Active as of today, the Voluntary Assisted Dying Act establishes a regime for Victorians to get medical assistance to end their lives.
The legislation passed in November 2017 and implemented over 18 months, during which an extensive education program and liaison with stakeholders took place to ensure that the system operates as intended.
To be eligible to access voluntary assisted dying (VAD) a person must be over the age of 18, an Australian citizen and ordinarily resident in Victoria. They must have:
- decision making capacity
- be diagnosed with an incurable, advanced, progressive, fatal medical condition that is expected to cause their death in no more than six months
- it is 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 VAD must complete special training and be a medical specialist or vocationally registered general practitioner. It is understood that about 100 doctors have so far completed the training, but expected that more doctors will follow as they receive requests for assistance from their patients.
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 VAD freely and without duress. The Act permits doctors to decline a request for assistance on the grounds that they have a conscientious objection to VAD.
The decision about whether to approve a request for VAD 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 VAD substance. They can self-administer the substance or have it administered by a medical practitioner, if they are unable to self-administer or have a condition that prevents them absorbing oral medications. The VAD substance will be dispensed by a state wide pharmacy located at the Alfred Hospital. If the patient cannot collect the substance a pharmacist will deliver it to them.
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.
What does this mean?
Experience overseas shows that between 20-30 per cent of people who apply for VAD 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 VAD if their pain becomes unbearable is a comfort in the terminal phase of their illness.
It is expected that there will soon be a number of applications from terminally ill people who have been waiting for the system to become active, but the overall number of Victorians accessing VAD is likely to be low.
If we can be of assistance in explaining this new law, please contact Paula Shelton on (03) 9321 9764.