Yesterday, 24 June 2021, in its 17th attempt, South Australia became the fourth Australian jurisdiction to pass Voluntary Assisted Dying (VAD) Legislation.

Queensland will be the fifth state to implement VAD laws if our parliamentarians support the Palaszczuk Government’s Voluntary Assisted Dying Bill 2021 (Qld) in September.

Before that, however, Queensland voters get to have their say. If you want your views considered by Parliament’s Health and Environment Committee, you have until 9 am on Friday 2 July.

The Queensland Bill was developed by the Queensland Law Reform Commission (QLRC) and introduced in Queensland’s Parliament in May.

Conscience Vote

The issues around VAD are presented to us in various ways. Often, we see or read real-life accounts of ‘good’ or ‘bad’ deaths. Many of us have supported a dying parent, friend or family member, and those experiences will have influenced our positions on VAD.

All 93 Queensland state politicians will discuss, possibly amend, and then vote on the Bill in September 2021 after it is reviewed by a Queensland Parliamentary Committee. MPs from all parties will have a conscience vote.

Premier Annastacia Palaszczuk, who is a Catholic, wants a respectful debate. When she spoke with Church leaders before tabling the Bill she said:

“… this is a choice, and it’s not going to be the right choice for a lot of people, but it’s got to be an option for people, and far be it for me to make that individual choice on how a person wishes to end their life.”

Queensland Bill

VAD laws have been passed in Victoria, Western Australia, Tasmania, and now, South Australia.

All Bills require that the person seeking VAD must be aged over 18, have decision-making capacity, and be in the late stages of advanced disease.

Jeannette Wiley from Dying with Dignity (DWDQ) Queensland says:

“The Bill that the Queensland Law Reform Commission has written is the best Bill in Australia so far. The laws in Victoria, are extremely limited: the Western Australian law is better than the Victorian law and the Queensland Bill is better again.”

Life Expectancy

Ms Wiley says a key difference includes the time a person seeking VAD is expected to die.

The Queensland Bill specifies a person can use VAD when they have up to 12 months to live. In all other states, the person seeking VAD must be expected to die in not more than six months except in the case of  neurodegenerative diseases such as amyotrophic lateral sclerosis, multiple sclerosis, and Parkinson’s disease, in which case the time is extended to 12 months.

Medical Practitioners

Ms Wiley says that individual health professionals can object to participating in VAD on moral, ethical or religious grounds.

The Queensland Bill uniquely allows for a registered nurse with appropriate training to administer the VAD medication. Ms Wiley says that this addresses issues of access for patients living in remote regions.

Eligibility

Each of the four states with current VAD laws requires those seeking VAD to have lived in the state for 12 months. However, the Queensland Bill allows for exemptions in limited circumstances, for example, people who live outside Queensland but close to the Queensland border with close family or treating doctors in Queensland.

Ability of institutions to object

While individual health professionals can object to participating in VAD, the Queensland Bill limits the capacity of faith-based health and aged care service providers to object to providing access to VAD. This provision is not available in some other jurisdictions, notably in Victoria, where some faith-based facilities have allegedly refused entry to practitioners enlisted to dispense VAD medication.

Objectors and Supporters

Ms Wiley said one argument that opponents to VAD use, is that there would be no need for this Bill if there were adequate funding for palliative care.

“In my opinion, and in the opinion of many people who’ve been with family members and friends at the end of their lives is that palliative care is wonderful. DWDQ supports more funding for palliative care. But palliative care doesn’t always alleviate people’s pain and suffering at the end of their lives. What people are asking for is choice: the operative word is choice.”

The Australian Medical Association (AMA) does not support VAD. The AMA did not speak to the Westender on the record. However, it did provide a copy of its submission on VAD made to the Inquiry into aged care, end-of-life and palliative care and voluntary assisted dying dated 20 May 2019. In it, the AMA says:

“AMA Queensland does not support the introduction of Voluntary Assisted Dying in Queensland. AMA Queensland believes that doctors should not be involved in interventions that have as their primary intention the ending of a person’s life.”

While many consider the AMA broadly representative of medical practitioners in Australia, it only has 6,000 members from more than 26,000 registered medical practitioners in Queensland. Other groups such as the Royal Australian College of General Practitioner (RACGP) and Doctors for Assisted Dying Choice do support VAD.

The RACGP says it supports patient-centred decisions in end-of-life care and respects that this may include palliative care and requests for voluntary assisted dying.

Associate Professor Arnold Gillespie from Doctors for Assisted Dying Choice says the AMA is not keeping up with the rapid changes in medicine and medical and social attitudes.

