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A choice for a proper closure: Contentious medical service lands in this state

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A choice for a proper closure: Contentious medical service lands in this state

pexels-ivan-samkov-8964512.jpg A choice for a proper closure: Contentious medical service lands in this state
Seniors with debilitating health conditions now have access to a controversial service offered across Australia. Disclaimer: This photo is not an accurate representation of the article's content. Image Credit: Pexels/Ivan Samkov

Healthcare services exist to help people live long, fulfilling lives.



Yet, one service has garnered nationwide attention for alleviating patients' suffering differently.




Today marks a significant milestone for Canberrans facing terminal illness: the Australian Capital Territory has become the seventh Australian jurisdiction to offer voluntary assisted dying (VAD), providing another option for those seeking to maintain control over their final days.



After an 18-month implementation period, the ACT's voluntary assisted dying scheme commenced today, 3 November.



This decision brought an end to nearly three decades of legal restrictions that prevented the territory from legislating on this deeply personal matter.



In 1995, the Northern Territory passed the Rights of the Terminally Ill, a world-first euthanasia legislation.



Two years later, the Federal Parliament passed legislation blocking territories from creating voluntary assisted dying laws. For years, the ACT remained 'an isolated island, unable to enact a voluntary assisted dying scheme while the rest of Australia's states began to allow it'.



This changed in 2022 with the passing of the Restoring Territory Rights Act, which repealed restrictions preventing the NT and ACT from legislating on voluntary assisted dying.




'We are really being much more open in these conversations and the reality that we're all going to die someday, and let's do everything we possibly can to improve our quality of lives every day up until that time.'

- Kate Reed, palliative care nurse practitioner



What makes the ACT scheme different

The ACT scheme differs from other state-based schemes in several ways.



Patients don't need to have a specific timeframe until they're expected to die.



To add, one of the two health practitioners who assess eligibility for assisted dying may be a nurse practitioner.



Lastly, patients in institutions that object to voluntary assisted dying will have greater access than in other states.



This flexibility addresses some of the concerns raised about other jurisdictions' restrictive approaches.




For many seniors living with degenerative conditions like Parkinson's disease, the removal of strict timeframe requirements offers hope for maintaining dignity without the pressure of artificial deadlines.



Understanding who can access the scheme

The eligibility criteria remain carefully structured to ensure appropriate safeguards while providing genuine choice for those who need it.



Applicants must be over 18, have lived in the ACT for 12 months (unless granted an exemption), have decision-making capacity throughout the process, and be acting voluntarily without coercion.[.p]

Crucially, eligible patients must have 'an advanced and progressive medical condition that is expected to cause death and is causing intolerable suffering'.



However, unlike other jurisdictions, there's no requirement for a specific prognosis timeframe.




ACT's 10-step VAD process



  • First request

  • First assessment

  • Consulting assessment

  • Second request

  • Final request

  • Final assessment

  • Administration decision

  • Prescription and supply

  • Administering VAD substance

  • After-death procedures

  • Note: Applicants can pause or withdraw from the process at any time.




A deeply personal decision for dignity

Former educator Gail Ford's story illustrates why this choice matters to Australians. Ford has watched Parkinson's disease systematically strip away her abilities over more than 20 years.



'Communication was very important and now I can't communicate,' she explained.



After a devastating year in 2024 that saw her spend five months across six different hospitals following serious falls, Gail found herself permanently wheelchair-bound with severely compromised basic functions.



'A text message might be two lines long; it could take me 10 minutes,' she described. For someone whose life was built on connecting with people globally, the isolation has been heartbreaking.



Her perspective on voluntary assisted dying is practical and thoughtful.



'I think about it like a ship with plimsoll lines—they sink when they've got too much on board,' Ford shared. 'If you get to the stage where you've got nothing that you're looking forward to, where you can't eat normally, you're just eating slush, what's life like?'



Curious of how other healthcare workers think about VAD? Watch here:



Source: Go Gentle Australia/YouTube



Australia's evolving landscape

Australia now has voluntary assisted dying laws operating in all six states and the ACT.



According to ACT officials, if a person meets all criteria, there will be no barriers to accessing voluntary assisted dying, making it 'the only place in the country where there isn't some exclusion for different places that people might live'.



Kate Reed, a palliative care nurse practitioner and director of the VAD implementation taskforce, emphasises that voluntary assisted dying doesn't replace existing end-of-life care.



'Everything else will still be there. Palliative care will still be there. This is adding to the healthcare of a person, not taking anything away,' Reed shared.



The scheme includes robust oversight through an independent board chaired by healthcare advocate Darlene Cox.



'We're monitoring it to look for opportunities to improve the service, to make sure that there are sufficient safeguards in place, that people really are entering into this voluntarily, that there is no coercion,' she explained.




The ACT government committed to a community consultation next year about expanding access to include people with degenerative conditions like Alzheimer's or advanced Parkinson's disease.



This scheduled review acknowledges that the conversation about end-of-life choices continues to evolve.



For Canberrans seeking information about voluntary assisted dying, healthcare providers can offer detailed guidance about the process and eligibility requirements. Speaking to your doctor or health professional is the best first step for more information about VAD.



Palliative Care Australia provides comprehensive information about end-of-life care options, while carer support services are available through the Carer Gateway (1800 422 737) for those supporting someone through difficult decisions.



The implementation of the ACT's scheme, with its innovative features and comprehensive safeguards, may well influence how other jurisdictions refine their own approaches to this deeply personal aspect of healthcare.



