Voluntary assisted dying, also known as voluntary euthanasia, is a complex and controversial topic that has been debated for many years in Australia. In recent times, there has been a growing interest and discussion about the legal, ethical, and practical aspects of voluntary assisted dying in the country.
This comprehensive guide aims to provide a thorough overview of voluntary assisted dying, covering its history, legal framework, eligibility and criteria, process and much more.
History of voluntary assisted dying in Australia.
Voluntary assisted dying has a long history of debate and discussion in Australia. The topic gained significant attention in the late 20th century when various attempts were made to introduce legislation allowing voluntary euthanasia.
However, these attempts faced strong opposition from different quarters, including religious groups, medical associations, and ethicists, leading to the failure of such legislation.
Legal framework for voluntary assisted dying in Tasmania.
Voluntary assisted dying in Tasmania is regulated by the End-of-Life Choices (Voluntary Assisted Dying) Act 2021 (the Act). The Act identifies when a person in Tasmania is eligible to access voluntary assisted dying and sets out the steps in the voluntary assisted dying process. It also establishes the Voluntary Assisted Dying Commission.
A person is eligible to access voluntary assisted dying in Tasmania if they meet all the eligibility criteria. These relate to age, residency, medical requirements, voluntariness, and decision-making capacity.
Eligibility and criteria for voluntary assisted dying in Tasmania.
To be eligible for voluntary assisted dying in Tasmania, there are strict criteria that must be met. These criteria are designed to ensure that only individuals who are genuinely suffering and near the end of life can access voluntary assisted dying.
Here is a comprehensive list of eligibility. A person is eligible if they:
- are aged 18 years or over;
- are an Australian citizen, permanent resident of Australia, or have been resident in Australia for at least 3 continuous years prior to making a first request, and have been ordinarily resident in Tasmania for 12 months before making the first request
- have decision-making capacity;
- are acting voluntarily and without coercion;
- have an enduring request for voluntary assisted dying (i.e. their request is ongoing); and
- have a disease, illness or medical condition that is:
- advanced and progressive (i.e. the person experiences active deterioration),
- incurable and irreversible
- expected to cause death within six months, or 12 months for a person with a neurodegenerative disease, illness or medical condition, and
- causing suffering that cannot be relieved in a way that the person finds tolerable. The person’s suffering may be physical or non-physical e.g. psychological, existential.
A person is not eligible for VAD on the basis of having a disability or a mental illness alone. A person with disability or mental illness may be eligible if they also have a disease, illness or medical condition that is expected to cause their death within the timeframe, and meet all of the other eligibility criteria.
Process of accessing voluntary assisted dying in Tasmania.
The voluntary assisted dying process in Tasmania has a number of formal steps, with medical practitioners determining eligibility at each point. It typically starts with the patient expressing their interest in accessing voluntary assisted dying to their attending physician.
The patient then goes through a thorough assessment to determine their eligibility, including physical, psychological, and social assessments. They will also need to be assessed by at least two independent medical practitioners who have taken specialised training in voluntary assisted dying.
If the patient meets the eligibility criteria, they must make a written and witnessed request for assistance to die. It’s important to note that the patient can withdraw their request for voluntary assisted dying at any step of the process. Once the request is approved, the patient can self-administer a prescribed medication to end their life peacefully. At any of the formal steps, the person will become ineligible if they lose capacity to make the decision, or if the medical practitioner believes they are not acting voluntarily.
Safeguards and protections.
Voluntary assisted dying legislation in Tasmania includes a range of safeguards and protections to ensure that the process is carried out safely and ethically. These safeguards may include multiple assessments by different healthcare professionals, mandatory waiting periods to allow for careful consideration, and the option for patients to revoke their request at any time.
The Act provides safeguards for Voluntary Assisted Dying (VAD), including restrictions on initiating VAD discussions and prohibiting family members from requesting VAD on someone's behalf. The person must make three separate requests, provide final permission, and the decision must be voluntary. VAD requires authorization, and medical practitioners must complete mandatory training. Penalties apply for inducing VAD, but there are protections for those assisting in good faith. The Voluntary Assisted Dying Commission monitors and issues authorizations.
Additionally, there may be provisions for conscientious objection by healthcare providers who do not wish to participate in the process. These safeguards are in place to minimise the risks of abuse and ensure that voluntary assisted dying is carried out in a compassionate and responsible manner.
Implementation challenges.
The implementation of voluntary assisted dying legislation in Tasmania has posed various challenges. The Voluntary Assisted Dying Act 2021 was the fourth attempt in Tasmania to pass VAD legislation. Unlike Victoria and Western Australia, Tasmania's law was not initiated by the government but was instead a private member's bill drafted and introduced by the Hon Mike Gaffney MLC. Mike travelled widely and exhaustively researched VAD in countries where laws had already passed in preparation for writing his bill.
Although the Tasmanian legislation was approved by the parliament in March 2021, an 18-month implementation phase was granted to establish the required procedures and ensure the medical community is adequately prepared.
Tasmania joins the ranks of Victoria and Western Australia as the third Australian state to offer voluntary assisted dying (VAD) services.
Final thoughts on voluntary assisted dying in Tasmania.
Voluntary assisted dying is a multifaceted and sensitive topic that involves various legal, ethical, medical, and societal considerations. It provides a compassionate option for individuals who are facing intolerable suffering and wish to have control over their own end-of-life decisions. However, it also raises concerns about potential risks, abuse, and ethical implications.
Ultimately, this should be approached respectfully as it can be a sensitive topic for many. Allowing people to die on their own terms means they can have a good death where their access to care and choices are respected. Furthermore, openly discussing death and dying can help prepare families for the passing and voluntary assisted dying can keep them more involved in the process, so they can ensure they’re close by for the final goodbye.
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