25-year-old woman chooses voluntary assisted death due to terminal illness
In this DML Report…
Annaliese Holland, a 25-year-old Australian woman, has been diagnosed with autoimmune autonomic ganglionopathy, a rare autoimmune disease in which the body attacks the autonomic ganglia, the nerves controlling involuntary functions. Symptoms began in her childhood, including chronic pain, nausea, and vomiting. For the past decade, she has relied on total parenteral nutrition through IV feeding, as her bowels function as if blocked despite no physical obstruction, and feeding tubes have proven ineffective due to persistent vomiting and delayed stomach emptying. She was transferred to an adult hospital at age 18, where she received her diagnosis, and at age 22, doctors informed her the condition was terminal.
Holland has endured severe complications, surviving sepsis 25 times from infections related to her IV line, which can lead to rapid onset of the condition. Medications for her illness have caused osteoporosis, resulting in constant pain, four spinal fractures, a fractured sternum, and near-catastrophic pressure on her heart and lungs. Her daily routine consists of medical procedures, pain management, and exhaustion, with significant milestones like her 18th and 21st birthdays spent in the hospital. Feeling stuck while peers advance in life, she described her existence as surviving rather than living, marked by isolation and an inability to form relationships.
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Holland opted for voluntary assisted dying (VAD), a legal option in Australia allowing terminally ill patients to self-administer life-ending medication. After a three-week evaluation, she was approved, expressing relief and happiness at the decision to end her life on her own terms. Her family, including father Patrick, mother Armanda, and sister, has been deeply affected; her father initially questioned if she was giving up but ultimately supported her plea to withhold further treatment. Holland emphasized that choosing VAD is not surrender but a recognition of having fought hard enough, and she plans to consider her family's feelings in the process.