Voluntary Assisted Dying Laws (VAD) (Vic) | Armstrong Legal

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This article was written by Sally Crosswell

Sally Crosswell has a Bachelor of Laws (Hons), a Bachelor of Communication and a Master of International and Community Development. She also completed a Graduate Diploma of Legal Practice at the College of Law. A former journalist, Sally has a keen interest in human rights law.

Voluntary Assisted Dying Laws (VAD) (Vic)


Voluntary Assisted Dying (VAD), often called “voluntary euthanasia”, is legal in Victoria under the Voluntary Assisted Dying Act 2017. The Act, which came into effect in 2019, provides for and regulates access to VAD.

Principles

The Act states a person exercising a power of performing a function related to VAD must consider principles such as:

  • every human life has value;
  • a person’s autonomy should be respected;
  • a person approaching the end of life should be provided with quality care to minimise their suffering and maximise their quality of life;
  • a person should be encouraged to openly discuss death and dying, and their preferences and values should be encouraged and promoted.

A registered health practitioner must not initiate a discussion about VAD with a patient or suggest it to a patient. A contravention is regarded as unprofessional conduct under health practitioner regulations.

Eligibility

To be eligible for VAD, the person must:

  • be aged at least 18;
  • an Australian citizen or permanent resident;
  • be ordinarily resident in Victoria and have lived in Victoria for at least 12 months;
  • have a disease, illness or medical condition that is:
    • incurable; and
    • advanced, progressive and will cause death; and
    • expected to cause death within weeks or months and not more than 6 months; and
    • causing suffering to the person that cannot be relieved in a way that the person considers tolerable;
  • have decision-making capacity.

A person is not eligible because they have a disability or a mental illness.

Assessment

A person can make a request to a registered medical practitioner for VAD. The request must be clear and unambiguous, and made personally. If the practitioner accepts the request, they become the person’s co-ordinating medical practitioner.

A first assessment is then made by a co-ordinating practitioner, who decides whether the person is eligible. The practitioner must have completed approved training. They can refer the patient to a specialist if they cannot determine whether the patient has the requisite disease, illness or medical condition, or whether the patient has decision-making capacity.

If the co-ordinating practitioner is satisfied the person is eligible, they must inform the person about matters including the patient’s diagnosis and prognosis; the potential risks of receiving a VAD substance for the purposes of death; and that the patient can discontinue the VAD process at any time.

The co-ordinating medical practitioner must then refer the person for a consulting assessment. To assess a person as being eligible for VAD, the consulting medical practitioner must be satisfied that the person:

  • meets all the eligibility criteria;
  • understands the information given to them;
  • is acting voluntarily and without coercion;
  • has made a request that is enduring.

If the practitioner confirms the person is eligible, other requirements under the Act must then be followed, including the making of a written declaration, a final request and final review.

Once these requirements are fulfilled, the practitioner can apply to the Department of Health and Human Services for a VAD permit that can be either a self-administration permit or a practitioner administration permit.

Practitioner objection

A registered health practitioner who has a conscientious objection to VAD has the right to refuse to:

  • provide information about VAD;
  • take part in a VAD request and assessment process;
  • apply for a VAD permit;
  • to prescribe, supply, dispense or administer a VAD substance;
  • to be present when a VAD substance is administered.

Administration permits

A self-administration permit authorises the co-ordinating medical practitioner to prescribe and supply the VAD substance to the person specified in the permit. It allows that person to obtain, possess, store, use and self-administer the substance. It also gives the person’s nominated contact person 15 days after the person’s death to hand over any unused substance to the dispensing pharmacy.

A practitioner administration permit authorises the co-ordinating medical practitioner to prescribe and supply the VAD substance to the person specified in the permit, and in the presence of a witness, to possess, use and administer the substance to the person. These acts are authorised only if the person is physically incapable of administering the substance themselves or digesting it.

Safeguards

The Act contains a variety of safeguards, including:

  • a person must make at least 3 separate requests for VAD;
  • a co-ordinating medical practitioner or consulting medical practitioner must:
    • hold a fellowship with a specialist medical college;
    • be a vocationally registered general practitioner;
    • have practised as a registered medical practitioner for at least 5 years after completing a fellowship with a specialist medical college or vocational registration (as the case requires);
    • have relevant expertise or experience in the disease, illness or medical condition expected to cause the death of the person being assessed;
  • labelling of a VAD substance must state that it is a VAD substance and that any surplus substance must be returned to the dispensing pharmacy;
  • a Voluntary Assisted Dying Board, which ensures compliance with VAD laws;
  • reviews of VAD decisions by the Victorian Civil and Administrative Tribunal.

Offences

The Act also contains offences relating to VAD which act as safeguards. For example, if a person, by dishonesty or undue influence, induces another person to make a request for access to VAD, they face a maximum penalty of 5 years imprisonment, or 600 penalty units ($109,044), or both. If a co-ordinating medical practitioner knowingly administers a VAD substance in contravention of a practitioner administration permit, they face a maximum penalty of imprisonment for life.

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