Euthanasia: New laws could see Victorians get lethal medicine within 10 days
File photoPeople with terminal illnesses could access lethal medication within 10 days of asking, under proposed euthanasia laws for Victoria, made public for the first time on Friday, that have been described as the most conservative in the world.
Serious disability or dementia would not be grounds for eligibility under the proposed laws.
New criminal offences could also be introduced to prosecute those who “induce” a person to request to die.
Details about Victoria’s proposed euthanasia laws are contained in 66 recommendations outlined in the Andrews government’s Ministerial Advisory Panel report on voluntary assisted dying.
Anyone who asks to die must go through a three-step request, the advisory panel recommended.
The patient must begin with a verbal request, followed by a formal written request, then a final verbal request.
A minimum of 10 days must pass between the first and final request, unless the person is assessed as likely to die within 10 days.
It is expected that, at first, about 150 people a year will access assisted dying legislation in Victoria and that this would likely increase.
The proposal document will shape the laws set to come before both houses of Victoria’s parliament next month and contains the most detailed information yet on what who will be eligible and the safeguards to be introduced.
Politicians will have a conscience vote and are not expected to vote along party lines, with the exception of the Greens who support voluntary euthanasia.
Professor Brian Owler, chairman of the panel, described the proposed laws as conservative and “distinctly Victorian” Photo: Andrew Meares
Professor Brian Owler, chair of the advisory panel and former president of the n Medical Association, has described the proposed laws as conservative and “distinctly Victorian”.
“If anything we can be criticised for the burden it may place on someone that is dying,” Professor Owler said.
Professor Owler said it was conceivable that a person “could obtain a prescription, visit a chemist to get a dose of medication and self-administer on that day”.
But he said this was not the usual experience overseas.
Seven key criteriaPeople must be able to fulfil seven key eligibility criteria – including that they are expected to die within a year, are aged over 18, have an incurable disease that will cause death and have a medical condition that is causing suffering that “cannot be relieved in a manner that is deemed tolerable”.
People with dementia will not have access to euthanasia.
Patients with motor neurone disease would have access to physician-assisted euthanasia, and help to physically administer a lethal dose if physically unable to do so.
The panel said while it accepted the loss of cognitive capacity may cause distress to some people “voluntary assisted dying must be ‘voluntary’ – that is, a person must have the decision-making capacity to make an autonomous choice – at all stages of the process”.
People with a mental illness or a disability would only be able to access euthanasia if they had a terminal illness and fulfil the other criteria.
The panel recommended that only the person who is terminally ill and wants to die can make a request to access lethal medication.
Neither a doctor, nor a carer, can request access and neither can a doctor initiate a discussion about ending one’s life.
A person may withdraw their request at any time, and once having done so, must begin the process anew if she or he decides to seek access to lethal medication again.
The panel also addressed the potential for “elder abuse” by a relative or carer, for example, who could conceivably benefit financially from the person’s death.
To guard against elder abuse, two independent assessments will be done to ensure a person’s request to die is voluntary and properly informed.
Anyone who requests to die will be required to create a written declaration of his or her enduring request, which will also be witnessed by two independent witnesses.
Neither witness can be in a position where they can financially benefit from the person’s death.
“It is important that elder abuse is addressed, and the panel is of the view that its recommended framework will identify and manage instances of elder abuse,” the ministerial advisory panel’s report said.
The panel recommended that all requests to die be independently assessed by two medical practitioners, neither of whom is in a position to benefit from the person’s death.
One must be a medical practitioner, such as a GP for example, who has been qualified for at least five years.
The other must be a specialist in the terminal illness or condition the person suffers.
Both assessors must have completed specified training beforehand.
Two side of the debateMuch unites those on either side of the euthanasia debate. Many agree that palliative care needs to be better funded and available to more Victorians sooner.
But they remain fundamentally divided on what rights should be given to a small number of people for whom even the best medical treatment is not enough to relieve their suffering.
Retired nurse Jane Morris says her mother Elizabeth was one of the minority of people who suffereda “horrific” and “torturous”death.
The 77-year-old, who had motor neurone disease, died in August 2014.
Ms Morris said her family remains traumatised by the last day of her mother’s life, as an attempt to terminally sedate Elizabeth was unsuccessful, despite”exemplary” palliative care.
“She had pain, breakthrough pain, because her prescribed dose was unable to adequately palliate her pain at all times,” Ms Morris said.
“She managed to express to us her fear and in one of her conscious moments was able to convey to us that she wanted to be fed through her PEG tube. This was so very traumatic for all of us, many staff included.
“However, orders were relayed to us by equally distressed staff that we should inform Mum that she was not to be fed.
“Why should we have been expected to inform our dying mother that we could not fulfil a dying wish?”
Ms Morris said every individual should be given a choice about whether they want to access assisted-dying laws.
“I don’t care what way people decide. I have respect for everyone’s choice. But I don’t think one ideology should trump another,” she said.
“The memories of mum’s horrific death have been seared into our memories.”
Palliative Care Victoria is one of the organisations which have declared it will oppose euthanasia laws, saying it “will lead to a growing sense of a duty to die”.
They say those who work daily with the dying, Victoria’s palliative care staff, are more likely than the general population to oppose assisted-dying laws (popular support stands at more than 75 per cent).
Palliative Care Victoria chief executive Odette Waanders said some still misunderstood palliative care, which meant some were going without help.
“There is a perception that palliative care means that you’re giving up, and you’re reaching the end of life and that nothing more can be done.
“But it can be done in tandem with treatment.”
The organisation is calling for an extra $65 million to be pumped into the sector by the Victorian government to improve access.