Euthanasia advocates slam state review for ruling out expansion

A review of Victoria’s voluntary assisted dying laws has ruled out expanding the scheme to people with dementia and letting doctors initiate conversations about euthanasia with the terminally ill.

A mandated five-year review of the law is underway, but the Health Department says it will “not consider changes to the legislation”.

Voluntary assisted dying is considered suicide under law, the Federal Court has ruled.Credit: Getty

The review, which has been slammed by euthanasia advocates, will instead focus on how the existing voluntary assisted dying (VAD) legislation is operating.

Senior medicine and law academics wrote to Victorian Health Minister Mary-Anne Thomas this week to express their concerns about the limited scope of the review.

“It is our view that to limit the review of the VAD system in this manner – that is, to exclude or prevent a review of the legislation itself – is mistaken and fails to discharge either the requirements of the legislation or the expectations of the community,” wrote Monash University’s Paul Komesaroff and Sydney University Professors Ian Kerridge and Cameron Stewart.

Komesaroff said while he thought the scheme had been successful, some aspects of it were cumbersome, restrictive and not fit for purpose.

He highlighted a clause – which was introduced as a safeguard to prevent coercion – that makes it illegal for doctors to start a conversation about voluntary assisted dying with terminally ill patients.

“The way it operates at the moment is universally regarded as being too restrictive,” he said.

“It obstructs conversations between professional carers and patients who are seeking information.”

Submissions to the review close later this month, with the findings to be tabled in parliament later this year.

St Kilda GP Dr Nick Carr is disappointed by the limited scope of the Health Department’s review into the state’s voluntary assisted dying laws.Credit: Joe Armao

Dr Nick Carr, who is one of the state’s most active prescribers of voluntary assisted dying medication, said the review was a missed opportunity.

“These are the most restrictive voluntary assisted dying laws in any jurisdiction anywhere in the world,” he said, pointing out that the law had 68 safeguards.

He’d like to see the scheme expanded to people with dementia (with stringent safeguards) and a relaxing of the requirement for patients to have a prognosis of death within six months (and 12 months for neurodegenerative diseases).

“That’s often a real barrier … it means people come to the process too late,” Carr said.

“We would like to help people who have been given a diagnosis that we know is going to kill them in the foreseeable future without having a specific time on it.”

Carr recently lost a legal challenge against the federal government over its law banning discussion about suicide over a “carriage service”, which includes phones, email and telehealth.

Carr had argued that the term suicide was different to voluntary assisted dying. The decision will have ramifications for terminally ill patients in regional and rural areas who want to access voluntary assisted dying but are unable to travel great distances for in-person assessments with specialists.

Dying with Dignity president Jane Morris labelled the review “disappointing”.

“We were sincerely hoping it would allow for some legislative change,” she said.

“Victorians, who were the leaders with voluntary assisted dying legislation, have become the laggards.”

She had hoped that the review would start a discussion about whether the state’s assisted dying scheme should be expanded to people with dementia.

It should have also looked at allowing nurses to administer voluntary assisted dying medication, she said. This would address the shortage of doctors prescribing the substance and pull the state in line with Western Australia, NSW, Tasmania and Queensland, where nurses can administer the substance.

A Victorian government spokesman said while legislative changes were not within the scope of the review, all legislation was reviewed and updated periodically to ensure it was fit for purpose.

He said the review would “consider how the laws have been implemented in Victoria and whether improvements can be made to how this is done in future”.

In 2017, Victoria became the first Australian state to introduce voluntary assisted dying legislation.

If you are troubled by this report or experiencing a personal crisis, you can call Lifeline on 131 114 or Beyond Blue on 1300 224 636.

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