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‘The law will be changed’: GP laments impact of VAD ruling


Jolyon Attwooll


1/12/2023 3:30:02 PM

A ruling this week in the Federal Court confirmed that telehealth cannot be used during the voluntary assisted dying process.

Doctor on phone
A Federal Court ruling now confirms it is illegal to use telehealth for voluntary assisted dying.

A Melbourne doctor has said a Federal Court judgement preventing the use of telehealth in voluntary assisted dying (VAD) will likely deter GPs from being involved in the process.
 
On Thursday in the Federal Court, Justice Wendy Abraham made the ruling, which judges that VAD comes under the definition of suicide, and supersedes a contradictory law in the Victoria VAD act.
 
Under the Commonwealth Criminal Code it is an offence to use a ‘carriage service’ – such as a phone or video call – to counsel or incite suicide.
 
The judgement signalled the failure of a case brought against the Federal Attorney-General by Melbourne GP Dr Nicholas Carr, who has been heavily involved in a campaign for VAD laws in Victoria.
 
While saying he would continue to work to amend the law, Dr Carr believes the ruling will have a detrimental impact on GPs who support VAD.
 
‘We struggle anyway to get GPs and specialists involved in voluntary assisted dying,’ he told newsGP.
 
‘It is not an easy process for people to take part in, it’s poorly remunerated and there are lots of other barriers.
 
‘And now with the threat of legal action for use of the telephone or internet for any form of voluntary assisted dying care, it’s certainly not going to help people feel enthusiastic about taking part.’
 
Having lodged the case last year, Dr Carr said he believes Justice Abraham looked at the law too narrowly.
 
‘I was really particularly disappointed that in court there was a very legalistic argument about words and definitions and dictionaries,’ he said.
 
‘The real human experience of what voluntary assisted dying is, and how gentle and peaceful and comforting it is, and how different that is from the awful realities of suicide, that human experience never got mentioned.
 
‘It was all that words and definitions.’
 
VAD laws have now been passed in all states.
 
The RACGP did not take a formal position on whether VAD laws should be introduced, instead advocating that GPs should expect patient inquiries when the laws changed and that any request ‘requires a respectful and compassionate response’.
 
The judgement is likely to have the greatest impact on VAD in more remote areas.
 
According to the latest annual report from the Victorian Voluntary Assisted Dying review board, GPs make up 71% of practitioners in regional parts of the state.
 
‘There are so many people who are very sick and disabled at the end of their lives, and travelling is a huge imposition, if not even close to impossible,’ Dr Carr said.
 
‘Not all those assessments can be done by telehealth, I absolutely recognise that, but there are circumstances where doing some of this work by telehealth is perfectly reasonable.
 
‘We can do some of the voluntary assisted dying work very safely by telehealth.’
 
Dr Carr says that the judgement means politicians will need to take action to change the law.
 
‘This affects the entire nation,’ he said.
 
‘It has been shown that a legal solution is not going to be successful through the courts from someone like myself.
 
‘It now has to be political.’
 
Despite the personal legal setback, Dr Carr remains hopeful that the Federal Law will eventually be amended, and said he is backing a private member’s bill from independent MP Kate Chaney to alter the federal laws.
 
‘This will change,’ he said.
 
‘It is simply wrong to conflate suicide and voluntary assisted dying, they are completely separate entities. They cannot be put into the same basket.
 
‘So this law will be changed.’
 
The Bill is also supported by independent MP and former paediatric neurologist Dr Monique Ryan.
 
According to polling conducted by the Australia Institute, 76% of Australians support VAD.
 
The office of Federal Health and Aged Care Minister Mark Butler was approached with an inquiry on whether he had a view on the ruling. A spokesperson redirected newsGP to the Attorney-General’s office without further comment.
 
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Dr Katriona Elisabeth Herborn   5/12/2023 9:08:16 AM

I believe for those in very remote areas this will prove discriminatory. In areas I’ve worked people do not even have access to an XRay. But they do have access to Telehealth!