Breaking the Taboo: How Australia Is Learning to Talk About Assisted Dying

Introduction

Not long ago, voluntary assisted dying (VAD) was one of Australia’s most politically charged topics. Now, it is legal in every state, and the Human Rights conversation has begun to shift. But while the law has advanced, cultural acceptance remains uneven — and access hurdles persist. Emerging data reveals both the reach of VAD and places where it remains just out of reach.

👉 If you’re new to the subject, see our Global Guide to Voluntary Assisted Dying.

From Silence to Legislation

Progress has been rapid. Victoria was the trailblazer, passing its law in 2017; it came into effect in 2019. Since then, Western Australia (2021), Tasmania (2022), Queensland (2023), South Australia (2023), and New South Wales (late 2023) have all joined the fold. The Australian Capital Territory is next — its VAD law will commence November 3, 2025.

Legal access now covers more than 95% of Australians — but the cultural shift to normalize the conversation is still catching up.

For the detailed rules in each state, see our Guide to Accessing VAD in Australia.

The Human Toll — and Relief

Victoria’s latest annual report (July 2023 to June 2024) reveals important insights:

768 applications for VAD were made, with 371 people ultimately choosing the option.
180 applicants died before receiving the medication, underscoring delayed initiation of the process.
The median time from first request to final request is 14 days; from initial request to dispensing, it’s 28 days.
Rural patients represented over one-third of applicants, even though they form less than a quarter of the population.

Nationally, VAD accounts for roughly 0.5% of deaths in Victoria and around 1% in Western Australia each year.

These figures aren’t just numbers. They represent people and families who found peace in knowing choice was there — even if they didn’t ultimately use it.

Why Talking About Death Is Still Hard

Australians are not used to discussing death openly. Advance care planning, palliative care preferences, and end-of-life wishes are often left unspoken until it is too late. VAD adds another layer of difficulty.

Families often hesitate to raise it, worried it will sound like “giving up.” Patients may fear being judged by loved ones or health professionals. Doctors and nurses themselves may be conflicted, sometimes choosing not to participate even though the law allows it.

The result: people who could legally qualify for VAD sometimes never ask — or ask too late.

Families looking for practical guidance should read our VAD Guide for Families in Australia.

Uneven Access: The Postcode Lottery

Even with laws in place, access to VAD depends heavily on where you live:

Residency barriers: All states require applicants to have lived in the jurisdiction for at least 12 months — meant to curb “death tourism,” but tragic when someone has lived in a state most of their life yet is excluded due to recent moves.
Eligibility variance: In Victoria and WA, the illness must typically be expected to cause death within 6 months (or 12 months for neurodegenerative conditions). Queensland sets a 12-month window for all conditions.
Practitioner availability: Victoria’s data shows only around 7 VAD-trained practitioners per 100,000 adults, with just three of the top ten busiest practitioners located in rural/regional areas.

These disparities strain families, especially those outside major cities who may face long travel or referral hurdles just to start the process.

Breaking the Silence Through Stories

Stories emerging from across the states reveal a growing human dimension to VAD:

Some patients report comfort in simply knowing they have a choice, even if they don’t use it.
Families speak of peaceful final moments, rather than crises.
Doctors say VAD conversations often open wider dialogues on treatment goals and palliative care — pushing the focus beyond death to what quality of life looks like.

Looking Ahead: The Next Frontiers

Australia’s journey with VAD isn’t over yet. Key challenges remain:

Territorial lag: The ACT’s law begins in late 2025; the Northern Territory still has no framework.
Equity gaps: Many rural and Indigenous communities still lack ready access. Telehealth limitations and low practitioner density compound the issue.
Palliative care balance: VAD is meant to complement, not replace, palliative care — but in places where quality palliative services are lacking, VAD may become the default, not the backstop.
Normalization: The greatest shift may be cultural. When Australians begin speaking about death and dignity with the same candor as drafting a will, the law will truly have arrived.

A Final Word

Despite legal advances, VAD remains difficult to talk about. Australia has made it legal — now it’s about making it accessible, equitably, and conversationally normal.

Change doesn’t happen overnight. But every time a family speaks openly about their end-of-life wishes, or a doctor broaches the topic with kindness, another layer of taboo falls away.

That’s how we move — from silence to understanding — one conversation at a time.