Assisted dying is now legal in Victoria. How did the nation respond?

Doug Hendrie

19/06/2019 2:53:48 PM

A significant number of Australians now have the right to die if they are terminally ill – and meet exacting criteria.

Older patient
Australians have expressed a broad range of opinions on voluntary assisted dying.

Victoria’s assisted dying laws will allow eligible patients to ask a doctor for access to a lethal substance. Two doctors have to approve the patient’s eligibility, and a patient must ask three separate times.
The scheme is opt-in for GPs, with around 100 Victorian doctors already signing up to be trained to assist terminally ill patients to die. Others have chosen to be conscientious objectors.
There is no obligation to participate, but doctors are not allowed to impede a patient’s access to assisted dying.  
The response from medical bodies, civil society, politicians and religious leaders has been significant.
Victorian Premier Dan Andrews, whose government passed the laws, was personally anti-euthanasia until he watched his father’s death from cancer.
On his Facebook account, he wrote about the effect it had on him:
‘People have been talking about what it means to them – so I wanted to talk about what it means to me. For me, it’s about my father Bob. By the time his many cancer treatments had run their course, there wasn’t much left of him. The radio. The chemo. The surgery. Month after month. Year after year. My dad passed away long before he died.’
‘And it’s only when you go through something like that – when you watch someone you love succumb to what some people might even describe as a “good death” – you start to wonder what on earth must qualify as a “bad death”. So many Victorians in the final months of a terminal illness are suffering far worse than my father did. They deserve to have that ultimate choice. They deserve to have that ultimate control. From today, they will.’
Victorian Health Minister Jenny Mikakos said Victoria has made a momentous change.
‘This is a historic change for Victoria and the entire country – we know other states will be looking to us and watching closely,’ she said in a statement.
‘We’ve made voluntary assisted dying legal because a person’s quality of death is part of their quality of life.’
However, the Catholic Church remains strongly opposed to the laws, and will not allow terminally ill patients to use the scheme in Catholic hospices and hospitals.
In a pastoral letter sent last week, Victoria’s bishops describe today as a ‘new and deeply troubling chapter of health care in Victoria’.
‘All of us who hold a principled opposition to euthanasia are now, in effect, conscientious objectors,’ the bishops write.
‘We object to the unnecessary taking of a human life, we object to the diminishment of the love that can be given and received in the last days of our loved ones, we object to the lack of adequate funding for excellent palliative care, we object to state-sponsored practices that facilitate suicide, and most of all we object to the lazy idea that the best response our community can offer a person in acute suffering is to end their life.’
But Catholic Health Australia chief Suzanne Greenwood told The Age she is aware some patients might wish to explore the option.
‘Our members will work with patients and residents ... to examine their options with them,’ she said.
‘If people in our care wish to access [voluntary assisted dying] from other providers, our services will not impede them. We will provide release from care as well as transfer if they wish to access services elsewhere.’
One of the first to seek assisted dying will be Margaret Radmore, a retired nurse with terminal metastatic cancer. She told The Age she was terrified of dying a painful death, like many she has seen in her career.
‘I felt sheer terror about the end and the journey till the end … I was just shattered. I thought, “Oh my god. I am going to die one of those awful deaths that I have seen and put my family through that”,’ she said.
‘My GP has put his hand on my arm and said to me many times, “But we do really good palliative care, Marg”. ‘But I know there are many cases where it is impossible to alleviate suffering. I choose not to suffer.’
A long time assisted-dying advocate, Nia Sims, has also praised the laws for giving her the ‘ability to choose a gentle death’.
Ms Sims has a rare autoimmune disease which is progressive and incurable. She wrote on the ABC website that the laws gave her ‘a new peace of mind that I won’t have to die a long traumatic death by slow suffocation or starvation’.
Almost 90% of Australians now support voluntary assisted dying, up 15% in six years, according to ABC Vote Compass data.
Similar legislation is being considered in Western Australia and Queensland, with both states already having requested public submissions on the issue, while last year the ACT and Northern Territory unsuccessfully lobbied to overturn federal law that prevents both territories from legalising voluntary assisted dying.
At a federal level, action is unlikely, with Prime Minister Scott Morrison on record as saying he would never support euthanasia.
On Twitter, many supported the new laws.

