and human share the same Latin root. To be human is a biological fact. To be humane is a moral choice.

Yet our laws demand mercy for a suffering animal and offer none to a person dying from dementia. If an animal were left to reach the condition advanced dementia forces on a human body, someone could be charged with cruelty and in all likelihood, imprisoned.

When it happens to our mothers and fathers, we call it natural.

𝗡𝗼 𝗼𝗻𝗲 𝘄𝗮𝗻𝘁𝘀 𝘁𝗼 𝘀𝘂𝗳𝗳𝗲𝗿. 𝗦𝗼 𝘄𝗵𝘆 𝗱𝗼 𝘄𝗲 𝗮𝗰𝗰𝗲𝗽𝘁 𝗶𝘁 𝗳𝗼𝗿 𝗽𝗲𝗼𝗽𝗹𝗲 𝗱𝘆𝗶𝗻𝗴 𝗳𝗿𝗼𝗺 𝗱𝗲𝗺𝗲𝗻𝘁𝗶𝗮?

Andrew spoke about the limits of palliative care. Now consider what those limits look like at the end of dementia.

In its final stage, dementia takes away the ability to swallow. Once that ability is permanently gone, a person can no longer take in food or water. They die of cachexia and dehydration, the slow wasting of a body that consumes its own reserves to stay alive. It can take days. Sometimes weeks.

My mother Hem died this way. It took ten days. She weighed around 24 kilograms by the end and looked like a prisoner of war. She was not comfortable.

This campaign estimates that between 9,000 and 13,000 Australians die this way every year.

Families are told that palliative medication will keep their loved one comfortable throughout this dying process. What they are rarely told is that this is not the same as other deaths.

𝗗𝗲𝗺𝗲𝗻𝘁𝗶𝗮 𝗰𝗵𝗮𝗻𝗴𝗲𝘀 𝘁𝗵𝗲 𝘃𝗲𝗿𝘆 𝘀𝘆𝘀𝘁𝗲𝗺𝘀 𝘁𝗵𝗮𝘁 𝗰𝗼𝗺𝗳𝗼𝗿𝘁 𝗱𝗲𝗽𝗲𝗻𝗱𝘀 𝗼𝗻:

🔸 The popular belief that the body makes its own natural comfort as it goes without food and water has never been shown to happen in dying people.

🔸 Dementia does not simply dull pain. Brain imaging shows people with Alzheimer's still process pain, and may find it more unpleasant than people without the disease.

🔸 People with dementia have lower levels of the body's own natural painkillers.

🔸 Alzheimer's-related damage can impair the part of the brain that releases those painkillers and switches on the body's own pain suppression. The same damage can reduce how well pain medication works.

🔸 The receptors that morphine and similar medications act on are measurably altered in parts of the Alzheimer's brain.

🔸 Part of any pain relief comes from expecting it to work. In Alzheimer's, that effect can be lost, so the same treatment achieves less.

𝗔𝗻𝗱 𝗻𝗼 𝗼𝗻𝗲 𝗰𝗮𝗻 𝗰𝗼𝗻𝗳𝗶𝗿𝗺 𝘁𝗵𝗲 𝗰𝗮𝗿𝗲 𝗶𝘀 𝘄𝗼𝗿𝗸𝗶𝗻𝗴:

🔸 No one has established whether medication given under or through the skin is reliably absorbed by a body that has wasted away.

🔸 Experienced doctors and nurses don't always agree on which signs mean a person with dementia is in pain.

🔸 With the same injury, people with advanced dementia have been given far less pain relief than people who can say they are hurting.

🔸 Sedation can quieten the outward signs of distress, but there is still no reliable way to confirm the distress itself has ended.

When someone is dying from dementia through cachexia and dehydration, comfort cannot be guaranteed. And the one person who could tell us whether the care is working can no longer say.
In the absence of that certainty, why do we force people to endure a prolonged dying process and simply hope the care is enough?

Hem’s Law exists to give families an alternative choice, when "maybe" is the only honest answer to the question, "is she suffering?"

