By Michael Cook
Euthanasia and assisted suicide became legal in the Australian state of Victoria on Wednesday. A bill authorizing “assisted dying” was passed by the State Parliament in November 2017; it took 18 months to set up the regulatory and administrative framework.
The first death under the law could occur in the next few days.
Health Minister Jenny Mikakos describes the law as “the safest and most conservative in the world”. She said that its 68 safeguards include the following:
Only adults with decision-making capacity, who are suffering and have an incurable, advanced and progressive disease, illness or medical condition that is likely to cause death within six months (or 12 months for people with neurodegenerative conditions) can access the scheme.
A person may only access voluntary assisted dying if they make three clear requests and have two independent medical assessments that determine they are eligible.
The request must always be initiated by the person themselves, with health practitioners who are treating the person and raise the issue subject to unprofessional conduct investigations.
A Voluntary Assisted Dying Review Board will review every case retrospectively.
About 100 doctors including GPs, cancer specialists and palliative care clinicians are doing mandatory online training in “voluntary assisted dying”.
A pharmacy service at Melbourne’s Prince Alfred Hospital is the sole service for dispensing lethal medications in the state. For people too sick to travel, the pharmacy service will deliver them their medication and provide information on administration – and then collect any unused medication.
The death certificate will record the underlying medical condition as the cause of death (Section 119).
This is not Australia’s first experience of assisted suicide. It was legal for a few months between 1996 and 1997 in the sparsely populated Northern Territory. But following a national backlash the Federal Parliament used its constitutional power to override the legislation. Victoria, however, is a state and Canberra has no power to quash the law.
Critics highlight what they regard as problems with the legislation:
John Keown, of Georgetown University, and author of a 2018 book, Euthanasia, Ethics and Public Policy: An Argument against Legalisation, warned that Victoria could be at the top of a slippery slope, notwithstanding the protestations of the government. “Quite frankly, any legislators who think they can avoid the slippery slope have learned little from other jurisdictions.”
And Xavier Symons, deputy editor of BioEdge, wrote in a Sydney Morning Herald op-ed that “The image of patients writhing in pain, which bolsters the case put forward by euthanasia supporters, is simply inaccurate. The typical patient who requests euthanasia is a well-palliated, white patient who feels that life has lost its purpose; or such patients have lost the ability to be the author of the final chapters of their own existence.”
“The word ‘dignity’ is bandied about here, as if dignity at the end of life hasn’t existed until this day,” commented Stephen Parnis, a former Australian Medical Association vice-president. “I’ve assisted thousands of people at the end of their life over 27 years of medical practice. Dignity does not require a lethal potion. Other states in Australia should be in no hurry to take this on. I think this legislation and the way it operates should be subject to enormous scrutiny.”
Catholic institutions are an important part of healthcare and aged care in Victoria. The state’s bishops issued a statement decrying the new law. However, hospitals and nursing homes will not block people from accessing will not cooperate with the new law.
“While we will not be providing voluntary assisted dying, we know our facilities are operating in an environment where patients or residents may wish to explore this option,” the Catholic Health Australia chief executive, Suzanne Greenwood, said. “If people in our care wish to access voluntary assisted dying from other providers, our services will not impede them. We will provide release from care as well as transfer if they wish to access services elsewhere.”
Michael Cook is editor of BioEdge where this appeared.