Denied access to euthanasia, they took their own lives. A coroner hopes their despair will not go unheeded

A coroner has asked those scrutinising the state’s voluntary assisted dying program to consider the suicide deaths of eight Victorians – and possibly a ninth – after all were knocked back from accessing the scheme.

The move has given hope to some assisted dying advocates, who have for months urged Victoria to follow in the footsteps of the ACT and drop the six-month life expectancy rule for non-neurodegenerative diseases.

A Victorian coroner has asked the state’s Voluntary Assisted Dying Review Board to consider several suicides by people who were ruled ineligible for the scheme.Credit: Getty Images

Coroner Simon McGregor recently reviewed cases in which people had died by suicide after failing to meet the strict eligibility requirements for voluntary assisted dying. He did this while investigating the September 2023 death of Windsor man Geoffrey McConachy.

McConachy’s body was found in his home by one of his sons and a family friend seven years to the day after his wife of 56 years had died.

The 82-year-old had suffered a stroke a year prior which left his speech profoundly affected and contributed to him developing a serious depressive illness. The coroner said McConachy, who was found to have died by suicide, lost interest in life and no longer wanted to go for walks, play backgammon or do other things he had previously enjoyed.

He had subsequently asked one of his sons to obtain a pamphlet for him on voluntary assisted dying.

The coroner found that while McConachy had a “greatly reduced quality of life”, all available evidence would suggest he was not eligible for voluntary assisted dying because he did not have a terminal prognosis.

Under Victorian law, voluntary assisted dying is accessible to those who are suffering from an incurable disease, are experiencing intolerable suffering and are expected to die within six months (or 12 months in the case of neurodegenerative conditions). The person must also be fully cognisant of their decision, an Australian citizen and a resident of Victoria.

The coroner’s review found nine similar cases in which the deceased had tried to access voluntary assisted dying but was not eligible. Of those, eight were found to have taken their own life and in the ninth case, the coroner was unable to determine the deceased’s intent, but suicide was a possibility.

While McGregor did not make recommendations regarding the cases he reviewed, he did refer his findings to the Voluntary Assisted Dying Review Board.

“A recurring theme throughout many of these deaths was the impact that voluntary assisted dying refusal had on the deceased,” he wrote. “Family members often reported that when people believed they would have access to voluntary assisted dying they maintained hope that they would be able to exercise control over how they died; when their access to voluntary assisted dying was refused, their consequent despair and frustration contributed to their decision to take their own life.

“I would ask the Voluntary Assisted Dying Review Board to remain open to considering this finding as part of a developing body of evidence about where there may be opportunities to improve the operation of voluntary assisted dying in the state.”

Dr Nick Carr, who backs an expansion of Victoria’s assisted dying laws, said he was hopeful that the findings would bring about legislative change. Carr added that a former patient was among the deaths reviewed by McGregor.

“He was a British citizen and had lived here 42 years,” the St Kilda GP said. “He had pancreatic cancer and was one of the first applications for voluntary assisted dying and was deemed ineligible because he was not an Australian citizen.

“He voted here, he had an Australian pension, he paid his taxes – so he was an Australian in every sense except he had not formally taken out an Australian citizenship.

“It was absolutely appalling. Not many cases leave me sitting at my desk crying, but that one did. Victorian law was, of course, a vanguard. But it is now a laggard.”

In 2017, Victoria became the first state in Australia to pass voluntary assisted dying laws, The scheme coming into effect in June 2019. But euthanasia advocates say the state’s laws are now among the most conservative in the country.

Proponents want the so-called gag clause, which prevents doctors from broaching the topic of voluntary assisted dying unless the conversation is initiated by the patient, to be scrapped. Western Australia’s assisted dying scheme came into effect two years after Victoria’s and has no such prohibition on doctor-initiated discussions.

Another element advocates want re-examined is the six-month life expectancy rule for non-neurodegenerative diseases, given prognoses can vary – sometimes significantly – doctor to doctor.

But not every doctor is onboard, with one emergency physician previously telling The Age that the current regime provided strong safeguards against wrongful deaths.

Monash University professor of medicine Paul Komesaroff, who supports removal of the so-called gag clause, said there should be another public debate before any legislative change.

“The appetite for change isn’t there with this government. But it is necessary and appropriate to be careful.”

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