New government may unify country on VAD

An Australian euthanasia expert believes the change of government may end the mandatory exclusions in the NT and ACT.

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New voluntary assisted dying legislation has brought NSW into line with all the other Australian states, leaving the Northern Territory and the Australian Capital Territory the last two without a VAD law. 

But one of Australia’s leading VAD experts believes the change of federal government could spell the end of their exclusion.  

The territories have been unable to introduce bills to legalise VAD since 1997, when Liberal MP Kevin Andrews introduced a federal bill revoking any VAD legislation (including in the future) in both the NT and the ACT. 

The decision also revoked the NT’s Rights of the Terminally Ill Act introduced in 1995. 

Professor Ben White, chair of End-of-Life Law and Regulation at the Queensland University of Technology, told Oncology Republic, that the new Labor Government might have a change of heart. 

“The Morrison government had specifically ruled out changing this Commonwealth law, but the new government has expressed a willingness to reconsider this and allow a conscience vote,” he said. 

“While I don’t anticipate this issue will be a priority for the government, I would not be surprised to see a private member’s bill early in the parliamentary term.” 

While patients in all Australian states may legally have access to VAD, there are still practical barriers, said Professor White. 

“A key challenge for patients wanting to access VAD is finding a doctor who is qualified and willing to assess them,” he said. 

“There are systems in place to support patients finding doctors, for example through the VAD Care Navigators, but this depends on eligible and willing doctors being available on their area.” 

There are also challenges for doctors, including GPs and oncologists. 

“A challenge for doctors who have their first patient seeking VAD can be navigating the system,” Professor White told OR. 

“However, there are now clear processes in both Victoria and Western Australia [the two states where VAD is already operational] to guide doctors through the steps needed to assess patients for VAD. The VAD Care Navigators can also help doctors with this.” 

He acknowledged that while some doctors may not wish to be involved in VAD, experience has shown this is a choice that some patients want.  

“If doctors are willing to be involved but haven’t yet had a patient ask, it is worth doing the training [as required by the legislation] now so that they are ready when that first request is made,” he said.  

“Doctors who are unsure about VAD might also consider doing the training or accessing other resources about VAD as part of exploring their position on the issue.” 

The MJA has published a guide on navigating VAD for each of the states which also provides details on how to access training for doctors in Victoria and Western Australia. Queensland, South Australia and Tasmania are in various stages of an 18-month implementation period in which training and workforce issues will be worked through and infrastructure created. 

Professor White said VAD care navigators were absolutely critical to the effective functioning of the system. 

“Care navigators can work closely with the person, their carers, family and friends, medical practitioners and healthcare teams to tailor support that meets the needs of the person,” he said. 

“For example, they may assist with identifying appropriate service referral pathways and connecting people to health practitioners and services that best meet their specific needs and goals of care.” 

QUT has a free training program for doctors called End of Life Law for Clinicians, which is funded by the Commonwealth Government. It covers the law on end of life decision-making more broadly. There are 11 modules, and Module 11 is on VAD.  

Professor White said it was launched in January this year and would be updated soon to include the NSW law.  

The training is accredited by the RACGP, ACEM and ACRRM, and many specialists claim CPD from their Colleges.  

QUT also has another resource called End of Life Law in Australia, which has a specific page explaining the law in all States on VAD.