Last week, I went to the hospital to act as a witness for a patient who is seeking voluntary assisted dying.
What is voluntary assisted dying?
Voluntary assisted dying, also known as VAD, has been a topic of much debate in Australia in recent years. In 2017, the state of Victoria became the first jurisdiction in Australia to legalise voluntary assisted dying for terminally ill patients who meet strict eligibility criteria. The legislation, known as the Voluntary Assisted Dying Act 2017, was enacted on 19 June 2019.
Under the Act, only patients who are at least 18 years of age, have decision-making capacity, and have an incurable illness expected to cause death within six months (or 12 months for neurodegenerative conditions) are eligible to request VAD. The patient must make three separate requests, including a written request, and undergo a series of assessments by medical professionals to ensure they meet the eligibility criteria. If the patient is deemed eligible, they can self-administer the medication or have a medical practitioner administer it.
The legalisation of VAD in Victoria has been controversial, with some arguing that it goes against the principles of medicine and the sanctity of life. However, proponents argue that it gives patients who are suffering from unbearable pain and have no hope of recovery the right to choose the time and manner of their death.
One of the key arguments in favour of VAD is that it gives patients autonomy and control over their own lives. It also helps to reduce the suffering of patients and their families, who may have to watch their loved ones suffer for extended periods.
Kerry Robertson was the first person in Victoria to access assisted dying. Four years after being declared free of breast cancer, Robertson developed a tumour in her bones that spread to her lungs, brain, and liver. Her palliative care team was unable to ease the pain. Her daughter, Nicole, told The Age that her mum wasn’t afraid of dying, but she was terrified of the pain.
“She left this world with courage and grace, knowing how much she is loved,” Nicole said. “For us, that was the greatest part, knowing that we did everything we could to make her happy in life and comfortable in death.”
Gary, a Richmond Tigers supporter
I went to the hospital on a Friday afternoon to meet the patient, his brother, the doctor, and another independent witness. The patient, Gary*, was waking from a nap; he’d taken a tour of the MCG earlier that day. His Richmond Tigers cap was nearby.
The doctor, who was very kind, explained everything and organised the documents. Gary told us he had terminal cancer, and there was nothing more medical science could do for him. He didn’t want to be in pain or have his family watch him suffer. He was in good spirits, told stories, and made jokes. It was bittersweet, of course; Gary’s brother both laughed and was teary at times. He was also very kind and expressed deep gratitude to us for coming.
Sometimes friends ask me how I can do this or what it feels like. I don’t have great answers to these questions. I feel fine. Gary knows his illness and his life better than I do. I respect his personal agency and ability to make an empowered choice at the end of his life. Gary doesn’t want to suffer. His doctor and brother don’t want him to suffer. I don’t want him to suffer, either.
Final thoughts
Critics argue that VAD is a slippery slope towards euthanasia and undermines the value of life. They also worry that vulnerable groups, such as the elderly and disabled, may be coerced into requesting VAD. But the law has many steps and safeguards to ensure that a person is not coerced to participate in VAD. Some argue that several of the 68 safeguards are obsolete and preventing some Victorians from accessing the VAD, particularly Victorians with a disability and those living in rural areas.
VAD has been successfully implemented in Victoria, with hundreds of patients choosing to access the service since it became legal in 2019. Overall, the legalisation of voluntary assisted dying in Victoria has opened up an important conversation about end-of-life care and the right to die with dignity. VAD provides a much-needed option for terminally ill patients who are suffering and have no hope of recovery.
*The patient’s name has been changed to protect his privacy.