31 October 2023

Voluntary assisted dying law introduced but actual health scheme still at least 18 months away

| Claire Fenwicke
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Go Gentle Australia CEO Dr Linda Swan, Human Rights Minister Tara Cheyne, Katarina , Corinne Vale and Dying with Dignity NSW's Dr David Swanton.

Human Rights Minister Tara Cheyne (second from left) said work would continue on the voluntary assisted dying legislation with stakeholders such as Go Gentle Australia CEO Dr Linda Swan, Katarina Pavkovic, Corinne Vale and Exit ACT chapter leader Dr David Swanton. Photo: Claire Fenwicke.

CONTENT WARNING: This article discusses suicide.

Katarina Pavkovic had to watch her father intentionally not eat food for five weeks when he decided he didn’t want to live anymore.

He had been suffering from Parkinson’s disease and had reached the point where he could no longer walk or talk, but he also wanted to die on his own terms.

“Towards the end, he could no longer face the intolerable suffering,” Katarina said.

“[He] would absolutely be smiling at the outcomes here today.”

That’s because now, just 11 months after Territory rights were restored, the ACT Government has introduced the Voluntary Assisted Dying Bill 2023.

Human Rights Minister Tara Cheyne introduced the proposed legislation to the Assembly on Tuesday (31 October). She said it was the greatest honour of her life.

“This bill is what we spent 25 years fighting for our Territory rights for,” she said.

“Voluntary assisted dying [VAD] is not an alternative to, nor does it detract from palliative care.

“It allows eligible individuals to make informed choices when they are at the final stages of their illness … it is not a choice between life or death, it is an additional choice.”

Extensive community and stakeholder consultation has taken place to formulate the proposed law, which allows access to VAD if a person is aged 18 years or older and:

  • has a condition that is advanced, progressive and expected to cause death
  • is intolerably suffering
  • has lived in the ACT for 12 months, or be provided an exemption by demonstrating they have a substantial connection to the ACT
  • is acting voluntarily
  • has decision-making capacity throughout the process.

All of these eligibility requirements must be met, with the individual required to undergo a multi-step request and assessment process, with the assessment conducted by two independent and suitably qualified, trained and authorised health professionals.

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One significant difference between the ACT’s scheme and other jurisdictions is that an expected timeframe to death does not need to be established.

Ms Cheyne said while it would have been simple to “copy and paste” the timeframe from other jurisdictions, removing this requirement was important.

“A timeframe to death is an arbitrary and unnecessary aspect of other state’s models,” she said.

“It’s very difficult in some circumstances and some illness for doctors to be able to accurately determine the timeframe to death for a person.

“[This will reduce] an individual’s intolerable suffering, as well as the stress and difficulty in having to request voluntary assisted dying very close to death.”

Another difference will be allowing experienced nurse practitioners to access the training to administer the VAD health service.

The bill does not mandate anyone take part in VAD but establishes minimum standards that must be followed by individuals and organisations, such as aged care homes and hospitals that conscientiously object to or cannot assist with voluntary assisted dying, not hinder access to VAD.

Katarina wishes her father could have been able to access the same option.

“It just would have eased suffering, not only for him but for everyone else around him,” she said.

“It would have given empowerment. It would have given choice, dignity and given us all the ability to say goodbye on our own terms.”

The government had been considering opening up the scheme to children aged 16 to 17 but decided not to pursue this option in the legislation presented.

A Select Committee on the bill has been established to examine the proposed law before it is debated. It must report by 29 February 2024.

It’s expected the VAD scheme will begin 18 months after the legislation passes to give enough time to set up this new health service with the necessary systems, safeguards and processes.

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Some are concerned this time period will impact families who need to access the health service now.

Corinne Vale’s mother took her own life in April while she was receiving palliative care for motor neuron disease.

“She made the decision really quickly after her diagnosis that she wanted to be the one who decided when her suffering became intolerable and when it was time to call it quits,” she said.

“If she had known at the time of her diagnosis that voluntary assisted dying was available to her, it would have immeasurably improved the remaining months of her life.

“She could have focused on enjoying that time with those of us who loved her rather than researching ways to take her own life … because of the choice she made, I couldn’t be there when she died, I couldn’t hold her hand and tell her that I loved her.”

Corinne has been speaking with ministers on whether an interim option can be established so that people can access other VAD schemes across the border in the meantime.

