NT expert advisory panel releases Voluntary Assisted Dying recommendations, including Aussie first proposal

An expert panel has recommended that anyone living a life of “intolerable suffering” should be able to access a future Territory Voluntary Assisted Dying scheme, regardless of their citizenship.

Following 14-months of consultation the NT independent expert advisory panel on Voluntary Assisted Dying (VAD) released its 132-page report on Wednesday. Picture: Sarah Reed

Territorians living a life of “intolerable suffering” could soon be able to die with dignity as an expert panel reveals their recommendations for a future voluntary assisted dying scheme.

Following 14 months of consultation the independent expert advisory panel on Voluntary Assisted Dying (VAD) released its 132-page report on Wednesday, advocating for patients over 18 with a “serious and incurable condition that is causing intolerable suffering” to be able to access life-ending care.

Currently Territorians are the only Australians who are denied the right to die.

The report said a terminal patient with 12 months left to live should be able to access a single, centralised service for the delivery of VAD, separate from existing NT Health facilities.

After passing two medical assessments the terminal patient could make a formal written request to access VAD treatment.

The report said patients should have the choice between having a health practitioner administer the lethal substance, or self-administering — including outside a clinical setting within their own home.

It said while doctors and nurses could conscientiously object to participating, they were not allowed to block their patients from accessing information or VAD consultations.

Controversially the report said those diagnosed with dementia would not be able to access the life-ending treatment.

Many Territorians shared their heartbreaking personal stories of watching their elders fade away due to the cognitive decline, turning into a “vegetable” or a “‘baby who never grows up”.

The panel’s survey of 1396 Territorians found 71 per cent believed that those diagnosed with conditions like dementia should be able to express their wish to die with dignity through an advance personal plan before they lost the “capacity to make that decision themselves”.

Report co-chairs Vicki O’Halloran and Duncan McConnel said this should be a future consideration — however it was not a formal recommendation in Wednesday’s report.

Independent expert advisory panel on Voluntary Assisted Dying co-chair Vicki O'Halloran. Picture: Glenn Campbell

Independent expert advisory panel on Voluntary Assisted Dying co-chair Duncan McConnel SC.

However the expert panel said those with a mental illness “secondary” to a terminal illness could still access the scheme as long as they maintained their decision making capacity.

In what would be an Australian-first, the expert group did not push for citizenship requirements to be part of the Territory’s VAD scheme.

It said given the NT was the last to legislate there should be no restrictions on residency other than patients had to live in Australia for two years and in the Territory for 12 months, with exemptions for cross-border communities and those with family, cultural or support networks in the Territory.

During a public consultation session in March, some highlighted that the removal of these citizenship requirements could open up the Territory to “death tourism”, with terminally ill patients travelling internationally to access the NT VAD scheme.

Former Chief Minister Marshall Perron, who introduced the Rights of the Terminally Ill Bill in 1995, made a submission to the VAD report.

The report also highlighted ethical debates over whether someone who was in “intolerable suffering” but with a predicted life expectancy beyond 12 months — or no time frame at all for death — should be able to access VAD.

Former Chief Minister Marshall Perron, who introduced the Rights of the Terminally Ill Bill in 1995, told the expert panel that allowing VAD for those who “suffer unbearably from incurable disease but are not terminal, is based on the principles of autonomy, dignity and compassion”.

However, the final recommendation landed on a 12-month life expectancy window in line with the Queensland legislation.

The report also highlighted the need to consult with Aboriginal communities to develop a culturally safe VAD framework, including provisions for interpreters and consideration of kinship and family decision making frameworks.

“The role of family, including important responsibilities and rights, was said to be of vital cultural importance, including for ensuring the safe passage of the person into the afterlife,” it said.

It recommended that family or culturally significant decision makers could act as a witness to formal requests to access VAD treatment.

The expert panel said to safeguard against coercion or abuse, the legislation could include a requirement for at least one other independent witness.

The Territory panel also recommended provisions for telehealth within some of the VAD consultation process — despite the practice currently being illegal due to 2005 federal anti-cyber-bullying laws which criminalised “disseminating ‘suicide-related materials”.

Finally the report emphasised the need for an independent statutory board to monitor compliance in every case, while suggesting a system-wide review after the first three years followed by regular five-year reviews.

It said the VAD service should be operational within 18 months of legislation being passed.