‘On his own terms’: James Valentine chose assisted dying but barriers remain for Australians wanting to access it | Assisted dying

The Evolution of End-of-Life Choice: Future Trends in Voluntary Assisted Dying

The recent passing of beloved ABC broadcaster and musician James Valentine has brought the conversation surrounding Voluntary Assisted Dying (VAD) back into the public spotlight. Valentine, who died at age 64 following a battle with oesophageal cancer, chose to go out on his own terms, surrounded by his family at home.

His decision was not just a personal choice, but a public statement. By choosing to publicise his use of VAD, Valentine aimed to lend his voice to the argument that such options are necessary for those facing terminal illness.

Breaking the Digital Barrier: The Push for Telehealth

One of the most significant future trends in end-of-life care is the urgent push to remove structural barriers to access. Currently, Australia stands as the only nation in the world with commonwealth legislation that prevents patients from using telehealth during the VAD process.

Advocates, including Go Gentle Australia, argue that this requirement creates a “horrendous process” for those who are immobile or living in rural and remote areas. As medical technology evolves, there is a growing demand for the federal government to align legislation with modern healthcare delivery.

The trend is moving toward a system where “common sense” prevails, allowing suffering patients to access assessments without the physical strain of multiple clinic visits.

From “Goodwill” to Sustainable Infrastructure

As VAD becomes more integrated into the healthcare system, the model of delivery is shifting. Currently, the system relies heavily on the goodwill of practitioners. However, experts warn that this is unsustainable.

With VAD deaths in 2024-2025 increasing by 48% to 3,329, the system is reaching an inflection point. Future trends indicate a necessary shift toward:

• Adequate Remuneration: Moving away from unpaid labour to prevent practitioner burnout.
• Specialised Training: Increasing the number of trained practitioners to reduce the current trend where one in three applicants struggle to find a supportive doctor.
• Standardised Guidelines: Integrating VAD into high-quality end-of-life care clinical standards.

Addressing Institutional Obstructions

A growing point of contention in the VAD landscape is the role of faith-based aged care homes and hospitals. Reports indicate that some of these institutions continue to refuse to facilitate access to VAD care, even when it is a legal choice for the patient.

The future of end-of-life care will likely involve a tighter regulatory framework to ensure that a patient’s legal right to VAD is not obstructed by the religious affiliations of their care provider.

The Normalisation of Patient Autonomy

VAD currently represents about 2% of all deaths in Australia, or 5% of cancer deaths. However, projections suggest this figure could double to 5% of all deaths over the next decade.

High-profile cases, such as James Valentine’s, help the general community understand that VAD is a legal and dignified choice. This visibility is expected to drive a cultural shift where “doing it your own way” becomes a standard part of the conversation around terminal illness.

VAD Legal Status by Jurisdiction

Currently, every Australian jurisdiction has legalised VAD except for the Northern Territory. Even as the NT government has committed to draft and debate a VAD law, no official timetable has been established.

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