Starvation by Design: Why Australia Must Face the Violence Disabled People Endure

When Ann Marie Smith died alone in her Adelaide home in 2020, starved and left to rot in a cane chair, the country mourned briefly, then moved on. Her name joined a list that is far too long: Willow Dunn in Brisbane, Joshua Djuric in Sydney, Kyla Puhle in Adelaide, and nine-year-old “Ebony” on the NSW Mid North Coast. Each case provoked outrage. Each was reported as “neglect,” a “tragedy,” or a “failure of one carer.” And each faded quickly from public attention.

But Ryan Thorneycroft, Peta Cook, and Nicole Asquith’s 2024 article Explaining the Unexplainable: Theorising the Starving of the Disabled Other challenges us to sit with these deaths and name them for what they are: violence. Slow, attritional, patterned violence that does not just happen by chance but is actively enabled by the systems we have built. Their work is essential reading for anyone in policy, service delivery, or advocacy who wants to understand not just how these deaths happen, but why they keep happening.

Naming Starvation as Violence

The first and most radical step the authors take is to insist that starvation is not just “neglect” — it is a form of harm in its own right. Starvation takes time. It is not a single act but a sequence of omissions, withdrawals, and failures over weeks, months, even years. Each missed visit, each delayed care plan, each cut in funding is a small act that accumulates until the body cannot go on.

In Australia, incident reporting systems, coronial investigations, and the media rarely label starvation explicitly. They prefer softer terms that disperse blame. This dilution is not just a semantic issue: it lets systems off the hook. If we call these deaths what they are — starvation deaths — we can finally see the pattern and hold people, agencies, and governments accountable.

Vulnerability and Harm by Design

One of the article’s most important contributions is its analysis of vulnerability as socially produced. Judith Butler’s notion of ontological vulnerability — that all humans are fragile and dependent — is re-cast here to show how disabled people are rendered extra-vulnerable through policy design, funding decisions, and bureaucratic categories.

Australian systems frequently label disabled people as “vulnerable,” but too often that label functions as an administrative box-tick rather than a trigger for urgent support. Under the NDIS, someone can be flagged as high risk but still experience cancelled shifts, staffing shortages, and review delays that deepen their precarity. This is what the authors call harm by design: when the very systems meant to protect disabled people create the conditions for their suffering.

If it takes months to starve someone, there are dozens of points where intervention could have occurred — by neighbours, GPs, support coordinators, or NDIA staff. When no one acts, that is not just personal failure, it is systemic failure.

Structural Violence: Beyond the Scapegoat

The article draws on Johan Galtung’s concept of structural violence to argue that starvation is not just about a single bad carer. We do ourselves no favours by scapegoating one individual and calling the case closed. Structural violence is harm that is baked into the architecture of society: how resources are distributed, who is surveilled and who is forgotten, who has the power to decide what support is “reasonable and necessary.”

In Smith’s case, the Royal Commission found that she “fell between the gaps of shared responsibility” between multiple agencies. This is classic diffusion of accountability. And it is not unique — coronial reports and safeguarding reviews repeatedly show the same problem.

Structural violence is harder to confront than individual cruelty because it requires us to change systems, not just punish perpetrators. But unless we do, we will continue to see new names added to the list.

Biopolitics: Who Gets to Live

Foucault’s concept of biopolitics is particularly apt for the Australian context. The state decides which lives are supported to “make live” and which lives are left to “let die.” This logic is visible in NDIS eligibility rules, funding rationing, and service deserts.

When the NDIA withdraws funding for essential supports because of budget targets, when a provider closes a service because it is “not financially viable,” when reviews take months while someone goes without food preparation support — those are not neutral administrative acts. They are exercises of biopolitical power that increase the risk of death for some Australians more than others.

Reform here means more than patching holes. It means legislating positive duties on agencies and providers to act when someone’s life is at risk — not merely when it is administratively convenient.

Disability’s Deathly Status: The Problem of Grievability

Perhaps the most confronting section of the article is its discussion of disability’s deathly status. Drawing on Agamben’s idea of “bare life,” the authors argue that disabled people are often treated as socially dead before they actually die. Their deaths provoke less outrage, their lives are framed as burdens, and their survival is seen as optional.

This framing is reinforced by media coverage that describes caring as “thankless” or “too hard,” and by court proceedings that highlight the “stress” on perpetrators more than the suffering of victims. This is why sentences for neglect often feel shockingly light: the victim is not seen as fully grievable.

Changing this means re-centring the humanity and value of disabled lives in public discourse. It means refusing to let “better dead than disabled” narratives go unchallenged. And it means insisting that every death in care is a scandal — not just a sad story.

Slow Violence and the Need for Visibility

Rob Nixon’s concept of slow violence is another powerful lens. Starvation is slow violence par excellence: it is incremental, hidden, almost mundane. Because it happens in private homes or group homes, it is easy for the rest of society not to see.

This makes regular monitoring and visibility checks critical. It is unacceptable that someone can go unseen for months while receiving public funding for care. Safeguarding reforms must include mandated in-person checks for participants with high support needs and public reporting of missed visits by providers.

Crip Utopias: Imagining Better Futures

Despite the bleakness of the topic, the article does not end in despair. Instead, it turns to crip utopias — futures grounded in interdependence, shared vulnerability, and care as a collective responsibility.

For Australia, this means moving away from the obsession with “independence” as the ultimate outcome measure and instead valuing connection, dignity, and belonging. It means funding cooperative living arrangements, peer-led initiatives, and culturally safe care models that prevent isolation. And it means co-designing reforms with disabled people from the start, not bringing them in as decorative afterthoughts.

From Theory to Policy

Applying these theories to Australia gives us a roadmap for action:

• Legislate a duty to protect life: Mandate safeguarding laws that compel agencies to intervene when the risk of starvation is identified.
• Name starvation explicitly: Update incident categories and death reviews to record starvation as a distinct form of violence.
• Close the gaps: End the fragmentation of responsibility by introducing clear escalation protocols across providers, NDIA, and health services.
• Resource monitoring: Fund regular visibility checks and nutritional assessments, with penalties for providers who fail to make contact.
• Shift the narrative: Launch public campaigns affirming that disabled lives are valuable and grievable.
• Invest in interdependence: Build systems that reward stable relationships, long-term care continuity, and community connection.

Conclusion: We Cannot Look Away

Starvation deaths are not inexplicable. They are horrifying, but they are also predictable — and preventable. Each case is a mirror held up to our systems, showing us where we have chosen not to see, not to act.

Thorneycroft, Cook, and Asquith remind us that these are not isolated failures but symptoms of a deeper design problem. If we want to stop adding names to the list, we must be brave enough to change the design.

Australia is at a crossroads: with the NDIS Review recommendations on the table, with safeguarding reforms in motion, with disability rights at the centre of public debate. The question is whether we will seize this moment to make starvation unthinkable — or whether we will wait until the next name shocks us, briefly, before we look away again.