Explaining voluntary assisted dying legislation

Monday 19 November 2018
Paula Shelton

Legalising voluntary euthanasia has always been a controversial issue with passionate advocates on both sides of the debate. Although political parties have been reluctant to address the issue for fear of a backlash from interest groups, research shows that Victorians overwhelming support medical assistance to die in limited circumstances.

The Voluntary Assisted Dying Act establishes a regime for Victorians to get medical assistance to end their lives. The system commences on 19 June 2019.

To be eligible to access voluntary assisted dying a person must be over the age of 18, an Australian citizen and ordinarily resident in Victoria. They must have decision making capacity and be diagnosed with an incurable, advanced, progressive, fatal medical condition that is expected to cause death their death in no more than six months. It must also be causing suffering that cannot be relieved.

In the case of neuro-generative disorders, such as Huntington’s Disease, the condition must be expected to be fatal within 12 months. Mental illnesses are excluded from the regime.

Medical practitioners who wish to assist patients with voluntary assisted dying must complete special training and be a medical specialist or vocationally registered general practitioner.

The system requires a patient to be reviewed by two doctors, one of whom must be a specialist in the relevant area. Both doctors must certify that the patient meets the criteria, including that they have decision making capacity and are making the decision to access voluntary assisted dying freely and without duress. The Act permits doctors to decline a request for assistance on the grounds that they have a conscientious objection to voluntary assisted dying.

The decision about whether to approve a request for voluntary assisted dying is made by the Secretary of the Department of Health & Human Services and the process is overseen by an independent Voluntary Assisted Dying Review Board.

If the request is approved the patient will be issued a permit that allows them to be dispensed the voluntary assisted dying substance. They can self-administer the substance or have it administered by a medical practitioner. Experience overseas shows that between 20-30% of people who apply for voluntary assisted dying do not use it, hopefully because good palliative care is effective in relieving their pain and distress. Patients report, however, that knowing they have the option of voluntary assisted dying if their pain becomes unbearable is a comfort in the terminal phase of their illness.

The Act makes it an offence to administer the substance outside the parameters of the permit or to another person. Substantial penalties apply to any breaches.

Some religious and other groups remain vehemently opposed to voluntary assisted dying and it is possible that legal challenges will be made to the Act or the operation of the voluntary assisted dying system. Others critics say that the Act does not go far enough, as it excludes people with long term severe conditions whose condition is not expected to be fatal within six months, such as quadriplegics. Other concerns include that by the time people with neuro-degenerative conditions have a life expectancy of 12 months they will very likely not have decision making capacity and be unable to consent to voluntary assisted dying.

It is uncertain how many Victorians will seek to access voluntary assisted dying, but the system will be closely monitored and regularly reviewed.

If we can be of assistance in explaining this new law, please call Paula Shelton on (03) 9321 9764.

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