Nurses, social workers and counsellors will for the first time be able to initiate discussions about euthanasia in Australia as an option for terminally ill people, under proposed new Voluntary Assisted Dying (VAD) laws in the Australian Capital Territory (ACT). The Australian reports they’re set to be passed as the most liberal framework for assisted suicide in the country.
The legislation which was recently introduced into the ACT parliament by the territory’s Labor-Greens government elevates the position of nurses to play a role in conducting assessments of a patient’s eligibility and administering the life-ending medication. In another unprecedented move, the bill departs from the rules in other jurisdictions by allowing patients to access assisted suicide without having a predicted time of death of 12 months or less.
The Australian explains that terminally ill people can access assisted suicide if doctors say they have fewer than six months to live in Victoria, Tasmania, NSW, South Australia and Western Australia, or 12 months in Queensland. To access the scheme, ACT residents will need to have been diagnosed with a condition that is “advanced, progressive and expected to cause death;” be enduring intolerable suffering; and to have lived in the territory for a year or be able to demonstrate a “substantial connection” to the ACT.
The ACT government backed away from its initial plan to abandon the “arbitrary” age cap that’s in place in other Australian jurisdictions and allow children as young as 14 to be eligible for the scheme. The proposed legislation requires all potential participants to be at least 18 years old. A disability, mental disorder or mental illness alone is not a relevant condition to qualify.
Last December the federal parliament overturned laws that had been in place for more than 20 years banning territory governments from implementing euthanasia, to clear the way to legalise the practice in the ACT and the Northern Territory. The ACT’s Human Rights Minister Tara Cheyne who is responsible for overseeing the reforms said: “We have consulted widely in developing our evidence-based model, which responds to the known issues in other jurisdictions and reflects the ACT’s unique circumstances, together with the Canberra community’s views.”
The Australian reports the ACT’s Barr government has the numbers to pass the legislation through the legislative assembly without any amendments. Opposition Leader Elizabeth Lee said Liberals would have a conscience vote after the laws are reviewed by a committee of Legislative Assembly members. She said allowing health professionals other than doctors to initiate conversations about assisted dying “raises some alarm bells” as does the rejection of any “time frame in relation to death.”
Bishop Mark Short of the Anglican Diocese of Canberra and Goulburn expressed “very significant concerns” about the bill in its proposed form. He told the ABC he did not accept the argument that time frames were an arbitrary requirement, saying: “The danger is that we’re inviting people to make the most profound decision there can be about the future of a human life without appropriate guidance and safeguards.” The bishop added he would also be focused on strengthening the support for conscientious objectors. In line with other jurisdictions, the ACT’s bill will allow medical and health professionals to conscientiously object to having any role in VAD.
Medical oncologist Dr. Cameron McLaren, who is the inaugural president of Voluntary Assisted Dying Australia and New Zealand, supported nurses, social workers and counsellors being able to discuss ‘end-of life’ options. “This goes a step further to ensure patients are aware of their options. I don’t see that as a deficit or weakness, I see that as a strength. A lot of people have intimate discussions with nurses and other allied health team members such as social workers. It’s not uncommon for social workers to come to doctors to say ‘we had a discussion about this, this is what they told me they want’. They’re often positioned really well to have these discussions,” Dr. McLaren said.
Queensland University of Technology expert on ‘end-of-life’ law Ben White also supported the empowering of nurse practitioners to assess a patient’s eligibility for the scheme, saying that it balanced safety with accessibility. “Nurse practitioners are a trusted group of practitioners; we trust them in other ‘end-of-life’ settings, and it‘s safeguarded in the legislation that if they’re not sure if someone is eligible they have to refer it to someone else,” he observed.
Go Gentle Australia chief executive Linda Swan also welcomed the elevated role of nurse practitioners within the scheme, saying: “Nurse practitioners are highly experienced and autonomous healthcare professionals. We are confident their role alongside doctors will help improve access to VAD in the ACT.”