There’s a saying that ‘the dissatisfied dead cannot noise abroad the negligence they have suffered.’ For Dr Roger Hunt (BM BS ’81, FAChPM ’00, MD ’03) a pioneer of palliative care in South Australia, the need to be that voice has resulted in a ripple effect of positive change nationwide.
Fifty years ago, Dr Hunt took a phone call while picking fruit for a summer holiday job to be told that he’d been accepted into Flinders Medical School. “I was elated by this news! It was 1975, and I still remember my student number beginning with 75”.
“Flinders Medical School was quite new, I was in the second intake, and the course was said to be different and more progressive. We had electives, which for me meant trooping up the hill for philosophy classes. This broad education gave me a good grounding for later debates about the ethics of end-of-life care.”
“Medical School was a pressure cooker of learning and exams, where we forged strong bonds, like a family with shared experiences that we carry for life as fellow alumni.”
“I recall car-pooling with friends from Mitcham, inter-year football games, and a vibrant social life. We knew how to let off steam. Friday happy hours near the lecture theatre were followed by our band rehearsals in the horse-shoe seminar room near the anatomy dissection room. In sixth year, I took clinical electives overseas to also explore my Irish roots.”
“An intern year at the Royal Adelaide Hospital was followed by rotations at the Repat (Repatriation General Hospital), a 6-month stint at the old Adelaide Gaol as a prison’s medical officer, then a paediatrics term back at Flinders” Dr Hunt says.
“I wasn’t really sure of my direction in medicine when I went from the FMC neonatal intensive care unit to hospice work at Kalyra Hospital, Belair – from life’s beginning to its’ end in one fell swoop!”
“Kalyra’s Medical Superintendent, Dr John Jackson, was heading overseas to a conference and he needed a locum. It was 1984 and it was serendipitous. I stepped in, the hospice work was a good fit for me, and the rest is history! The clinical work was interesting, you could be innovative to relieve suffering, it involved meaningful communication around a profound event, and it felt good to be in a valuable new health care movement.”
“Soon I was also working with the formative Southern Community Hospice Programme based at FMC that reached out to terminally ill patients across the region. This became the model for services that later developed in other regions of Adelaide.”
In 1988, with the closure of Kalyra Hospital (it became a nursing home), Dr Hunt became a founding member of Daw House Hospice, at the Repat. This was site of Flinders’ world-first Chair in Palliative Care (taken up by Professor Ian Maddocks). Dr Hunt created and coordinated foundation topics for the Masters of Palliative Care degree, which were among the first online courses for Australian and international students.
“We set up the first national conference for palliative care in Australia in 1990, and led the formation of the peak body, Palliative Care Australia. The Chapter of Palliative Medicine that recognised the new specialty was established in 2000 and I was ‘grandfathered’ as a foundation fellow” he says.
“After achieving a Flinders’ Doctor of Medicine degree (by published work), I was appointed Director of the Western Adelaide Palliative Care Service in 2003, and then Medical Head of Central Adelaide Palliative Services (2011-13). I enjoyed leading efficient, harmonious multidisciplinary teams and shaping services.
“I was always interested in the legislative support for palliative care. In South Australia, a parliamentary inquiry led to the Consent to Medical Treatment and Palliative Care Act 1995, to protect patients’ autonomy and their clinicians’ ability to relieve suffering – this was the world’s first legislation to have ‘palliative care’ in its title.”
“But for many patients it was not enough. As far back as the early 1990s, patients and their families had convinced me that voluntary assisted dying (VAD) reforms were needed.”
Despite facing adversity, Dr Hunt became known for his advocacy work for VAD. He has featured in media, including Four Corners programs, and gave evidence to numerous parliamentary committees.
“The motivating factor was the patients, because I’d sat at their bedside and some would say, ‘Roger, there’s got to be a better way than this, I should be able to have more control, more dignity,’” Dr Hunt explains.
However, his colleagues in palliative care were against VAD. “They were influenced by early hospice leaders who were religious and named their services after saints, and they would say that ‘in our expert hands, we can address all suffering, so none of our patients want a hastened demise’,” says Dr Hunt.
“These were things that I could see were not true, there was evidence that they weren’t true, and it needed to be called out”.
“All the surveys in the best hospices around the world showed that patients were suffering. They had multiple concurrent symptoms – pain, breathlessness, nausea, weakness et cetera – they were suffering not just physically but psychologically and many patients wanted control over their dying.”
“The palliative care community back then did not like to hear such things, so slings and arrows came my way, and there were efforts to gag me. On the flip side I found camaraderie in the VAD reform movement, including with luminaries like Marshall Perron, Dr Rodney Syme and Andrew Denton.”
Dr Hunt served on ministerial committees in Victoria (2017) and Western Australia (2019), the first states to enact VAD legislation, and he advised the South Australian parliament during passage of legislation. Currently, he serves as a member of the South Australian VAD Review Board.
“After pushing for so many years without success, all of a sudden the whole country has VAD legislation (except for the Northern Territory). It is a remarkable vindication to see the turnaround, including in the palliative care community, and I can only admire the many compassionate people who now help to make VAD the valuable choice that it is for people with terminally illness,” Dr Hunt says.
“However, there is still work to be done. The legislation was designed with so many safeguards that some of them don’t serve the interests of patients and clinicians. It can be too difficult for some people who are very vulnerable and weak, approaching the end of the life, to jump through the necessary hoops. As with all legislation, as society learns what works and what doesn’t, it will evolve over time.
“I feel fortunate to have had a really fulfilling career, to start on the ground floor and be part of the growth and change in palliative care. Like my colleagues, I’ve felt privileged to help people through terminal illness, to be immersed in the love and care surrounding them, and to receive heartfelt gratitude.
“Some challenges in my journey demanded thoughtful analysis, a firm grasp of what is right, and perseverance. Thankfully, I was well prepared by my family and by my education at Flinders.”
Dr Roger Hunt was awarded a 2025 Convocation Medal for outstanding leadership in end-of-life care as a clinician, service developer, researcher, teacher and advocate for legislative reform.