Former ABC reporter and The Project producer Ryan Sheales linked to a piece about the death of his sister from osteosarcoma.
‘[W]hen the time came, Kate’s death was lonely. It was even more tragic than it needed to be,’ he wrote.
‘She exercised the only power and control she had left. Nothing was going to make my sister well again. But I will forever wonder how much better her death would have been if her family and friends had been there to hold her hand.
‘If my sister was alive today she would be applauding these new laws and thanking those who have campaigned so tirelessly to see them realised.’
Others have expressed concerns over risk.
Emergency doctor Dr Stephen Parnis, who has previously lobbied against euthanasia, has argued the new laws are ‘fraught with risk’ of wrongful death.
He cited a piece by Deakin University Associate Professor Mark Yates, who this week wrote that he was saddened by legislation that ‘weakens the fabric of our society and puts the frail elderly at risk’.
Associate Professor Yates said the new laws leave doctors open to risks of accusations of unprofessional behaviour.
The wife of terminally ill Victorian firefighter Troy Thornton, who sought euthanasia in a Swiss clinic early this year – before the laws Victorian were in effect – told Yahoo News that her husband’s goal was having the right to choose.
‘His whole thing was having the right to choose a good death over a bad one. To have dignity. He got that,’ she said.

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Edwin Pragasam   20/06/2019 11:06:35 AM

As caring GPs we have been helping patients to have a dignified and comfortable journey. Now it is more complicated with Geriatricians, Palliative care and Nursing Home staff. We don’t require politicians , judges and Religion to get involved in patient care.

Johnny   21/06/2019 12:34:34 AM

Firstly, do no harm.
Can this sort of anti-Hippocratic practice cause de-registration?

Tony Powell   21/06/2019 1:51:13 PM

Hey, Johnny! Why is Al Qaeda more compassionate than you?

The 9/11 hijakcers got to die instantly!

Dr Akil Islam   22/06/2019 8:47:48 AM

Firstly, to the pro-euthanasia colleagues, politician how do you eliminate the confounding of depression during terminal illness? And if they coexist, how can you prescribe suicide? And how do you exclude the confounding effect of family members seeking secondary benefit?
Pain exists. Terminal illness exists. Loss exists. Trauma exists. Death exists.
The evidence of benefit for euthanasia scientifically does not exist. It is not a science of medicine.
Our push-button, cotton-wool, function-for-consumption society now 'progresses' at the needle of raw emotion rather than first principles, rational thought, scientific study and deep reflection. Driving this train is the notoriously hasty and loose footed media and political industries. When will we wrestle the science of health care back into the hands of those who have studied it?
I hope the RACGP realise we have been professionally run-over (again).

Well at least there's permaculture.

Anonymous   24/06/2019 5:01:53 PM

Good palliative care at end of life should eliminate the need for euthanasia. If the pain can be managed, suffering can be minimized - people will not elect euthanasia. Doctors are reluctant to increase pain medicine dosage - due to concern that it will hasten death or/& they will be reprimanded by regulatory body. A terminally ill patient with higher pain medication might die few days earlier. Is this not the better palliative approach than euthanasia.
There has been much debate at regulatory level re the correct pain medicine guideline. Guidelines are just that and Doctors should not be punished for using one guideline and not another as it is more flexible with pain management. Regulatory bodies need to apply commonsense and allow medical discretion. It is always easier for regulators such as HCCC or AHPRA to reprimand based on paper investigation. A compassionate, committed clinician is best placed to consult family/ patient and action a dignified, comfortable death.

Anonymous   25/06/2019 7:59:59 PM

There are comparatively few situations when assisted dying might even be a consideration and I am concerned that legislation will affect more people adversely than it might do good. In my experience in visiting elderly care facilities over many years I have been repeatedly asked by relatives to abnormally accelerate peoples deaths when the resident is by all accounts still enjoying their lives . I have been repeatedly asked to stop palliative medication even paracetamol because of excess cost to the family. I have also noticed on one occasion when a relative was particularly adamant that her mother should die, that she had forged and wrongly dated an advanced health care directive on behalf of her mother. Determining whether a person is fit or ready to make a decision about ending their lives or making decisions about future treatments which they know very little about is a complex and difficult thing.