𝗧𝗵𝗲 𝗵𝗮𝗿𝗱𝗲𝘀𝘁 𝗰𝗼𝗻𝘃𝗲𝗿𝘀𝗮𝘁𝗶𝗼𝗻, 𝗮𝗻𝗱 𝗮 𝗱𝗶𝗳𝗳𝗲𝗿𝗲𝗻𝘁 𝗼𝗻𝗲

Andrew called dementia "the hardest conversation of all," and said it is by far the most common question Go Gentle is asked. He was honest about why: "asking a doctor to end the life of someone who can't look them in the eye and say, yes, this is what I want, is enormous."

He is right. That conversation deserves the careful research Go Gentle has committed to, and I'm glad it's happening.

But there comes a point in dementia where that question is no longer the one being asked.

VAD is a person's own decision to end their life before their illness does. It is a decision about the quality of life.

Hem's Law applies only once swallowing has permanently failed, life-sustaining treatment has been withdrawn or is no longer appropriate, and two independent practitioners have certified that death is imminent and irreversible. At that point, no one is deciding whether this person will die. The disease has already settled that. The only decision left is how long the dying takes, and what the person endures along the way.

That is a decision about the quality of death.

No doctor needs to look someone in the eye and ask whether they want to die. The question in front of the family and the clinician is a different one. Must this death be prolonged when suffering cannot be reliably relieved?

𝗖𝗼𝗺𝗽𝗹𝗲𝗺𝗲𝗻𝘁𝗮𝗿𝘆, 𝗻𝗼𝘁 𝗰𝗼𝗺𝗽𝗲𝘁𝗶𝗻𝗴

Andrew noted that palliative care has not been weakened by VAD. Four in five people who choose VAD also benefit from palliative care, and more palliative care doctors and nurses are becoming VAD providers, "understanding it as another form of end of life care."

That is the continuum Hem's Law belongs on. Palliative care, to help people live as well as possible for as long as possible. VAD, for people who can still make that choice for themselves. And for the narrow point at the very end of dementia, where VAD cannot reach and palliative care cannot promise comfort, a lawful way to bring an imminent and irreversible death to a merciful end.

Hem's Law takes nothing from either. It sits alongside both and closes the one gap they leave.

𝗪𝗵𝘆 𝘁𝗵𝗶𝘀 𝗰𝗮𝗻𝗻𝗼𝘁 𝘄𝗮𝗶𝘁

The ethical, medical, legal and political questions around extending VAD to dementia will take years to work through. They should be worked through carefully. As Andrew said, "saying too hard is not an option."

But people are dying of cachexia and dehydration this week, in homes, hospitals and aged care across the country, with their families sitting beside them. A narrowly drawn reform for the point where death is already certain does not need to wait for the hardest conversation of all to be settled. It can move now, alongside that work, for the people who need it now.

Andrew closed with the goal Go Gentle has worked toward for ten years: for all Australians, "the chance of a good death, the choice not to suffer."

"𝗔𝗹𝗹 𝗔𝘂𝘀𝘁𝗿𝗮𝗹𝗶𝗮𝗻𝘀" 𝗵𝗮𝘀 𝘁𝗼 𝗶𝗻𝗰𝗹𝘂𝗱𝗲 𝘁𝗵𝗲 𝗼𝗻𝗲𝘀 𝘄𝗵𝗼 𝗰𝗮𝗻 𝗻𝗼 𝗹𝗼𝗻𝗴𝗲𝗿 𝘀𝗽𝗲𝗮𝗸 𝗳𝗼𝗿 𝘁𝗵𝗲𝗺𝘀𝗲𝗹𝘃𝗲𝘀

Sign the petition, share this post, together we can change the law. Andrew has proven that.

Dying with Dignity NSW Dying with Dignity ACT Inc. Dying with Dignity Queensland Dying With Dignity Victoria Voluntary Assisted Dying South Australia Dying with Dignity WA Vadanz Voluntary Assisted Dying Australia & New Zealand

Mataphor Matt Walther challenges you to adopt the positive approach to life using Metaphors, Similes, Humor, and wise quotes to improve your life and self-talk ! Eg: You don’t need to be great to start, but you need to start to be great 😊

A tribute to the woman so often blamed for “doing nothing at home” — when that “nothing” is actually everything: the invisible labor, the quiet strength, the endless care, and the love that keeps an entire family standing.