This state's latest move affects doctors and patients eyeing this controversial service
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Disclaimer: This article discusses distressing themes such as death. Reader discretion is advised.
As modern medicine continues to advance, several treatments and care services have been on the rise.
However, this also meant the rise of end-of-life care across the world.
In a significant shift around end-of-life care in Australia, a state recently announced several changes that could bring relief to Australians facing terminal illness.
Victoria finalised a compassionate and controversial decision to scrap a 'gag clause' that previously prevented doctors from initiating discussions about voluntary assisted dying (VAD) with their patients.
The repeal of this clause gave profound relief to doctors in the state, including Dr Nick Carr.
For several years, doctors like Dr Carr have been in a heart-wrenching ordeal as they watched patients endure excruciating pain.
These heartbreaking sights have been compounded by the fact that doctors could offer all legal care options, including VAD.
'It's quite perverse,' Carr remarked as he looked back at the frustration of being silenced by the law.
The inability to discuss VAD, unless directly asked by the patient, has been a source of ethical conflict for healthcare providers who are committed to comprehensive patient care.
Victoria's pioneering stance on VAD began in 2017 and officially took effect in 2019.
Since then, other Australian states except Northern Territory have enacted similar legislation.
It highlighted that Victoria's once 'groundbreaking' laws now appear more conservative compared to other jurisdictions.
The review that led to this decision found that Victoria's VAD laws were functioning as intended.
The review's findings showed that 1,527 VAD permits were issued in Victoria between 2019 and 2023.
About 912 of these individuals opted to use the VAD substance.
Compliance was remarkably high, with only 14 cases of non-compliance, half of which involved the delayed return of the VAD substance by relatives.
No misuse was reported, which reinforced the safety and integrity of the VAD process.
However, the said review also stated that certain safeguards were inadvertently hindering access to this critical end-of-life choice.
The gag clause was initially introduced to prevent coercion and the premature ending of lives.
Yet, this clause has been identified as an impediment, especially for patients suffering terminal conditions.
The state government's acceptance of the review's five recommendations marked a commitment to improving access to VAD in the state.
These reforms aimed to increase community awareness, enhance accessibility for Aboriginal and Torres Strait Islander people, and better serve multicultural communities.
Health Minister Mary-Anne Thomas emphasised the importance of reforming the VAD laws to ensure equitable access throughout Victoria.
'We're looking to remove barriers and improve the experience for all patients, their families and health practitioners,' Minister Thomas shared.
Among the proposed changes was the removal of the citizenship and residency requirement for VAD applicants.
This change was a significant development for non-citizens who may need the service.
One such case was that of Julian Bareuther, a United Kingdom citizen who was ineligible for VAD despite living in Australia for 40 years.
Dr Carr, who served on the board of Dying With Dignity, recalled Mr Bareuther's tragic case.
'He came and saw me eight days after the laws came into effect,' Dr Carr recalled.
'He had pancreatic cancer and wanted VAD, but because he was not formally an Australian citizen, he was denied the option.'
'If the government removes that requirement, it would be a huge and welcome change,' Dr Carr ended.
The government also considered extending the life expectancy rule for non-neurodegenerative diseases from six to 12 months as an acknowledgement of the variability in medical prognoses.
Additionally, the requirement for third assessments for patients with neurodegenerative conditions could be removed, and the time between the first and final VAD request could be shortened.
These proposed reforms have been met with enthusiasm from advocacy groups.
Dying With Dignity Victoria president Jane Morris and Go Gentle chief executive Linda Swan applauded the government's commitment to reducing barriers and needless suffering.
'We've heard so many unfortunate stories from people who've faced these barriers. To think that they may be righted is just the most incredible feeling,' Ms Morris stated.
'They show the government is listening to terminally ill people and their families and the health professionals who care for them,' Ms Swan added.
As Victoria aligned its legislation with other Australian jurisdictions, conversations around VAD have significantly evolved.
The proposed changes should reflect a growing recognition of the importance of patient autonomy and the need for compassionate end-of-life options.
How do you feel about these changes to Victoria's VAD laws? Do you believe that doctors should have the right to discuss all legal, medical options with their patients? We invite you to share your thoughts on this sensitive issue in the comments section below.
