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- [00:03]
A
Well, this is a bit of a strange moment for me and probably for you as well. I have to tell you something. There's something I have to share that has been going on in my life and that I now have to tell you about because I'm not going to be here for a few months. I've got to go off and deal with something and the thing I've got to go off and deal with is cancer. I've got a cancer and I'm.
- [00:25]
B
From his diagnosis with esophageal cancer in 2024 to openly wrestling with end of life decisions, Beloved ABC broadcaster and longtime voice of Sydney afternoon's James Valentine took his listeners along with him as he stared down his own death.
- [00:43]
A
I'm James Valentine and this season we're talking about death or on this episode, why we don't talk about it enough.
- [00:51]
B
Now, after his passing, that openness continues with James Decision to share the fact that, that he ended his life through voluntary assisted dying, or vad.
- [01:02]
C
He was able to do the vad, which was really important to him. So we were all able to be together and just, you know, yeah, it was really beautiful. In his final moments, he was still concerned about making a difference. And that was something that was so important to him that we mentioned that.
- [01:23]
B
I'm Nicole Johnston and you're listening to 7am today go gentle Australia founder Andrew Denton on James decision and why some Australians still have trouble accessing VAD despite it being legal in all but one Australian territory. It's Wednesday, april 29th. Andrew, you knew James Valentine and had spoken to him about voluntary assisted dying. How did that conversation go? And could you tell us about how open he was while facing death?
- [02:06]
D
About a year before James died, I did a remarkable podcast conversation with him and a clinical psychologist, Dr. Kerry Noonan, which in James's inimitable style, he titled, let's talk about death, baby. And we spoke very openly about the difficulty of confronting death, the way conversations shut down around it, about how to have those conversations and about what happens after people die and how to have those conversations. And it was remarkably raw because of James's situation. He was in between his first cancer treatment and he had gone into remission. But at the end of the conversation, and I remember very clearly, I could see James getting emotional and I asked him, I said, what are you feeling right now, James?
- [02:53]
A
Look, we have a funny connection over many decades and to observe you go through, to see you transform into doing that work's been quite extraordinary. And I'm probably just contemplating my Own
- [03:06]
D
death and exactly right, James. And I think it says a lot about his courage and his skill as a communicator that he was prepared to be so open about something about which many of us are very closed now.
- [03:21]
B
James had decided that he wanted his family to share with the public how he died. Why do you think that he wanted them to know? And what type of impact do you think that kind of conversation and sharing will have on the community?
- [03:38]
D
Look, it shouldn't be courageous, but unfortunately there's a great deal of stigma that sits around voluntary sister dying. It's a stigma that was in many ways created, enforced and amplified by its opponents, most particularly the Catholic Church, who still refer to it as some form of suicide, even though the leading suicide prevention organizations in Australia see it as something distinctly different. It's a choice between two forms of death. I think they wanted to talk about it because they. For the same reason that James wanted to talk about his illness and his diagnosis and his treatment, that he wanted to demystify and model a good way to approach end of life.
- [04:15]
C
We knew it was coming. We knew there was sort of no way out of this, but to be able to sort of do it on his own terms was really important to him and to sort of get that choice as much as he could in this time. And he really wanted to know, like he. He wanted it to be something that people knew that he did, that if there's ever, you know, he could lend his voice to the argument of why this is such a necessary thing for so many people, the fact that his
- [04:42]
D
kids have now gone on air and talked about what those last days were like for James, the. The level of control and love it enabled.
- [04:50]
C
Everyone's bringing a. A heavy heart to it, and it's a big loss, but he was so full of joy still. And we're full of joy and we're laughing along to all the clips and the saxophone.
- [04:59]
D
And James had a big living wake where he was farewell by 300 of his friends and the people who loved him. So it leaves, and I'm sure it's left James's family and friends with beautiful memories of James. And, you know, I understand he played the sax, which of course was part of his essential Persona. And you still grieve. Death is still the loss it will always be, but at least you know that that person has died in as merciful a fashion as is possible, and that you've been part of that and you have helped them with their final wishes. So I think all that informed James choice And the family's willingness to be so public about it.
