Queensland MPs missed an opportunity to minimise the risks in their euthanasia law

It is outrageous that Queensland politicians have ignored peak medical bodies, including the Australian Medical Association, which lobbied against the euthanasia law (“Vote raises pressure on euthanasia”, 17/9).

Life-saving amendments to minimise wrongful deaths through misdiagnosis and incorrect prognosis were rejected. Amazingly, the new law does not require diagnosis of a terminal illness and a prognosis of less than 12 months to be made by a specialist in the patient’s condition – two junior GPs will do.

The Queensland law allows euthanasia to occur 12 months from the forecast date of death, whereas the four other states that have legalised this have wisely put the time limit at six months out because evidence shows that doctors are better at predicting if you will live less than six months but are very poor at predicting whether you will live less than 12 months.

The fact the new law does not require a mental health check to ensure that a patient requesting euthanasia is of sound mind and not suffering from treatable depression will mean even more wrongful deaths.

There also are no protections in the new law against coercion and elder abuse.

Dr Belinda Goodwin, Wynnum, Qld

The Commentary piece by Frank Brennan (“Three ways Queensland’s assisted dying bill goes too far”, 16/9) on the voluntary assisted dying legislation warrants challenging in a number of areas. The inability of Victorian doctors to raise VAD as an end-of-life option (among other options) is seen by many of us involved in patients with incurable, advanced, terminal disease as an impediment to honest and open discussions at this crucial stage of life.

Western Australia’s VAD laws, now in practice, also permit discussion of VAD as long as palliative care options are also explored. In Victoria, and in overseas jurisdictions, 80 to 90 per cent of patients who are approved for VAD are involved with a palliative care service. It is just fantasy to suspect that “evangelising health practitioners” will be rolling up to “ageing, sick people” – the median age of VAD patients in Victoria is 73 – to enlist them in a VAD program.

Brennan’s comments about conscientious objection need to be further debated. Under Victorian abortion laws, doctors with moral or religious objections to this procedure are obliged to refer the patient, not necessarily “to another doctor prepared to perform the abortion”, as Brennan asserts, but to another practitioner who is prepared to talk openly about the patient’s choice and refer on as appropriate.

The same, in my opinion, should apply with doctors with a conscientious objection to VAD. Referring to another health professional, who is confident and knowledgeable, for further discussions about VAD should not be construed as being complicit with the “action” of VAD.

Finally, his statement, “There are no reported problems in Victoria” with respect to Catholic aged-care facilities and VAD is just plain wrong. Members of our Victorian VAD doctors’ community of practice can recount numerous examples of how patients’ access to this legal medical process has been impeded by rigid thinking and unnecessary transfers when the patient is extremely unwell. Remember, for these elderly folk in aged care, that is their home and should be respected as such.

Dr Greg Mewett, palliative care physician, Ballarat, Vic

O Henry!

I was devastated to read Henry Ergas supporting vaccine passports, and shattered that he thinks true libertarians can support them (17/9). But then I realised he’s an economist, not a medical expert. And as he would be the first to admit, it all depends on the assumptions. Some of his are just plain wrong.

The data clearly shows that vaccines protect against serious illness and death. Ergas’s tort analogy simply does not apply – no harm is imposed on the vaccin­ated by the unvaccinated. As he concedes, both can carry and shed the virus.

All of us, including the vulnerable, are likely to be periodically exposed to the virus. That can’t be changed by placing limits on the unvaccinated; the solution is to get vaccinated.

No vaccine is 100 per cent guaranteed, though. If you are exposed to the virus before immunity develops, you might still get sick. If the vaccine was mishandled before administration, it won’t work. The immune system of a few individuals does not respond. But the risk to people in these categories is also not reduced by placing limits on the unvaccinated.

Finally, herd immunity is unlikely to ever occur with this virus because those who are immune can continue to carry it. Thus the whole free rider argument is irrelevant.

I enjoy reading Henry more when he sticks to economics.

David Leyonhjelm, Drummoyne, NSW