In addition to marriage equality, another hot topic of debate in Australia is assisting dying. This month, a bill to legalise assisted dying for terminally ill people was introduced to the Victorian government.
Under the Voluntarily Assisted Dying Bill, people suffering from a life-limiting and incurable condition would be given the right to choose a doctor-assisted death. According to opinion polls, three quarters of the general public supported assisted dying for terminally ill people but in a recent survey by the Australian medical Association only 40 per cent of doctors were in agreeance and 50 per cent were directly opposed to it. Some doctors have expressed concern about people being coerced, as well as concerns about being subject to criminal action if something goes wrong. Other doctors feel they don’t have sufficient training or awareness of the role.
An expert panel were involved in an independent investigation into proposed legislation on assisted dying and made 68 recommendations, all of which have been accepted by the Victorian Premier. Along with eligibility criteria, the panel also considered relevant policy and legal issues. The proposed model also includes safeguards in response to concerns that the system could be open to abuse. Under the scheme, the person requested an assisted death must be of sound-decision making capacity and likely to die within 12 months. Further, the condition must be causing suffering that is intolerable for the person. Only a patient can initiate a request for assisted dying and must be individually assessed by two doctors, one of whom is a specialist in the condition or illness involved.
The role of doctors
There is still debate over the method of administering and type of lethal medication to be used but the framework outlines the role of doctors in assisted dying. In the first instance, patients wishing to access lethal medication must first approach their regular doctor. Doctors may opt out of accepting the role of coordinating doctor and the patient is free to see another medical practitioner. On accepting the role, the doctor must ensure the patient meets the eligibility criteria and has been given sufficient information. The coordinating doctor then refers the patient to another medical practitioner to undertake a second independent assessment.
The next stage is that the assessments are then considered by a Voluntary Assisted Review Board. A written declaration to proceed must be completed by the patient and witnessed by two independent witnesses in the presence of the coordinating medical practitioner who may then write a prescription for a lethal dose of medication. In order to write such a prescription the medical practitioner must apply for a permit from the Department of Health and Human Services. The patient will then self-administer the medication unless they are physically unable to do so, in which case only the coordinating medical practitioner has authority to administer the medication unless unwilling or unable to do so, in which case the role may be given to the consulting medical practitioner. The lethal dose of medication must be administered in the presence of an independent witness.
If the bill is passed, terminally ill Victorians aged 18 years or over would be able to seek a medically assisted death from 2019. It is estimated that around 150 people a year will access the scheme.