Voluntary Assisted Dying in Victoria

It was reported earlier today that Kerry Robertson was the first person in Victoria to be granted a permit to end her life under the state’s new voluntary assisted dying laws, the 61-year-old was in a nursing home in Bendigo when she died on July 15.

In November 2017 the Victorian parliament passed the Voluntary Assisted Dying Act (‘the Act”) providing a safe legal framework to enable a patient to die. In circumstances where a person wishes to avoid the suffering that cannot be managed in a way they consider tolerable, they may request medication to control the time and location of their death.

A ministerial advisory panel on voluntary assisted dying outlined safeguards concerning eligibility and access, medication management and storage, protections for practitioners, and reporting and oversight of the Act.

Safeguards for members of the community include the required “voluntariness” for accessing voluntary assisted dying; the discussion must be initiated by the person directly and cannot be initiated by a health practitioner; importantly a person requesting voluntary assisted dying must have decision-making capacity at the time of the request. It is not possible to request voluntary assisted dying in an advance care directive.

Safeguards for health practitioners include provisions for conscientious objection; a medical practitioner can refuse to participate in any processes related to voluntary assisted dying, including providing information, assessing eligibility, and prescribing or administering drugs.

Medical practitioners participating in voluntary assisted dying must be registered as relevant to their speciality and must complete training on voluntary assisted dying. To monitor and report on the operation of the Act a Voluntary Assisted Dying Review Board has been established.

The Act prescribes a practice of “self-administration”, enabling a patient to self-administer a prescribed lethal substance without the necessity of a doctor. In the circumstance that a patient is unable to self-administer, the Act provides that a medical practitioner can administer the substance.

To be eligible to access voluntary assisted dying a person must be;

An Australian citizen or permanent resident aged 18 or older who has lived in Victoria for at least one year before requesting voluntary assisted dying, and has the legal capacity (they can understand, retain, and make a judgement and communicate their decision) concerning voluntary assisted dying, and

Diagnosed with an incurable advanced and progressive illness that is predicted to cause death within no more than 6 months (or no more than 12 months for those with a neurodegenerative diagnosis) causing suffering that cannot be relieved in a way considered tolerable by the person.

The legislation outlines a formal procedure for accessing voluntary assisted dying, with specific requirements for a person making a direct request to a doctor; followed by an initial assessment conducted by a “coordinating medical practitioner” to determine eligibility.

A second assessment will be performed by another doctor ( “consulting medical practitioner”) to confirm the person’s eligibility. Following the second assessment, the person will make a further written declaration, signed in the presence of two witnesses and the coordinating medical practitioner.

At least nine days after the first request (unless death is likely to occur before this time has elapsed) the person will make a final request to the coordinating medical practitioner; the coordinating medical practitioner will conduct a final review to certify the request and assessment process. They will then apply for a permit, either for self-administration or practitioner administration. The drug is delivered in powder form that provides a painless, relatively quick and peaceful death.

At any stage of the process, a person who has requested access to voluntary assisted dying may change their mind and decide not to proceed.

 

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