Voluntary assisted dying: The current state of affairs

The Voluntary Assisted Dying Bill 2019 easily progressed to the consideration in detail stage in WA’s legislative assembly via a conscience vote 44–12, but is expected to face a more difficult passage through the upper house.
 
If successful, WA would become the second state in Australia to legalise voluntary assisted dying, after Victoria officially legalised the practice in June.
 
WA’s proposed bill differs slightly to Victoria’s legislation, but would allow terminally ill patients likely to die within six months, or 12 months if living with a neurodegenerative condition, to access the scheme, provided they meet all the requirements.
 
However, while voluntary assisted dying appears to have the support of the WA community, critics – including WA Police Minister Michelle Roberts – are concerned about the standard of safeguards and the lack of a requirement for a psychiatric assessment.
 
‘The fact that we need safeguards means there is something inherently worrying about the principle,’ Ms Roberts said.
 
‘There exists the very real [opportunity] for abuse … no one can tell me doctors don’t make mistakes.’
 
WA is not alone in considering voluntary assisted dying legislation, with almost every state and territory across the country investigating its merits.
 
Australian Capital Territory
The ACT Government recently responded to an End of Life Choices report, tabled in March, which examined options currently available to dying residents and considered options for a potential voluntary assisted dying scheme.
 
The report did not make any recommendations as to the implementation of a scheme, as territories do not have the power to enact such legislation, but the ACT Government did agree or note all 24 of its recommendations.
 
One of those recommendations included providing in-principle support to fund so-called ‘death cafes’ (despite misgivings about the name) that would allow people to meet and discuss issues surrounding end-of-life choices, as a way of breaking down barriers and increasing education on the issue.
 
ACT Health Minister Rachel Stephen-Smith has said the Government wants to offer more choices for people in end-of-life care and called for more autonomy to be able to legislate on the matter.
 
‘Individuals must have the right to make their own choices at the end of their lives,’ she said.
 
‘We will continue to advocate for the ACT community to have the right to determine its own position on voluntary assisted dying.’
 
New South Wales
NSW last voted on voluntary assisted dying legislation in 2017, where it was defeated by one vote in the upper house.
 
Even if it had passed, the bill would likely have subsequently failed to pass the lower house due to bipartisan opposition. There is no indication the current NSW Government is considering new legislation at this time.
 
Northern Territory
The NT passed Australia’s first voluntary assisted dying laws in 1995, but they were overturned less than two years later by the Federal Government’s Euthanasia Laws Act 1997.
 
That law stripped the rights of both the NT and ACT to legislate on voluntary assisted dying, prompting a failed campaign led by Senator David Leyonhjelm to restore the territories’ rights.
 
Queensland
Queensland is in the midst of a parliamentary inquiry into aged care, end-of-life and palliative care, and voluntary assisted dying.
 
The state parliament recently agreed to extend the length of the inquiry from a finish date of 31 November 2019 to 31 March 2020, with a final report expected on the same day.
 
Public submissions closed in April, by which time it had attracted nearly 5000 submissions, while three hearings are scheduled for next week.  
 
The final report will focus on a range of aspects associated with voluntary assisted dying, including characteristics of a potential scheme, community support, overseas examples, and potential requirements and safeguards.
 
South Australia
The Steven Marshall-led SA Government has also undertaken an inquiry into end-of-life choices, with public submissions closing last month.
 
A voluntary assisted dying bill was most recently defeated in 2016, the 15th time such legislation had been rejected in the state.
 
Tasmania
Voluntary assisted dying advocates are reportedly preparing to again reintroduce legislation into parliament. A proposed bill has been authored by community organisation Dying with Dignity Tasmania, based largely on legislation that failed to get through parliament in 2017.
 
If passed with amendments, Tasmania’s legislation would be ‘less restrictive’ than Victoria’s, as it would not stipulate that substance be self-administered, while it would also exclude the requirement for a terminal prognosis.
 
‘It leaves out people particularly with neurodegenerative conditions, spinal disintegration, chronic pain,’ Dying with Dignity’s Margaret Sing said.
 
‘A lot of people end up, at the end of their lives these days, with one, two or three chronic conditions which make their lives an absolute misery.’
 
Victoria
Victoria was the first Australian state to legalise voluntary assisted dying, and 11 people have reportedly been granted approval to access the scheme so far.
 
Privacy concerns prevented the state’s Voluntary Assisted Dying Review Board from publishing data on assessments, applications, approvals, and the substances dispensed in its annual report; however, it is anticipated de-identified data will be included in future reports.
 
The number of people who access the scheme will be released every six months during the next two years, with the next report due in February.
 
More than 300 doctors, including GPs, have so far undertaken specialist voluntary assisted dying training, with approximately one-third based in regional Victoria. It is eventually expected that around 150 people will access the scheme annually.

The article has been updated to clarify that the proposed bill has only reached the consideration in detail stage.

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