- [05:43]
B
And as you said, his family, they've spoken about how special the time was leading up to his death because they knew it was coming. Is that a common feeling for families in this sort of situation?
- [05:58]
D
We often hear this about people who choose vad, that even if they were unsure about the process or unsure about the original choice of the person going through it, they deeply value the fact that they were able to have that time without the levels of distress and, and collapse that I was describing before. I've learned there's a scarier C word than cancer, Nicole, and that's cascade. And sometimes at the end of life, your medical condition can really accelerate out of control. And the great value of vad, the choice of that is it gives you the offer of control. Even if things accelerate very quickly, if you have that medication there with you or if you have access to that medication, you can still make things happen in a way that you want them to be. I'm just thinking of a young man whose local palliative care service and nurses did an extraordinary job. They facilitated him dying on the beach, which is where he wanted to die. He'd grown up near the beach. You know, I think for myself, gee, wouldn't I like to go with a. Perhaps a decent cheeky cocktail and a nice sunset and beautiful music and my football team having won the premiership, that might be a bit hard, but that's. Isn't that what we want? We want to die as who we are, not as a sh of who we are.
- [07:16]
B
Coming up, the barriers still standing in the way of voluntary assisted dying.
- [07:26]
A
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- [07:58]
B
Andrew Voluntary assisted dying is now legal in every state except the Northern Territory. But it still doesn't feel like something that Australians are really comfortable talking about. Why is that, do you think? And what examples have you seen of that kind of taboo playing out in our healthcare systems and in aged care?
- [08:18]
D
It's an enforced taboo Still. I mentioned earlier the people that oppose this law. It's always been their line to describe this as suicide, which has a very different meaning in society. The most senior Catholic in this country, the Archbishop of Sydney, Reverend Anthony Fisher, at the end of last year described doctors going into hospitals to legally assist people to die as quote, unquote, kill teams. You can't get much more aggressive or stigmatic than that. And it astonishes me that a man of Christian faith who marches under the banner of mercy would use such aggressive and ugly language about medical professionals helping people at the end of their life. There's a lot of other problems too. You know, we did a survey of most of Australia's aged care providers in each state and nationally to see what kind of information they provide about VAD. And only 5% full providers provide full information about VAD. So there's an institutional reluctance to talk about this. Doctors are often dismissive or sometimes openly hostile towards people and make requests because of their personal beliefs. And even in the Aged Care act, which was rewritten and re legislated last year, despite repeated and treaties from ourselves and others, within the definition of end of life care, there's no mention of that. So this flows down and the kind of behaviour we see sometimes is inexcusable.
- [09:41]
B
And yet, despite all those problems and the debate and the taboo, we've seen the applications for voluntary assisted dying rise by more than 40% in the last year or so. But still almost half of patients who start the process don't actually finish it. Why do you think that is?
- [10:01]
D
Well, there's a number of reasons. First of all, the law itself, the process is not meant to be easy to get through. It's meant to be careful and deliberative, and that's as it should be. And not everyone chooses to proceed. It's a choice. And some people choose palliative care. Some people feel just having that control was sufficient for them, so they don't choose to proceed. Buck, there's also the other factors, as I was mentioning before, hostility and obfuscation from doctors when asked, you know, there's a fine line between conscientious objection, which the law allows, as it should, and conscientious obstruction. I spoke to a man in Sydney last year who died of cancer, who had been told by his doctors he had between three and six months to live, which has legally made him eligible for vad. But when he asked them to support his application, they just stonewalled him. And they stonewalled him for months. And he got to a point where in tears, he said, to his oncologist, I'm dying, please, I need this information. And at the end they gave him the information and he immediately switched to somebody that would support his case. And when you consider the fact that the Catholic Church still provides a lot of Australian health care and is deeply opposed to vad, they describe it as intrinsically evil. They are concerned if they don't seem to support vad, that will affect their career prospects. And when you have, as I said, Archbishop Anthony Fisher describing VAD doctors as kill teams, you get a sense of how that pressure might flow through to people that may support VAD within the Catholic health system, but are afraid to say so.
