Federal roadblock looms for euthanasia drugs

The federal government would reject any request by Victoria for legislation that might be needed to approve lethal drugs.

Health Minister Greg Hunt

The federal government would reject any request by Victoria for legislation that might be needed to approve the use of lethal drugs should a controversial bill to allow the country’s first euthanasia laws pass the state’s upper house.

Health Minister Greg Hunt says the federal government would not legislate to “facilitate” specific euthanasia drugs, which at present would be unlikely to gain approval from the federal regulatory body, the Therapeutic Goods Administration.

“This is a matter for the states to determine under the Constitution,” Mr Hunt said.

“There appears to be considerable uncertainty as to what pathway it would follow if (this bill) is passed. But the commonwealth will not be seeking to change laws to either facilitate or thwart any matters before the TGA, which will follow the usual process.”

As opponents of the euthanasia laws ramped up the campaign against the bill, the Australian Medical Association also warned that the most common drugs used for assisted deaths were not licensed in Australia and that the independence of the TGA must be assured.

The response from the Turnbull government comes after Victorian Health Minister Jill Hennessy last week appeared not to rule out the potential for Victoria to require federal approval for the use of banned pharmaceuticals.

But Ms Hennessy’s office yesterday suggested the Victorian government would go around any federal laws with the likely use of a “cocktail” of different drugs that individually already had TGA approval.

A spokesperson for Ms Hennessy said the implementation panel would ultimately decide what the mechanism would be, in a process to take 18 months.

“(But) what we expect is that we will likely use a cocktail of drugs already approved by the TGA,” the spokesperson said. “This will be decided by pharmacologists, not by politicians.”

A senior Health Department source said if the bill was passed, it was most likely that doctors would seek to prescribe existing TGA- approved medicines “off-label” in combination with other medicines and probably at doses exceeding those in the TGA indications.

This presented a “medico-legal” issue for doctors, who would need to be confident they were acting within the law, in the best interests of patients, and within the scope of their medical practice.

AMA federal president Michael Gannon said that, similar to its position on medicinal cannabis and codeine, his organisation supported the independence of the TGA. “We would not lobby Greg Hunt to block any laws … yet we would ask the TGA to very carefully consider the potential risks of any substance, and the risk of diversion into the community,” Dr Gannon said.

“I derive no reassurance from the oft-repeated line that there are 68 safeguards … and for the minister to talk about a ‘cocktail’ of drugs gives me no comfort at all.”

The Pharmacy Guild of Australia confirmed some members had already expressed concern about the consequences of the bill.

Guild executive director David Quilty said it was unclear what the repercussions for pharmacists might be. Pharmacists took their role in the health system “very seriously” and put patients’ welfare first, Mr Quilty said. “I’d envisage that if these laws come into being … and should the Victorian Government seek to facilitate these outcomes, we would want to be having some very significant discussions with them.”

Mr Hunt last week told an AMA dinner he took a very “conservative” view on the issue and had concerns about the social impacts. “At a personal level …. while I respect the views of everyone … I would exercise my conscience to vote no,” Mr Hunt told The Australian. “This is on the basis that it in my view this would represent a pathway to a changed relationship between our seniors and our community and create a risk of subtle but real pressure on older Australians.”

Victorian opposition education spokesman Tim Smith warned Victoria would “become the death tourism capital of Australia” if it passed the upper house. “Given the bill only stipulates that a patient be resident in Victoria, that will only require them to lease a property, albeit briefly, to satisfy the ‘resident in Victoria’ requirement.”

Victorian federal MP and assistant treasurer Michael Sukkar described the bill as “one of the most terrifying pieces of public policy Australia has ever seen”.

“There’s no restriction on doctor shopping, like a Dr Kevorkian, who’ll freely approve the killing,” Mr Sukkar said. “And once the lethal concoction of drugs is dispensed, the patient is on their own ... can just imagine the grisly sights that await us when people administer the drugs incorrectly, as will certainly occur.”