This was published 6 months ago
Cherryl Barassi’s doctor says he should be allowed to raise assisted dying with patients
Melbourne doctors have backed calls to overhaul Victoria’s assisted dying laws, arguing it’s time for the state to be brought into line with others that have implemented more lenient rules since following in the footsteps of the Andrews government.
But not everyone agrees, including an emergency physician and the state’s opposition leader, who expressed concern about the erosion of important safeguards in place since June 2019.
The renewed debate comes after Cherryl Barassi, the widow of AFL great Ron Barassi, spoke to The Age about not qualifying for help under the current framework.
St Kilda GP Dr Nick Carr has now chosen to identify himself as Barassi’s doctor – with her permission – and publicly back his patient’s call for Victoria to become an example of best practice.
Carr said Victoria’s so-called gag clause, which prevents doctors from broaching the topic of voluntary assisted dying unless the conversation is initiated by the patient, needed to be scrapped.
“A Victorian doctor cannot inform someone about voluntary assisted dying unless asked, which is fine if you’re a highly educated English-speaking person,” Carr said.
“But someone else … might not be aware it’s available. Voluntary assisted dying is a medically valid procedure and we should be able to tell people that it’s an option.”
Western Australia’s assisted dying scheme came into effect two years after Victoria’s and has no such prohibition on doctor-initiated discussions.
Between 2022 and 2023, 0.65 per cent of all registered deaths in Victoria were linked to voluntary assisted dying. This is almost half the rate of Western Australia during that scheme’s first year of operation, according to the Voluntary Assisted Dying Review Board’s latest publicly available annual report.
“While it is not possible to be definitive about the reasons for this difference, the fact that health practitioners in WA are not prohibited from initiating discussions about voluntary assisted dying provided that they provide advice on all other options for treatment, may explain a higher access rate in the initial implementation period than experienced in Victoria,” the annual report states.
The so-called gag clause is not the only part of Victoria’s framework that some doctors want rewritten.
Elsternwick’s Dr Harley Powell, from Doctors for Assisted Dying Choice, said Victoria should follow the ACT and drop the six-month life expectancy rule for non-neurodegenerative diseases.
“That would be a big change,” Powell said. “It would help people with progressive diseases that are going to cause death in a more distant time in the future.”
Carr agrees: “The reality is we doctors are hopeless at prognoses.”
The doubters
But emergency physician and former Australian Medical Association president Dr Stephen Parnis said he had strong reservations, particularly for patients vulnerable to exploitation by family members.
“The stakes are clearly so high that, if we get this wrong, then we have a wrongful death,” Parnis said.
“There is so much attention on the practice of assisted dying that it has, I think, undermined and delayed improvement in the provision of palliative care – which should be more available and understood by the wider population. That can help so many more people.”
Asked about Barassi’s plight on Tuesday, Victorian Opposition Leader John Pesutto said he believed assisted dying laws should stay as they are.
“One of the challenges you face is that once you start to undo the safeguards that are in place, where does it end? It can’t just be a system that’s allowed to unravel.”
The upcoming campaign
Dying with Dignity board member Michelle Hindson said her organisation would bring forward a social media campaign and lobby MPs in the wake of Barassi telling her story.
“Dying with Dignity Victoria is turning 50 this month, which is also the five-year anniversary of the act. So we will be highlighting what we think are the most important areas the government needs to address to make the legislation fair,” she said.
Victoria is due to publish the findings of a review into its scheme later this year. However, those who support an expansion of current laws are concerned the review will focus only on the operation of those laws, and not the act itself – leaving little or no room for a legislative overhaul.
Health Minister Mary-Anne Thomas said on Tuesday that community members were consulted as part of the review.
“By speaking with those involved in voluntary assisted dying, this operational review will allow us to look at how the law has been implemented and consider ways to make the existing system work even better for those who need it,” she said.
“This statutory review of the voluntary assisted dying laws will consider how the laws have been implemented and whether they are operating as intended.”
Greens MP Sarah Mansfield, a doctor before entering parliament, said Victoria was once a leader in this area but now lagged other states and territories.
“There is an urgent need for greater discussion about broadening eligibility to include more conditions so that those people who have fallen through the cracks aren’t forced to suffer.”
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