As modern medicine continues to advance, several treatments and care services have been on the rise.
However, this also meant the rise of end-of-life care across the world.
In a significant shift around end-of-life care in Australia, a state recently announced several changes that could bring relief to Australians facing terminal illness.
Victoria finalised a compassionate and controversial decision to scrap a 'gag clause' that previously prevented doctors from initiating discussions about voluntary assisted dying (VAD) with their patients.
The repeal of this clause gave profound relief to doctors in the state, including Dr Nick Carr.
For several years, doctors like Dr Carr have been in a heart-wrenching ordeal as they watched patients endure excruciating pain.
Voluntary assisted dying (VAD) has been a legal medical option in several Australian states. Image Credit: Pexels/Valentin Angel Fernandez
These heartbreaking sights have been compounded by the fact that doctors could offer all legal care options, including VAD.
'It's quite perverse,' Carr remarked as he looked back at the frustration of being silenced by the law.
The inability to discuss VAD, unless directly asked by the patient, has been a source of ethical conflict for healthcare providers who are committed to comprehensive patient care.
Victoria's pioneering stance on VAD began in 2017 and officially took effect in 2019.
Since then, other Australian states except Northern Territory have enacted similar legislation.
It highlighted that Victoria's once 'groundbreaking' laws now appear more conservative compared to other jurisdictions.
The review that led to this decision found that Victoria's VAD laws were functioning as intended.
The review's findings showed that 1,527 VAD permits were issued in Victoria between 2019 and 2023.
About 912 of these individuals opted to use the VAD substance.
Compliance was remarkably high, with only 14 cases of non-compliance, half of which involved the delayed return of the VAD substance by relatives.
No misuse was reported, which reinforced the safety and integrity of the VAD process.
However, the said review also stated that certain safeguards were inadvertently hindering access to this critical end-of-life choice.
The gag clause was initially introduced to prevent coercion and the premature ending of lives.
Yet, this clause has been identified as an impediment, especially for patients suffering terminal conditions.
The state government's acceptance of the review's five recommendations marked a commitment to improving access to VAD in the state.
These reforms aimed to increase community awareness, enhance accessibility for Aboriginal and Torres Strait Islander people, and better serve multicultural communities.
Health Minister Mary-Anne Thomas emphasised the importance of reforming the VAD laws to ensure equitable access throughout Victoria.
'We're looking to remove barriers and improve the experience for all patients, their families and health practitioners,' Minister Thomas shared.
Among the proposed changes was the removal of the citizenship and residency requirement for VAD applicants.
This change was a significant development for non-citizens who may need the service.
One such case was that of Julian Bareuther, a United Kingdom citizen who was ineligible for VAD despite living in Australia for 40 years.
Dr Carr, who served on the board of Dying With Dignity, recalled Mr Bareuther's tragic case.
'He came and saw me eight days after the laws came into effect,' Dr Carr recalled.
'He had pancreatic cancer and wanted VAD, but because he was not formally an Australian citizen, he was denied the option.'
'If the government removes that requirement, it would be a huge and welcome change,' Dr Carr ended.
The government also considered extending the life expectancy rule for non-neurodegenerative diseases from six to 12 months as an acknowledgement of the variability in medical prognoses.
Additionally, the requirement for third assessments for patients with neurodegenerative conditions could be removed, and the time between the first and final VAD request could be shortened.
These proposed reforms have been met with enthusiasm from advocacy groups.
Dying With Dignity Victoria president Jane Morris and Go Gentle chief executive Linda Swan applauded the government's commitment to reducing barriers and needless suffering.
'We've heard so many unfortunate stories from people who've faced these barriers. To think that they may be righted is just the most incredible feeling,' Ms Morris stated.
'They show the government is listening to terminally ill people and their families and the health professionals who care for them,' Ms Swan added.
As Victoria aligned its legislation with other Australian jurisdictions, conversations around VAD have significantly evolved.
The proposed changes should reflect a growing recognition of the importance of patient autonomy and the need for compassionate end-of-life options.
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I am so sorry you and your beloved husband had to go through this dreadful pain. May your husband rest in eternal peace.