- [11:41]
B
Andrew, your organisation, Go Gentle Australia, is campaigning for telehealth to be an option for patients who want to go through this process. Why do you think that's so important?
- [11:53]
D
Well, it's a matter of equity, really. Not all sick people live near a doctor, not all sick people live near a hospital. The problem with telehealth, it's a strange one, really, because it refers to a thing called the Commonwealth Criminal Code and it's an amendment that was written in 2005, long before our VAD laws existed, saying that it's illegal to use a carriage service to encourage or assist in suicide. But as I mentioned before, state's law and leading suicide prevention organizations do not see VAD as suicide. They are different things. However, this law has been interpreted in different states to mean that doctors can't use telehealth or zoom or email or even a text to discuss or advise parts of the VAT process. In some states, they have to use snail mail to send a prescription. This is a very anomalous law which should have nothing to do with vad. And everybody from the state's attorneys generals to health ministers to the AMA has petitioned the Federal Attorney General, Michelle Rowland, to fix this law. It's a pretty easy fix. You just remove VAD from the definition of suicide and the law, but complete silence. You know, I find it hard to understand. The Prime Minister has always been supportive of this law. He came to the launch of Go Gentle at the National Press Club a decade ago. It's causing unnecessary harm and it's difficult to understand why the government won't act on what is a relatively easy fix.
- [13:17]
B
Andrew, you've been campaigning for this for so long now and you've achieved so much, but what is really the ultimate goal and where do you want Australia to be on this issue over the next five to ten years?
- [13:31]
D
Well, I would like to see first of all just VAD normalised. As a compassionate person centered part of end of life care, I would like it to be thought of in exactly the same breath as palliative care. You know, it's interesting that 80% of the people that choose VAD are also in palliative care. These things are all part of the same discussion. And I do have a real question about taxpayer funded healthcare facilities which obviously have a faith basis, denying legal care to taxpayers in their care. I think that's a real issue and I think we need to look at the laws that govern this. You know, currently VAD doctors, they have no peak organization. There's no government support for their needs, for instance remuneration. So I'd like to see them supported. And you know, I think that John Lennon song whatever gets you through the night, whether it's VAD or palliative care or your faith or none of the above, these should be all uncontested spaces. They should be supported. If your faith tells you that VAD is not something you want to be involved in, I completely support your right not to be involved. But our laws should recognize that this is legal and that people should not be allowed to stand in the way of it. News flash. We're all going to die and we all want to be taken care of as best we can when we die. And that's my dream, that this is an uncontested thing for all Australians wherever they live, no matter their faith, no matter their beliefs.
- [15:05]
B
Andrew, it's an important topic and thank you so much for speaking with us about it.
- [15:10]
D
Thanks Nicole, really appreciate it.
- [15:26]
B
Also in the news, the federal government's released draft laws aimed at forcing major tech companies to to pay for Australian news published on their platforms. Under the proposed news bargaining incentive, platforms like Meta, Google and TikTok would face a tax of 2.25% of their Australian revenue if they don't strike commercial deals with news publishers. The government says the law is designed to fix gaps in the existing bargaining code after platforms were able to avoid payments by pulling back from news and is expected to raise up to $250 million a year. And a UK parliamentary inquiry has cast doubt on the country's ability to develop and deliver nuclear submarines promised as part of the Aukus defence pact. The deal, estimated to cost up to $368 billion, is meant to deliver Australia its first US built submarines by the early 2000-30s before delivering British designed submarines within the same decade. But the House of Commons Defence Committee says decades of underfunding workforce shortages and low submarine availability in Britain could derail the plan. I'm Nicole Johnston and this is 7:00am thanks for listening.