Euthanasia Bill: How voluntary assisted dying would work in SA

Voluntary euthanasia has now been legalised in South Australia – but how will it work? Three different assessments, medicine delivered in a locked box – this is the process.

South Australia has now become the fourth state to legalise voluntary euthanasia.

The Voluntary Assisted Dying Bill passed the House of Assembly on Thursday morning.

The laws are expected to come into effect in 18 months – but how will it work?

The Advertiser spoke with Melbourne-based VAD-trained oncologist Dr Phillip Parente. The Monash University Associate Professor has been providing VAD assessment since March 2020.

Several of the specialist’s oncologist patients were among 224 Victorians who have died using VAD in the law’s first 18 months.

Dr Parente, who once opposed VAD based on his Catholic beliefs, said all of his patients to date had self-administered the VAD medication after a thorough and rigorous application process that takes no fewer than nine days, and on average 19 days, to complete

“They must have capacity to administer the medication on their own, unassisted,” he said. Patients unable to swallow or too weak to self-administer can apply for intravenous practitioner administration.

Supplied Editorial Fwd: can you upload and link to VAD story in today's plan? Didge xx

The first step, he said, was a patient initiating interest in or requesting VAD.

“We cannot initiate that conversation, nor can family – it has to come from the patients.”

Once the VAD legislation and process is explained, with an interpreter if required, the treating doctor can accept or deny the patient’s VAD request.

Three phases before permission to die

If accepted, the first of a three-phase process begins involving the treating or lead practitioner.

“The lead practitioner needs to assess whether the patient meets eligibility criteria, like residency, having full decision making capacity, is deciding voluntarily and without coercion, has a terminal illness and a life expectancy of six month or less, or a progressive neurological illness with a life expectancy less than 12 months.”

A second medical practitioner is then appointed to crosscheck the eligibility criteria and safeguards and then, if approved, both doctors, the dying patient, their appointed contact person and two independent witnesses sign a written declaration for the final step of approval.

Based on the information provided by the assessing doctors, a decision to issue the VAD permit will be given in by the Chief Executive of the Health Department (in SA).

How the medication is delivered

Once approved, the treating practitioner will write a script and it is then up to the patient as to whether or when they use it.

The medication is delivered to the dying patient in a locked box by two pharmacists. The medication comes in powdered form and is mixed on site into a liquid by the dying patient or their contact person before administration.

A crowd on the steps for Parliament House holding a vigil for the Voluntary Assisted Dying vote last month. Picture: Tom Huntley

The pharmacists will check again for capacity and coercion and provide written and verbal instructions to the patient on preparing and taking the medication.

Death can occur from a few minutes up to two hours after administering the medications and involves the patient becoming unconscious.

Details of the exact medications used are not made public, and the patient or their nominated contact person must return unused medication within two weeks of it being supplied.

Originally published as Euthanasia Bill: How voluntary assisted dying would work in SA