“If someone you love tells you that they don’t want to ride their terminal illness all the way to the end … and the palliative options don’t meet their needs, it’s important they have the option to control the manner and timing of their passing,” Corinne said.

“For my mum, she wanted that choice.”

The scheme will be reviewed after it has been in operation for three years.

Further information on voluntary assisted dying in the ACT is available online.

If the issue of voluntary assisted dying raises issues for you or your family, you can contact Lifeline on 13 11 14 or Griefline on 1300 845 745.

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Tara Cheyne has listened to those who are suffering and who deserve the option of a dignified death

I thought that the GreensLab council already introduced voluntary assisted dying last weekend with their drug decriminalisation madness.

At last!

Thank you ACT Labor, ACT Greens and Tara Cheyne!

It will end up like Canada. Patient: Doctor, I have a cough. Doctor: I’ve booked you in for the big green needle, like at the pound

Good. If VAD gets implemented in an accessible and practical form that will be the best thing the ACT government has ever done for us.
To put it simply, my body my choice. Not your body and not your choice to either make me or stop me using VAD. After watching a close relative suffer through a protracted and undignified death I asked the doctor if anything more or differently could have been done. The doctor just looked at me and said, “voluntary assisted dying”.
So to the opponents of VAD I say keep your beliefs to yourself and don’t dictate or devalue the choices of others to determine their own demise, however and whenever they choose. Remember this – my body, my choice. Not yours.

My body my choose *is* important – including for example when people are being coerced to get an injection that they don’t want – but that never meant you can get whatever medical treatment you want. It does not mean a healthy person can walk into a hospital and say they want chemo treatment despite not having cancer, for example. It *does*, however mean a person can say no to any treatment a doctor recommends.

This is just the start… Once you devalue human life it’s not long before the restrictions mentioned in the article are removed. Like the Netherlands, who’ve had assisted suicide for a while and have decided that depression can also count as “intolerable suffering”, and they allow assisted suicide to children. (If you don’t believe me, Google it, there’s even a BBC article about a woman who was “helped to die” simply because of mental health troubles.)

So before long, we’ll have depressed kids going to doctors saying “help me, I feel so depressed I want to kill myself” and sure, the initial method might be a bit of therapy, a few more drugs, but if that doesn’t work at first, the doctor will just go “well, yeah, life is just too hard for you so I can just kill you if you want”.

I see you’ll all have to stop trying to keep people from jumping off bridges then won’t you? Because now, if someone’s decided their suffering is too much then they’re allowed to just kill themselves… “There’s always hope”? I guess you don’t care anymore that a depressed person might simply be unable to see the light at the end of the tunnel.

Very disappointed that Australia has fallen this far.

I see blind speculation is rife.

I have yet to see anything that suggests that we should offer VAD to anyone who gets as much as a paper cut. That is not the intent, and I have yet to see anyone point to a specific clause in the legislation that suggests it will be. This is for people in specific circumstances: people who have an illness that is likely to be terminal, whose quality of life is likely to remain low. They will be given a choice in how the remainder of their time on this earth will be handled.

I see the speculation on this has started already. I would love to see someone point to the specific clause that will allow people to be offered this if they have as much as a paper cut. If you can point to this l will happily join the list of protestors.

From what I can tell, this is for a specific scenario: those who have illnesses that are likely to be terminal, whose quality of life is likely to remain low.

Victor Bilow3:10 pm 31 Oct 23

This is just the start because now, if someone’s decided their suffering is too much then they’re allowed to just kill themselves… “THEY ALREADY DO KILL THEMSELVES” When family have to spend weeks to find there child who has hung themselves in the bush or walk into the garage to see a young person who has hung themselves with a wire noose because the Canberra mental section refused to admit them 3 times when he looked for help. Over 3,000 deaths by suicide occur each year in Australia In 2022, there were 3,249 deaths by suicide – an average of about 9 deaths per day – with a rate of 12.3 per 100,000 population.

It’s not blind speculation. It’s *already happening in other countries*.
And nowhere did I say anyone who gets a “papercut” would be able to get it: My example is people who have depression being told they can just kill themselves instead of medical professionals doing everything they can to help that person get out of depression.

Here’s the BBC article I mentioned where this literally happened in the Netherlands:
A woman has now been legally killed because doctors gave up on helping her. And she’s certainly not the only one.

There are a lot of things that ‘happen in other countries’ that don’t occur here, good and bad. Blind speculation that it will happen here because it does somewhere else.

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