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By the end of 2023, eligible people in all Australian states will be able to apply for voluntary assisted dying as the final three states' laws will become operational this year.
This year began with Queensland's voluntary assisted dying law commencing operation on January 1. South Australia has followed, its new policy coming into effect on January 31, with the New South Wales law to commence on November 28.
These states join Victoria, Western Australia and Tasmania, whose laws have been operating for more than three years, one year and three months respectively.
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The Australian Capital Territory and Northern Territory may be poised to follow after the Commonwealth lifted a ban of more than 25 years on territories passing voluntary assisted dying laws.
The ACT has already signalled it will introduce such laws by 2024 and circulate a discussion paper in the coming months.
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Hundreds have chosen to end their lives with voluntary assisted dying
There is now a clear picture emerging of voluntary assisted dying in Australia, with hundreds choosing this in states where it is legal.
In Victoria, 604 people have been assisted to die in the three years between June 2019 and June 2022 (the latest figures publicly available). Some 75 per cent of people being assisted to die since the law commenced were 65 or older; more than 80 per cent of applicants had cancer.
In the last reporting period (July 1, 2021 to June 30, 2022), deaths from voluntary assisted dying represented 0.58 per cent of deaths in the state.
In Western Australia, uptake has been much higher than expected, with 190 people (1.1 per cent of deaths in the state) choosing voluntary assisted dying in the first year. This is higher than the number of Victorians who accessed voluntary assisted dying in the first year, even though WA's population is much smaller.
In the western state, almost 88 per cent of eligible applicants were aged 60 or over and 68 per cent of patients requesting voluntary assisted dying had cancer.
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In both states, more than 80 per cent of patients requesting voluntary assisted dying were also receiving palliative care. Eligible applicants cited the inability to engage in activities that make life enjoyable, and the loss of autonomy, as the two most common reasons for accessing voluntary assisted dying.
How does the voluntary assisted dying system works?
In Victoria and WA, bodies that oversee voluntary assisted dying have found the system safe. According to their reports, only people who meet the strict eligibility criteria have been able to access it.
Those providing voluntary assisted dying and state-based services designed to help prospective patients access it has praised the set-up as supportive and compassionate.
However, there are barriers to access, including:
• The statutory prohibition preventing Victorian doctors initiating conversations about voluntary assisted dying
• Commonwealth restrictions on discussing voluntary assisted dying via Telehealth and email
• The need to show evidence of Australian citizenship or permanent residency can preclude some long-term residents from accessing voluntary assisted dying if they cannot prove their status
• The lack of eligible doctors willing to provide voluntary assisted dying
• The lack of proper remuneration for doctors lengthy and complicated administrative processes
• Non-participation by some aged care and healthcare providers
Many of these issues are heightened in rural and remote areas.
While it is still early days in Tasmania, access issues have already been reported. These result from a lack of trained doctors, and a complicated and lengthy request and assessment process.
How can the issues be addressed?
Voluntary assisted dying legislation in each state requires it to be reviewed after a certain period. For both Victoria and WA, the review will begin this year.
But it is not yet clear how these reviews will be conducted, or what evidence considered.
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For some issues, law reform might be needed. For others, a policy response may be possible.
For example, potential barriers might be addressed through better remuneration for participating practitioners, strategies to support individuals living in rural and remote areas and a more flexible application of the Australian residency rules.
These mandated reviews present an important opportunity to improve how voluntary assisted dying laws operate in practice. It is pivotal these reviews are evidence-based.
Fortunately, there is a growing body of published evidence that can guide and inform these reviews – from the bodies that oversee voluntary assisted dying and from research on voluntary assisted dying practice.
Now voluntary assisted dying laws are operational in all Australian states, or will be by the end of the year, the next challenge is to ensure current barriers to access are removed while continuing to ensure the system operates safely.
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Source: 9News
