Legislation has been introduced to make changes to the Australian state of Victoria’s assisted dying laws to make them more accessible and compassionate. The proposals were introduced after a five-year review of the Act, which legalised assisted dying in Victoria in 2017, and came into force in 2019. With assisted dying soon to be discussed by a Select Committee in the House of Lords ahead of the upcoming Committee Stage of the Assisted Dying Bill, we hope our politicians can learn from other jurisdictions which have introduced assisted dying legislation safely and compassionately.
What is the current assisted dying legislation in Victoria, Australia:
Currently, the Victorian law sets out that an adult must have six months left to live in order to access assisted dying, unless they have a neurodegenerative condition, at which point they may have up to 12 months left to live. A person must have full mental capacity throughout the process and be experiencing unbearable suffering from their condition.
A person must have two assessments, or three assessments if they have a neurodegenerative condition, and there must be a period of at least nine days between the first assessment and the second.
A doctor is forbidden to discuss assisted dying in any form unless the patient explicitly raises it first, which was colloquially known as the ‘gag clause’, and all doctors can conscientiously object and remove themselves from the process.
What are the proposed changes:
A number of changes are proposed in the Bill that change eligibility, process, and access to assisted dying.
The life-expectancy access rule will be expanded from six to 12 months for all conditions, and a third assessment will no longer be needed for people with neurodegenerative conditions. The time between the first and second assessment will be reduced from nine to five days.
The ‘gag clause’ will be removed, allowing doctors to raise the issue of voluntary assisted dying with terminally ill patients. Health practitioners who conscientiously object to assisted dying will now be required to provide a minimum amount of information to patients, to allow them to make their own choices.
There are further changes to residency requirements, expanding the assisted dying workforce, and banning conflicts of interest, so practitioners cannot be beneficiaries or family members of people accessing the scheme.
What prompted the changes:
As part of their law, the Victorian government was required to have a large-scale independent review five years after the operation of the act. This is very similar to the legislation proposed in the UK. The independent review, which was a result of extensive research and community consultations, found that assisted dying ‘is a safe and compassionate end-of-life choice available to eligible Victorians.
The review found that families overwhelmingly valued the care and support provided by assisted dying medical practitioners. 93% of families reported that the process was compassionate.
‘The application was as good as it possibly could be… handled compassionately and efficiently.’ (Family member)
‘Just knowing that he had the option to access [assisted dying] was huge for him, even if he never ended up needing to use it.’ (Family member).
The laws are expected to take about 18 months to enact. They will be reviewed after three years of operation, and then every five years after that.
What has the response been?
The Premier of Victoria, Jacinta Allan, claimed the changes would make it easier and fairer for those with terminal illnesses, whilst still keeping the process robust and safe. She said:
‘People who are terminally ill and suffering in pain deserve the choice to live out their last days with dignity. We’re reforming [the Assisted Dying Act] to make it clearer and more compassionate for patients and their families, while keeping the safeguards secure.’
The Australian Royal College of GPs has welcomed the move, saying:
voluntary assisted dying during discussion about end-of-life options. The removal of this ‘gag clause’ will have such a meaningful impact, as will extending the life expectancy limit for eligibility from six months to a year.
‘Every patient, no matter their postcode, deserves to die with dignity and not have to experience unnecessary suffering in their last weeks and months.
‘It’s the right thing to do after listening to the experts and those impacted by the limitations of the current scheme. Once again, I congratulate the Government on advancing these reforms’
How does this compare to the proposals in the UK:
The Terminally Ill Adults (End of Life) Bill, currently making its way through the House of Lords, is limited to people who have six months left to live or fewer. There are no exceptions for people with neurodegenerative conditions, although MPs did discuss such a change at Committee Stage of the Bill in the House of Commons.
There has never been a ‘gag clause’ proposed in UK legislation, and an attempt to introduce one was defeated by 256 votes to 230 at Report Stage in the House of Commons. A similar amendment has been proposed by Lord Goodman of Wycombe in the House of Lords.
Every single applicant for an assisted death in the UK will need to be approved by a panel consisting of a social worker, a psychiatrist, and a senior lawyer. This is not required in Australia. Furthermore, an applicant must wait seven days after their first assessment, and then 14 days after their second assessment, before they can have an assisted death.
Nathan Stilwell, Assisted Dying Campaigner at Humanists UK, said:
‘We hope parliament takes note of the learning from the review of assisted dying laws in Victoria. We must take into account all the international evidence and, where possible, learn from other countries about how to construct the most compassionate law possible, rather than seeing the same issues arise.
‘Adults in the UK deserve the right to a compassionate and dignified assisted death. 20 people a day die in pain, even with the best care, and for those people, they should have a choice at the end of their lives. No-one should be forced to die in pain when internationally more compassionate options are available.’
Notes
For further comment or information, media should contact Nathan Stilwell at nathan@humanists.uk
Humanists UK have people and their loved ones who would be affected by this change available for the press.
If you have been affected by the current assisted dying legislation, and want to use your story to support a change in the law, please email campaigns@humanists.uk.
Humanists defend the right of each individual to live by their own personal values, and the freedom to make decisions about their own life so long as this does not result in harm to others. Humanists do not share the attitudes to death and dying held by some religious believers, in particular that the manner and time of death are for a deity to decide, and that interference in the course of nature is unacceptable. We firmly uphold the right to life but we recognise that this right carries with it the right of each individual to make their own judgement about whether their life should be prolonged in the face of pointless suffering.
We recognise that any assisted dying law must contain strong safeguards, but the international evidence from countries where assisted dying is legal shows that safeguards can be effective. We also believe that the choice of assisted dying should not be considered an alternative to palliative care, but should be offered together as in many other countries.
Read more about Humanists UK’s campaign to legalise assisted dying in the UK.
Humanists UK is the national charity working on behalf of non-religious people. Powered by over 150,000 members and supporters, we advance free thinking and promote humanism to create a tolerant society where rational thinking and kindness prevail. We provide ceremonies, pastoral care, education, and support services benefitting over a million people every year and our campaigns advance humanist thinking on ethical issues, human rights, and equal treatment for all.