5 June 2024

How VAD legislation was amended to protect the vulnerable from coercion

| Claire Fenwicke
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Protections have been introduced to VAD legislation. Photo: Michelle Kroll.

Language in the proposed voluntary assisted dying (VAD) law has been tightened to ensure no one with a disability or mental disorder is pressured into or encouraged to access the service.

Several amendments to the Voluntary Assisted Dying Bill 2023 were debated across two days in the Legislative Assembly earlier this week before the law was ultimately passed.

One tranche of changes from Human Rights Minister Tara Cheyne was to clarify that people with a disability, mental disorder or mental illness could voluntarily access the scheme, but only if they also satisfied the other eligibility criteria.

“A disability or mental disorder alone will not make a person eligible for voluntary assisted dying,” she said.

“This is a critical safeguard to protect individuals with a disability from stigmatisation and harm arising from assumptions about their disability and their willingness to access voluntary assisted dying.”

Disability Minister Rachel Stephen-Smith said the change was needed because some of the conditions outlined to make a person eligible for VAD could also be considered a disability.

“The new proposed [clause] indicates that the person doesn’t meet the requirements for voluntary assisted dying solely because they have a disability,” she said.

“But that an illness or a condition that would otherwise enable them to meet the eligibility requirements … wouldn’t be ruled out because it could also be understood as a disability.”

Language was further clarified to make sure there was the ability to make a more “nuanced” distinction between conditions that are permanent impairments but also progressive and cause death (which could be assessed as eligible to access VAD) and those that are solely the effects of an accompanying disability that would not, on their own, allow for eligibility.

Ms Stephen-Smith said this was an important protective measure.

“The government seeks to ensure that no one who is experiencing a disability, mental disorder or mental illness solely is ever pressured or encouraged to seek voluntary assisted dying,” she said.

“[It will also enable] people with disability, who are otherwise eligible, to access voluntary assisted dying.”

READ ALSO People with dementia won’t be able to access VAD in Canberra but it’s not the end of the conversation

The definition of what constitutes a person to have an “advanced” condition was also further clarified.

A person’s relevant conditions will be considered advanced if their functioning and quality of life have declined or are declining and are not expected to improve, as well as if any treatments for the condition (that are reasonably available and aren’t primarily for pain relief) have lost any “beneficial impact”.

“These amendments make it clear that it is not the intent of this legislation that the definition of ‘advanced’ be limited to the final days, weeks or months of life,” Ms Cheyne said.

A person will be considered as approaching the end of their life even if it’s uncertain whether their advanced relevant conditions will cause death within the next 12 months.

“There may be instances where an individual’s timeframe to death is unclear, unpredictable or when the person’s prognosis has a range of outcomes,” Ms Cheyne said.

Many other jurisdictions have a six to 12-month timeframe to death for people to be able to access VAD.

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One issue that was raised was around the storage of unused voluntary assisted dying medication.

The proposed legislation states any leftover medication must be returned to an authorised supplier (by an authorised contact person) within 14 days of either a person’s death or their decision not to use the medication.

Canberra Liberals backbencher Elizabeth Kikkert wanted this timeframe shortened to no more than 72 hours.

“This shorter timeframe ensures that the medication is either used for the intended purpose and safely returned to authorities before any mishaps can occur,” she argued.

“By reducing the return period, we significantly lower the risk of unauthorised access and potential misuse and death.”

The committee inquiry into the bill recommended the return timeframe should be no longer than 48 hours.

As Ms Kikkert did not raise this as an amendment, it was not a point that the Assembly could debate.

Ms Stephen-Smith made assurances that the legislation and associated regulation would have “significant safeguards” to ensure the appropriate storage and disposal of approved substances.

Ms Cheyne also argued it was about striking a balance between mandated timeframes and compassion.

“An authorised contact person is often a close family member of the deceased, and an appropriate period of time is considered necessary to allow them to grieve,” she said.

Amendments by Shadow Mental Health Minister Ed Cocks to broaden provisions for conscientious objectors, including not having to provide information about where the scheme could be accessed, were also voted down.

Opposition leader Elizabeth Lee was unsuccessful in removing the requirement for the first review of the law to consider whether someone can access VAD if they’d lived in the ACT for less than 12 months (if they don’t meet other exemption criteria) and to consider whether the law should be expanded to include children with “decision-making capacity”.

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@Ken M
I refer you to section 8 of the ACT’s Voluntary Assisted Dying Act 2023:

“8 Voluntary assisted dying not suicide
For the purposes of a territory law, and for the purposes of a contract, deed or other instrument entered into in the ACT or governed by a territory law, an individual who dies as the result of the administration of an approved substance by or to the individual in accordance with this Act—
(a) does not die by suicide …”

Constant repeating of your BS doesn’t change the fact that it is BS.

Did you come up with that all by yourself?

I do not begrudge that you are probably in the roughly 20% who voted “It’s a slippery slope” in the largely random poll in this page. Some people are, and quite a few of those like to write here.

The solution has been mentioned often: if you don’t like it, don’t do it. Quite literally, no-one is forcing you, whereas you want to dictate reasonable, ethical, personal, choices by others who recognise themselves as being in specified circumstances at end of natural life.

Again JS, I don’t care what cowardly wordplay the Act hides behind. It’s suicide. You and everybody else knows that. Some of us are just not happy to lie to ourselves.

