Finally NSW joins the other states & territories and introduces euthanasia, writes Richard Mills, former President of Dying with Dignity NSW.ON 28 November, a significant milestone occurred in NSW that particularly affects pensioners, superannuants and their end-of-life choices.
A terminally-ill person in NSW now has the legal right to ask a doctor for help to die, because a Voluntary Assisted Dying (VAD) Act has come into force.
Who can get euthanasia?
The eligibility rules are quite restrictive. To access the VAD Act, you must be likely to die within six months (or 12 months if you have a neurodegenerative disease like motor neurone). You must be suffering in a way you consider intolerable; you must be acting voluntarily; and you must be mentally competent.
Neither a disability nor a mental illness is sufficient on its own to make you eligible; you must also have a terminal illness.
What is the process?
The process is not simple, and will probably take about three weeks.
You have to be assessed as eligible by two independent doctors and they may refer you to a specialist, or perhaps a psychiatrist.
A VAD Board supervises and approves each step in the process. If it agrees that all requirements have been met, it will authorise you to receive the lethal medication that you need.
A pharmacist then dispenses the medication directly to you or your agent, and it is stored in your home in a locked box.
You then decide if you want to self-administer the medication or have a doctor do it for you, and you take it when you choose to.
Euthanasia elsewhere in Australia
NSW is the last Australian state to introduce a VAD Act. Victoria was the first in 2017, followed by WA in 2019, and Tasmania, South Australia and Queensland in 2021.
Reports so far on the implementation of VAD legislation are positive. Relatives and carers have valued the fact that their loved ones had control over the end of their life, and that their death was quick, painless and dignified.
Slightly more men than women have accessed VAD; the median age has been 74; most had cancer; and most were receiving palliative care. A significant proportion lived in regional or rural areas.
In every State, the number of deaths has been considerably less than the number of requests, and the number of deaths has been between 0.5% and 1% of total deaths. In NSW, 1% of total deaths in a year would number about 600.
However, some people have found it hard to find a doctor willing to help and the process to be complicated.
Some health practitioners may not participate in VAD services because of a conscientious objection, and others may decline for other reasons.
Some faith-based hospitals and aged care facilities may also decline to participate.
Euthanasia in regional NSW
People in the regions should have the same access to VAD services as city dwellers, and NSW Health is employing a number of Visiting Medical Officers to deliver VAD to patients who have no other access to a VAD provider. Those doctors will be available to travel to regional and remote areas.
There is also a NSW Government program that may provide financial help towards travel and accommodation costs when a patient needs to travel long distances for treatment that is not available locally.
What can you do to keep control?
Make an Advance Care Directive, which lets you set out clearly what medical treatment you want – or do not want – at some time in the future when you cannot speak or make decisions for yourself. You cannot make a request for voluntary assisted dying in your advance care directive.
If you are considering voluntary assisted dying or if you are a family member, friend or carer of someone who is considering it, please start to talk to them about end of life wishes. Talk to your doctor.
Your doctor may initiate a talk with you specifically about VAD as part of a discussion about general options for end-of-life care, and these options would include palliative care.
For more information, go to the Health Department’s website at https://www.health.nsw.gov.au/voluntary-assisted-dying/Pages/default.aspx or ring their Care Navigator Service on 1300 802 133.
For more information about Advance Care Directives ring Advance Care Planning Australia on 1300 208 582.
For Dying With Dignity NSW, click here.
ON 28 November, a significant milestone occurred in NSW that particularly affects pensioners, superannuants and their end-of-life choices.
A terminally-ill person in NSW now has the legal right to ask a doctor for help to die, because a Voluntary Assisted Dying (VAD) Act has come into force.
Who can get euthanasia?
The eligibility rules are quite restrictive. To access the VAD Act, you must be likely to die within six months (or 12 months if you have a neurodegenerative disease like motor neurone). You must be suffering in a way you consider intolerable; you must be acting voluntarily; and you must be mentally competent.
Neither a disability nor a mental illness is sufficient on its own to make you eligible; you must also have a terminal illness.
What is the process?
The process is not simple, and will probably take about three weeks.
You have to be assessed as eligible by two independent doctors and they may refer you to a specialist, or perhaps a psychiatrist.
A VAD Board supervises and approves each step in the process. If it agrees that all requirements have been met, it will authorise you to receive the lethal medication that you need.
A pharmacist then dispenses the medication directly to you or your agent, and it is stored in your home in a locked box.
You then decide if you want to self-administer the medication or have a doctor do it for you, and you take it when you choose to.
Euthanasia elsewhere in Australia
NSW is the last Australian state to introduce a VAD Act. Victoria was the first in 2017, followed by WA in 2019, and Tasmania, South Australia and Queensland in 2021.
Reports so far on the implementation of VAD legislation are positive. Relatives and carers have valued the fact that their loved ones had control over the end of their life, and that their death was quick, painless and dignified.
Slightly more men than women have accessed VAD; the median age has been 74; most had cancer; and most were receiving palliative care. A significant proportion lived in regional or rural areas.
In every State, the number of deaths has been considerably less than the number of requests, and the number of deaths has been between 0.5% and 1% of total deaths. In NSW, 1% of total deaths in a year would number about 600.
However, some people have found it hard to find a doctor willing to help and the process to be complicated.
Some health practitioners may not participate in VAD services because of a conscientious objection, and others may decline for other reasons.
Some faith-based hospitals and aged care facilities may also decline to participate.
Euthanasia in regional NSW
People in the regions should have the same access to VAD services as city dwellers, and NSW Health is employing a number of Visiting Medical Officers to deliver VAD to patients who have no other access to a VAD provider. Those doctors will be available to travel to regional and remote areas.
There is also a NSW Government program that may provide financial help towards travel and accommodation costs when a patient needs to travel long distances for treatment that is not available locally.
What can you do to keep control?
Make an Advance Care Directive, which lets you set out clearly what medical treatment you want – or do not want – at some time in the future when you cannot speak or make decisions for yourself. You cannot make a request for voluntary assisted dying in your advance care directive.
If you are considering voluntary assisted dying or if you are a family member, friend or carer of someone who is considering it, please start to talk to them about end of life wishes. Talk to your doctor.
Your doctor may initiate a talk with you specifically about VAD as part of a discussion about general options for end-of-life care, and these options would include palliative care.
For more information, go to the Health Department’s website at https://www.health.nsw.gov.au/voluntary-assisted-dying/Pages/default.aspx or ring their Care Navigator Service on 1300 802 133.
For more information about Advance Care Directives ring Advance Care Planning Australia on 1300 208 582.
For Dying With Dignity NSW, click here.
