Voluntary Assisted Dying: how the Victorians will do it

Victoria’s Voluntary Assisted Dying Ministerial Advisory Panel (the Panel) has been working on developing a safe and compassionate voluntary assisted dying framework for Victoria.

The Legislative Council’s Legal and Social Issues Committee (the Parliamentary Committee) provided a broad policy direction for voluntary assisted dying that focused on allowing a person to self-administer a lethal dose of medication. The role of the Panel was to consider how this could work in practice and to ensure only those making voluntary and informed decisions and at the end of their life could access voluntary assisted dying.

The Panel determined that voluntary assisted dying implementation should be considered in the context of existing care options available to people at the end of life.

Guiding principles

In formulating its recommendations, the Panel relied on a number of guiding principles. These principles are that:

  • Every human life has equal value.
  • A person’s autonomy should be respected.
  • A person has the right to be supported in making informed decisions about their medical treatment and should be given, in a manner that they understand, information about medical treatment options, including comfort and palliative care.
  • Every person approaching the end of life should have access to quality care to minimise their suffering and maximise their quality of life.
  • The therapeutic relationship between a person and their health practitioner should, wherever possible, be supported and maintained.
  • Open discussions about death and dying and peoples’ preferences and values should be encouraged and promoted.
  • Conversations about treatment and care preferences between the health practitioner, a person and their family, carers and community should be supported.
  • Providing people with genuine choice must be balanced with the need to safeguard people who might be subject to abuse.
  • All people, including health practitioners, have the right to be shown respect for their culture, beliefs, values and personal characteristics.

The Panel recognised the need to balance respect for autonomy with safeguarding individuals and communities in relation to voluntary assisted dying. The Panel believes that the eligibility criteria, the process to access voluntary assisted dying, and the oversight measures recommended appropriately balance these aims.

Eligibility criteria

To access voluntary assisted dying, a person must meet all of the following eligibility criteria:

  • be an adult, 18 years and over; and
  • be ordinarily resident in Victoria and an Australian citizen or permanent resident; and
  • have decision-making capacity in relation to voluntary assisted dying; and
  • be diagnosed with an incurable disease, illness or medical condition, that:
    • is advanced, progressive and will cause death; and
    • is expected to cause death within weeks or months, but not longer than 12 months; and
    • is causing suffering that cannot be relieved in a manner the person deems tolerable.

The recommended eligibility criteria ensure voluntary assisted dying will allow a small number of people, at the end of their lives, to choose the timing and manner of their death. There is no intention to give people who are not dying access, and the legislation will not give these people an option to choose between living and dying.

The eligibility criteria ensure the voluntary assisted dying framework provides a compassionate response to people who are close to death and choose to request voluntary assisted dying to give them greater control over the timing and manner of their death.

The Panel recommends that a person must have decision-making capacity throughout the voluntary assisted dying process. This requirement is fundamental to ensuring a person’s decision to access voluntary assisted dying is their own, is voluntary, and is not the product of undue influence or coercion. The Panel recognises that this will mean some people who may want to request voluntary assisted dying will be excluded.

People with dementia who do not have decision-making capacity, for example, will not be able to access voluntary assisted dying. People will also not be able to request voluntary assisted dying in an advance care directive. This may disappoint many people in the community, but the Panel is of the view that having decision-making capacity throughout the voluntary assisted dying process is a fundamental safeguard.

In addition, the Panel sets out detailed guidelines as to the qualifications of the medical personnel involved in the approval process, as well as the actual procedure and safeguards in regards to the handling and disposal of the medications used in the voluntary assisted dying process.

The full report is available here.

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