For many Australians like Gail Ford, these new laws offer the possibility of 'dying with dignity' and to choose their final chapter on their own terms.



If you're considering end-of-life options, please consult with your healthcare provider before making any decisions. Support is also available through services like Lifeline (13 11 14) and Beyond Blue (1300 22 4636).





  • Primary source






  • Voluntary Assisted Dying—End of Life Law in Australia—QUT

    Cited text: 'VAD will commence operation in the ACT on 3 November 2025.'


    Excerpt: After an 18-month implementation period, the ACT's voluntary assisted dying scheme commenced today, 3 November.







  • How ACT's voluntary assisted dying laws came to pass | The Canberra Times | Canberra, ACT

    Cited text: 'Federal Parliament passed Liberal member Kevin Andrews' private members' bill, blocking the territories' rights to legislate on voluntary assisted dying...'


    Excerpt: Two years later, the Federal Parliament passed legislation blocking territories from creating voluntary assisted dying laws. For years, the ACT remained 'an isolated island, unable to enact a voluntary assisted dying scheme while the rest of Australia's states began to allow it'.







  • Euthanasia and assisted suicide in Australia—Wikipedia

    Cited text: 'The scheme differs from the tenets of other state-based schemes, namely; patients do not need to have a specific time frame until they are expected to...'


    Excerpt: The ACT scheme differs from other state-based schemes in several ways.





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I think my mum would have opted to have this.

I cared for her and she was screaming in agony before she passed away. She had horrible secondary infections that the doctors couldn’t help with. It was so distressing not being able to help her.

The last time I saw her she was begging to go. One of the infections eventually spread to her heart.

You’re at peace now dear mum. 💔
 
If only we could all just go to sleep one night and not wake up. EOLCP isn't always pain free.
Personally l don't want to be in pain nor do l wish to wander in circles all day not knowing where I am, who l am or who anybody else is. I don't want someone wiping my bum feeding me etc.
 
I think my mum would have opted to have this.

I cared for her and she was screaming in agony before she passed away. She had horrible secondary infections that the doctors couldn’t help with. It was so distressing not being able to help her.

The last time I saw her she was begging to go. One of the infections eventually spread to her heart.

You’re at peace now dear mum. 💔
:(
 
  • Like
Reactions: NannaKay
My mother wanted to die on her own terms. She made speeches pushing for VAD. In the end, she suffered in ways she never should have. Her greatest fear was dying alone, but she did in the end because of the cruel attitude of the staff at the Aged Care Home she resided in and the failure of medical experts to notice signs.
The law in many states is farcical. Seems ACT has it more right than most. Once a person has reached a stage where there is no quality of life, they should be allowed to go. The whole debate about it is absurd. We can already specify, as early in life as we choose, the conditions under which we want artificial help to live withdrawn. Why not allow people to specify the conditions under which they want help to die in exactly the same way? What is the difference? Let people consult lawyers and doctors and make their wishes known while they are mentally fit and agile and able to resist influencers. Problem solved.
 
This is your life, its about time you had a say in when you are tired and wish to go into your "forever sleep".
 
An essential component in my view is assisted dying for those with advanced dementia. It is an horrific existence, a burden on the entire family, and yet such people are excluded because they are deemed not capable of making such a decision. There needs to be some provision to request assisted dying should such a situation arise. It is too late once dementia is diagnosed.
 
We euthanise pets when they are suffering but we try to prolong humans life. It seems just wrong
 
My mother wanted to die on her own terms. She made speeches pushing for VAD. In the end, she suffered in ways she never should have. Her greatest fear was dying alone, but she did in the end because of the cruel attitude of the staff at the Aged Care Home she resided in and the failure of medical experts to notice signs.
The law in many states is farcical. Seems ACT has it more right than most. Once a person has reached a stage where there is no quality of life, they should be allowed to go. The whole debate about it is absurd. We can already specify, as early in life as we choose, the conditions under which we want artificial help to live withdrawn. Why not allow people to specify the conditions under which they want help to die in exactly the same way? What is the difference? Let people consult lawyers and doctors and make their wishes known while they are mentally fit and agile and able to resist influencers. Problem solved.
I totally agree! This is especially important in cases of dementia. I saw my husband go through the indignity of dementia. Should that happen to me, I would not want to continue such a pathetic and awful existence!
 
An essential component in my view is assisted dying for those with advanced dementia. It is an horrific existence, a burden on the entire family, and yet such people are excluded because they are deemed not capable of making such a decision. There needs to be some provision to request assisted dying should such a situation arise. It is too late once dementia is diagnosed.
I totally agree NannaKay.
I am so sorry your mum and your family suffered, especially given her obvious choice to end a certain way.
When I updated my will, I updated my wishes regarding end of life directives. The hospitals take these very seriously.
My late hubby also had his wishes in writing. The primary directive was the usual DNR, and, he did not want to be kept alive by machines to live out his last days as a vegetable. That's what happened. We were all in the hospital room, the nurse came in and said can you give us a few minutes while we clean him up, then, his wishes were carried out. They soon came out to me and said he was gone. In those last hours, he did not know we were there. He left us as he wished, however, I stress that it was not a case of assisted dying. They took him off life support as he wished.
Having these things in writing is very important before one loses the ability to choose.
I would hope the same can happen with the assisted dying situation. Nobody wants to see those we love go through the pain that so many have to suffer. We need to have the choice to go with dignity.
Some might say it is not a good topic to talk about. I say, we will all be there in the end.
My hope is that we will be allowed to make that ultimate choice the same way that end of life directives is set up.
 

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