First things first. What is voluntary assisted dying?
Let's get straight to the acronym - VAD. It's the term used by Australian lawmakers and advocates to refer to the lawful assistance provided to a person by a health practitioner to end their life. Terms like ‘euthanasia’, ‘doctor-assisted suicide’ and ‘physician-assisted dying’ are also used when discussing this topic.
So it's euthanasia we're talking about?
A form of it, yes. And that word stems from the Ancient Greek for “good death”. Euthanasia - the act of intentionally ending a life to relieve suffering - is not a new concept.
And what about VAD?
So to dive right in, the premise is that the act itself is performed by the patient and not a medical professional. The nature of the assistance to die is through a lethal medication prescribed by doctors that the patient takes themselves. Under the laws that are currently in place in Australia, there is an exception for a person who cannot physically take or digest that medication. In those cases, a doctor can help administer it.
So how many other countries around the world have implemented VAD laws?
Surprisingly very few. We're talking Belgium, Canada, Colombia, Luxembourg, the Netherlands, New Zealand and Spain. And in the US there are 10 jurisdictions that have what they call 'death with dignity' statutes.
Is that because it's controversial?
Exactly. And the debate for and against VAD has played out a few times in Australia in recent times.
So what do critics say?
On this side of the debate, it for many it has a lot to do with religion. And just to be clear, it's not correct to say that people with religious beliefs oppose VAD. In fact, there are polls that show strong support of VAD laws from people with religious beliefs. But the religious argument goes that we don't have the right to take our own lives and some consider it a sin. They say it's an immoral practice akin to suicide and murder that violates the intrinsic value of life.
And what's the non-religious argument against VAD?
That services such as palliative care, aged care and mental health supports should be improved to ensure that people don't suffer in the end stages of their lives.
So what do supporters say?
Those in support of VAD often talk about their own experiences of watching a loved one suffer with a terminal illness. They also raise concerns about poor quality of life and the desire for a peaceful death.
Some say VAD should be extended to non-terminally ill people...
That’s right. A poll taken by National Seniors Australia a couple of months ago saw two-thirds of the 3,500 respondents support VAD even if a person’s illness wasn’t terminal. And they said there is support for making it accessible to all seniors over a certain age, whether ill or not.
Will that be allowed in Oz?
That's not on the cards here, and neither is extending eligibility to access the laws for people who are struggling with a mental illness or a disability. It's a controversial topic...
So back to Oz - where were the first VAD laws passed here?
In 1995, the Northern Territory became the first jurisdiction in the world to pass laws allowing a doctor to end the life of a terminally ill patient at the patient's request.
But that's not the case now, is it?
No, the laws were struck down by the Federal Government in the first term of the Howard Government. It also passed a bill that removed the power of the territories to legalise VAD, but the states still hold that power.
So for a long time, we didn't have those laws. What happened?
There were several cases of people being charged with helping people to die, although prosecutions have been rare. One name that has popped up in the news time and time again has been Dr Philip Nitschke.
He’s the founder of Exit International and was the first doctor in the world to administer a legal, lethal voluntary injection under those NT laws. After the legislation was overturned, he continued to campaign for VAD and to help people end their own lives with guides and advice.
So which was the first Aussie state to pass VAD laws?
That would be Victoria, which passed legislation in 2017 that made it legal for someone who fits the criteria for VAD to end their own life. That law came into place in 2019 and it has been a template for other states to follow.
What are the rules?
That the patient is aged 18yo and over; is an Australian citizen/permanent resident. They have to have decision-making capacity; and have a disease, illness or medical condition that is incurable, advanced, progressive and will cause death within 6 months. That's extended to 12 months for people with neurodegenerative diseases like motor neurone disease.
And there’s a whole process for patients to go through…
Yep. For example, 2 doctors over a series of appointments have to assess the patient as being suitable to access VAD.
How many Victorians have accessed VAD since then?
When the laws were passed, the Victorian Government predicted about 150 people a year would end their lives using the arrangement provided for by the laws, and that seems to be what's transpired.
So what about the other states?
VAD laws have since been passed in Western Australia, Tasmania, South Australia, and Queensland.
And NSW could become the last state to implement VAD laws?
That's right. NSW has knocked back the laws before, but this week Independent Member for Sydney Alex Greenwich introduced VAD laws into the parliament.
Does he have much support?
He does - from across the political spectrum. But there are some who are vehemently opposed.
So what's going to go down?
Dunno - it's an observe and wait. One thing to note: newly installed Liberal Premier Dominic Perrottet and Labor leader Chris Minns are giving their MPs a conscience vote.
And the territories?
As we mentioned, they have no ability to make their own laws on this. And there are no plans for the Morrison Government to move in that direction.