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, public opinion, benefits and concerns, palliative care and end-of-life options, ethical considerations, 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 Australia.
The legal framework for voluntary assisted dying in Australia is complex and varies among different states and territories. As of April 2023, Victoria, Western Australia, Tasmania, Queensland and South Australia have legalised voluntary assisted dying for limited circumstances and only for people who meet the criteria.
New voluntary assisted dying laws will come into effect in New South Wales on 28th November 2023.
Currently, voluntary assisted dying is illegal in the Northern Territory and Australian Capital Territory. However, these territories weren’t able to pass their own laws on the subject until recently - a ban was lifted in 2022. Both territories plan to change their laws in the coming years.
In Victoria, the Voluntary Assisted Dying Act 2017 was enacted, which allows eligible adults with a terminal illness and intolerable suffering to request and receive assistance to die. Similarly, in Western Australia, the Voluntary Assisted Dying Act 2019 was passed, permitting eligible adults to access voluntary assisted dying under certain conditions.
Eligibility and criteria for voluntary assisted dying.
To be eligible for voluntary assisted dying in Australia, there are strict criteria that must be met. Different states have slightly different eligibility, however eligible adults must be mentally competent, have a terminal illness that is expected to cause death within a specified timeframe, experience intolerable suffering that cannot be relieved, and make voluntary and informed requests for assistance to die.
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 or permanent resident, who has been resident in the State for at least 12 months when they first request voluntary assisted dying (these criteria can be met in other ways in Tasmania, Queensland and New South Wales);
- 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 will cause death. In all States except Tasmania it must also be progressive (i.e. the person experiences active deterioration),
- incurable (Victoria, South Australia and Tasmania only), and irreversible (Tasmania only),
- expected to cause death within six months, or 12 months for a person with a neurodegenerative disease, illness or medical condition. In Queensland, however, a person expected to die within 12 months may apply for VAD, 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 will not be eligible for voluntary assisted dying based on having a disability or mental illness (or in New South Wales, dementia) alone – they must meet all of the criteria above.
Process of accessing voluntary assisted dying.
The process of voluntary assisted dying in Australia involves several steps. 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.
Safeguards and protections.
Voluntary assisted dying legislation in Australia 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.
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.
Public opinion and controversies.
Voluntary assisted dying is a highly contentious and divisive topic in Australia, with varying opinions from different segments of society. Additionally, the introduction of legislation in Australia has been met with both support and apprehension.
Advocates for voluntary assisted dying argue that it provides a compassionate option for individuals suffering from intolerable pain and a diminished quality of life to have control over their own death. They argue that it promotes autonomy, choice, and dignity for patients at the end of their lives. It may also alleviate the financial burden of prolonged medical care.
However, opponents raise concerns about the potential for abuse, the devaluation of human life, and the ethical implications of intentionally ending a person's life, even in the context of terminal illness. The topic has sparked heated debates and discussions among policymakers, healthcare professionals, ethicists, and the general public.
Palliative care and end-of-life options.
Palliative care, which focuses on providing relief from pain and other distressing symptoms, is an important aspect of end-of-life care. It is often seen as a complementary approach to voluntary assisted dying, with the goal of improving the quality of life for patients who are facing a terminal illness.
Palliative care aims to address the physical, emotional, psychological, and spiritual needs of patients and their families, providing support and comfort during this challenging time. In addition to palliative care, there may be other end-of-life options available to patients, such as hospice care, home-based care, and advanced care planning. It is important for patients and their families to be aware of the full range of options and make informed decisions based on their individual circumstances.
Ethical considerations.
The ethical considerations surrounding voluntary assisted dying are complex and multifaceted. Some argue that it is a compassionate and ethical option for individuals who are facing immense suffering and have a desire to end their life on their own terms. They argue that it respects the autonomy and dignity of patients, allowing them to make choices about their own life and death.
However, opponents raise ethical concerns about intentionally ending a person's life, even in the context of terminal illness. They argue that it goes against the principles of medical ethics, which prioritise the preservation of life and the relief of suffering through palliative care.
Ethical debates also revolve around issues of fairness, access to care, and the potential for societal impacts. It is crucial for policymakers, healthcare professionals, and society as a whole to carefully consider the ethical implications of voluntary assisted dying.
Implementation challenges and lessons learned.
The implementation of voluntary assisted dying legislation in Australia has posed various challenges. These challenges may include issues related to training and education of healthcare professionals, access to care in rural and remote areas, reporting and documentation requirements, and coordination among different stakeholders involved in the process.
There may also be challenges related to public perception, stigma, and misconceptions about voluntary assisted dying. Lessons learned from other jurisdictions that have implemented similar legislation, such as the Netherlands, Belgium, and Canada, can provide valuable insights into potential challenges and best practices for implementation in Australia.
In the Netherlands, voluntary assisted dying has been legal since 2002 and is available to patients who have unbearable suffering without prospect of improvement, and who have requested it voluntarily, explicitly, and repeatedly. According to the Dutch government's report on the implementation of the law, there has been a gradual increase in the number of cases of voluntary assisted dying, with around 7,000 cases reported in 2017. The report also indicates that the majority of cases involve patients with cancer, and that the process is generally carried out in a careful and responsible manner with high levels of compliance with the legal requirements.
In Belgium, voluntary assisted dying has been legal since 2002 as well. Similar to the Netherlands, the law allows patients to request voluntary assisted dying if they are suffering from an incurable illness, have an advanced and irreversible condition, and are experiencing unbearable suffering. According to a study published in the New England Journal of Medicine, approximately 2% of all deaths in Belgium are due to voluntary assisted dying. The study also found that most cases involved patients with cancer, and that the process was generally carried out in compliance with the legal requirements.
In Canada, voluntary assisted dying became legal in 2016 with the passage of the Medical Assistance in Dying (MAID) legislation. The law allows patients who are eligible to request and receive medical assistance in dying if they have a serious and incurable illness, disease, or disability that causes intolerable suffering, and their natural death is reasonably foreseeable. According to the latest report by Health Canada, there were 7,595 reported cases of MAID in Canada between June 2016 and October 2020. The report indicates that the majority of cases involved patients with cancer, and that the process was generally carried out in a careful and responsible manner with high levels of compliance with the legal requirements.
It is essential to learn from these experiences and address any challenges proactively to ensure the smooth and responsible implementation of voluntary assisted dying.
Final thoughts on voluntary assisted dying.
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.
Part of being prepared for your end-of-life is planning for your funeral in advance with a Prepaid Funeral. If you’re interested in a Bare Prepaid Funeral, you can head to the link below for an instant quote for your area, or give our incredible Prepaid team a call on 1800 202 901.
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