 “It’s not a question of what the AMA thinks. It’s a choice that the patient makes. Now, the doctor, of course, has the right not be involved. They can say their ethics don’t permit them to participate. But that is irrelevant. The legislation gives the patient the choice, it is not the choice of the doctor.“

Associate Professor Gillespie also considers that palliative care provides compassionate end of life care, one aspect of which is Terminal Sedation.

“A doctor can give increasing doses of something like morphine to a patient, provided that in giving that morphine the doctor’s intent is not to kill the patient, nor to hasten their death, but to relieve pain. That’s what’s been happening.”

“This is legal, provided the intent of the doctor is to relieve distress not to cause death. It is illegal if the intent is to cause death.  Only the doctor knows what the intent is, and this is cannot be measured.”

Associate Professor Gillespie says VAD gives the patient time to sort out their affairs, gather their family, discuss their choice, and get them on side and be with them to say goodbye at the chosen time of death.

Other objections to the Bill, Ms Wiley of DWDQ says, are often religiously based despite most people of faith supporting VAD choice.

Some faith groups, Christian, Jewish, and Islamic, vigorously oppose the VAD legislation. For example, Archbishop Mark Coleridge of the Catholic Church in Queensland states that palliative care is poorly funded, particularly in the regions, and said in a statement to the Government: “the focus on palliative care has been lost amid the haste to introduce euthanasia”…

“That leaves those Queenslanders without the dignified end to their life that they deserve. Instead of being offered palliative care, they will be offered death.”

The Anglican Church in Queensland has made similar objections to VAD laws, as has the Uniting Church of Australia.

Uniting Church Elder Everald Compton AO has been a campaigner for voluntary assisted dying for over 50 years. Everald was one of the founding directors of National Seniors Australia. After 35 years on the board, he retired at 80 and joined Dying with Dignity and formed “Christians for Voluntary Assisted Dying Queensland.”

“I’ve been working with DWDQ to try to get the legislation prepared and we have finally reached a time after all the years where that’s has happened.”

Everald has been an elder in the Uniting Church for 63 years and says despite the official position of the Churches, many Christians share his view[1] that terminally ill people should have the option to elect for VAD.

“One of the roles of an elder in the Church is to help families when people die, and I’ve attended many deaths. I have seen many (dying) people over the years who wanted to die and couldn’t because the law didn’t allow them.”

Mr Compton said he used to believe that God decided who died when he was in Sunday school. “But as I grew older, I totally discounted that.”

“Nature decides when people die, accidents decide when people die: what God does, what Jesus Christ does, is give us the spiritual power to handle death.”

Mr Compton has set out his ideas in a new novel, “A Beautiful Sunset: A Novel about the Final Curtain Call of Life“. See box below.

Making a submission

This QLRC diagram outlines the process proposed in the Bill for accessing VAD in Queensland.

There are three ways to have your say:

  1. Complete a short “tick” form here, or
  2. Send an email to hec@parliament.qld.gov.au, or
  3. Post a letter to: Health and Environment Committee, Parliament House, George Street BRISBANE

You must provide your name and address for your submission to be accepted.

References

[1] FactCheck Q&A: do 80% of Australians and up to 70% of Catholics and Anglicans support euthanasia laws? 1 May 2017 https://theconversation.com/factcheck-qanda-do-80-of-australians-and-up-to-70-of-catholics-and-anglicans-support-euthanasia-laws-76079

[2] “A Beautiful Sunset: A Novel about the Final Curtain Call of Life” by Everald Compton is available Directly from the Dying with Dignity Website https://www.dwdq.org.au/  or online, or through your local bookstore.

A Novel about the Final Curtain Call of Life

This year Everald Compton AO published a novel about a dying man’s decision to voluntarily end his life.

“One of the reasons I wrote my book is to present voluntary assisted dying as a human story rather than as legal argument,” Mr Compton said.

“There’s been all sorts of books written about voluntary assisted dying worldwide: there’s a myriad of them. And they’ve all been written by the doctors or lawyers or people who are deeply committed to it, and they only get very limited number readers because most people don’t want to read a learned argument about it all. And I made a decision it would be best to sweep people along with an interesting story that they would enjoy reading.”

Mr Compton said the novel form allowed him to include a range of elements that surround voluntary assisted dying.

“If I wrote a learned treatise I’d probably only get a hand full of readers, but if I wrote a novel, which was a page turner, that would make a big different.”

“I made sure there were characters on all sides of the debate. The hero of the book is a radical Anglican priest who wants to die by voluntary assisted dying. It’s the story of all he goes through with his Church and with conservative politicians and others, when he decides he wants the last three months of his life to be on his terms.”

When launching Mr Compton’s book a few months ago, former Premier Campbell Newman, a supporter of VAD, said, “For those MPs who have not made it here … I hope those that are here can convey to them: have some courage and listen to the community.”

Cover image: Shutterstock