And byline, our other lefty shill, I have no objection to people with terminal illnesses that will result in a painful death using assisted suicide. My objection is to the lie that “voluntary assisted dying” is something other than assisted suicide.

If you are happy people can now kill themselves, that’s great. Just be less of a coward and call it what it is. Suicide. This stupidity is like calling murder “Involuntary assisted dying”.

@Ken M
LMAO You really have issues with not being able to argue facts don’t you? Your elected government has legislated that VAD is not suicide. Similarly, your elected government has legislated on murder and the definition is not “involuntary assisted dying”. Until your elected government determines otherwise on VAD or murder, it is what the current law dictates and anything else is just down to your jaundiced opinion. Perhaps you should try pushing a different neocon agenda as you are struggling on this front.

Ken M, I did not use or exclude any particular words; it would be pointless because it is not in fact the issue, or even an issue.

The problem is that you invest some descriptive terms or synonyms with symbolism which exists only in your and similar minds. JustSaying offers correct and wholly sensible definitions, they exist in law, without the fluff of your symbolic, “meaning”.

The image you conjure is someone prancing on a chair screaming “A rat! A rat!” while a calm person identifies mus musculus, and you are just as terrified anyway.

Ah, yes, legislation somehow changes reality. Killing yourself isn’t suicide because the ACT government said so. LOL. You’re cooked. This is what cult mentality looks like.

Again, JS, hiding behind weasel words just shows that you have a problem with people killing themselves. I’m happy to call it what it is and be in favour of it. Why are you so afraid of it?

@Ken M
“yes, legislation somehow changes reality” Finally you seem to be getting it. The reality is that under this legislation people can choose to seek assistance to compassionately end the suffering they are enduring in reality.

“Killing yourself isn’t suicide because the ACT government said so” VAD is not always self administered, it can be assisted. And yes, YOUR democratically elected government in the ACT, has enacted a law which states that someone who dies under VAD legislation does not die by suicide. Fact!
Oh unless you can provide evidence from another Australian jurisdiction, maybe a coronial inquest, where someone who died under that jurisdiction’s VAD legislation was deemed to have committed suicide.

“I’m happy to call it what it is and be in favour of it.”
No you are not happy to call it (VAD) what it is. You want to call it suicide which it is not. Suicide as a concept is the ultimate act of despair and loneliness. VAD is also a concept and is an act of compassion and relief. The fact that you want to conflate the two just shows your inability to comprehend the totally disparate thought processes which lead to each act.

I’m not afraid of “it” – I just don’t accept your aberrant version of what you think is reality.

Again, you know you are lying to yourself. It’s assisted suicide. Just because your dear leaders decree something, that doesn’t make it so. Please take your tongue off of the boot.

@Ken M
“Again, you know you are lying to yourself”
Do I? I would have thought anyone, who has a modicum of intelligence and who reads my previous posts n this subject, would see I “know” no such thing.

“… because your dear leaders decree something …”
The beauty of democracy is that they are also your “dear leaders” and when these democratically elected “leaders” enact legislation, that does “make it so” for all of us.

“ It’s assisted suicide.”
No. As I have said before, assisting or encouraging (i.e. aiding, abetting, procuring, counselling, commanding or inciting) another person to commit suicide is illegal in all Australian States and Territories. What is so difficult for you to comprehend about this.

Rather than I take my “tongue off of the boot”, you would be much better off taking your head out of your own orifice.

Ken M, the import of words seems lost on you. You have not denied that your frantically repeated claim is born of some symbolic meaning or other you invest in the word, and so you have lost the plot completely on why it really matters.

It is a legal fact that VAD is not suicide, thus obviating any problems with life or death insurance, superannuation and other matters. Feel free to call it icy ducks or something if that helps with your conceptual difficulties with VAD. It remains exactly the same.

Oh, look, as usual the comments janitor is using their political bias to stifle discussion and giving one side free reign to post whatever garbage they like. LOL


@Ken M
Yes, you do seem to have had pretty free reign to post your unsubstantiated and fact-free garbage, not to mention pejorative puerility, while I have given you factual legislative references which demolish that garbage.

Hiding behind weasel words does not change what it is. No reasonable person actually believes that legislation changes reality, only brainwashed cultists. I can’t imagine followinh ideology that requires lying to myself every day.

It meets the dictionary definition of suicide. It’s assisted suicide. The government saying a cat is a dog or black is white does not make it so. Pretending otherwise is absurd.

@Ken M
Rather than nonsensical blithering, why don’t you actually present some facts to support your (supposed) argument? At the moment, your argument is simply “because I say so”.

I find it’s a fatuous exercise engaging in a battle of wits with you, when you constantly demonstrate you are only half armed for the engagement.

To whom or what are you replying, Ken M? Some fantasy you are having?

We understand that you don’t.

You two are deranged.

@Ken M
If making you look foolish, by following the rule of law, is your definition of “deranged”, then is it any wonder you persist with your totally unsubstantiated and baseless notion. “La la land” was not only a movie, it also describes the state of alternate reality that you inhabit.

“The government saying a cat is a dog or black is white does not make it so.”
OMG what a ludicrous analogy. Is that seriously the best you have? And you call us deranged! PMSL

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