Push for med school VAD training to lift doctor voluntary euthanasia involvement

Student doctors would receive training in voluntary assisted dying as part of their university degrees under new plans.

Victorian emergency doctor Dr Stephen Parnis has serious concerns about proposals to include VAD training for doctors in medical degrees.

Student doctors would receive training in voluntary assisted dying as part of their university degrees under plans to tackle a shortage of medicos participating in state VAD systems.

The proposal is being discussed in multiple jurisdictions amid concerns a shortage of VAD-trained doctors in some areas is preventing greater uptake of voluntary euthanasia, particularly in Tasmania and Victoria.

In Tasmania, only a “handful” of doctors have done the required VAD training, amid a severe statewide GP shortage.

The architect of that state’s VAD laws, upper house MP Mike Gaffney, has approached the University of Tasmania’s Medical School about including part or all of the official VAD training in medical degrees.

Dying with Dignity revealed South Australia’s Health Department had started discussions with universities in that state along similar lines. In Victoria, the group said VAD-practising doctors had been invited to address medical students.

On November 28, NSW will become the last state to have an operating VAD system, and Dying With Dignity said the inclusion of VAD training in medical degrees should be considered by universities in all states.

“It took so many decades to get these laws passed and so to have a situation where someone is facing a terrible end and just can’t find a doctor because of the small number (trained) that is really devastating,” said Shayne Higson, DWD NSW chief executive.

“The easier we can make it for doctors, in all the states, the better. An increase in the supply of doctors willing to participate will benefit every state. They’ll all have to look at it.”

Shayne Higson is an advocate of assisted dying. Picture: Sam Ruttyn

While some jurisdictions imposed minimum years of service requirements on doctors wanting to participate in VAD, graduate training would still be beneficial, Ms Higson said.

“It would still be worthwhile because they then would only need to do a refresher course,” she said. “Every jurisdiction would agree that they could do with more (VAD trained) doctors.

“In Victoria, there definitely are people who are passing away before they get through the (VAD) process and a lot of that has to do with getting access to doctors who will participate.

“So if training was included in university courses it would benefit people’s end of life choice.”

Mr Gaffney said it “made sense” for medical students to complete at least some of the VAD training and he had a meeting scheduled with UTAS next week to discuss the idea.

“If they do the modules they only have to decide whether they want to be involved or not,” he said. “To me, the modules are base learning anyway … all about how to appropriately speak to somebody who’s in a dire situation. There are modules based on the legislative requirements that they possibly wouldn’t do to start with, but all the other stuff about reassuring patients and assessment would be part of the deal.”

Mr Gaffney said all medical students in Belgium completed VAD training. The Australian Medical Association said it did not have a position on the issue, but including VAD training in medical degrees faces opposition within the profession.

Victorian emergency physician and former AMA national vice-president Stephen Parnis expressed “serious” concern about the “distressing” push.

“If the vast majority of the medical profession are unwilling to participate – which remains the case – then I think the zealots who push this like a craze need to think about why that might be, rather than think about involvement (of) people at the most junior stages of their careers,” Dr Parnis said.

“In the race to bring this to its availability, many people have I think suspended their ability to critically appraise this.”

He was concerned about the adequacy of VAD training designed to meet state legislative requirements. “While other areas of healthcare do things with online modules and do it yourself packs, I remain fundamentally concerned that people can qualify to do this on the basis of a few hours in front of a computer,” Dr Parnis said.

UTAS and SA Health did not respond by deadline.