Victoria's assisted dying law.

Victoria was the first Australian state to pass an assisted dying law.

More than 60 safeguards are built into the Voluntary Assisted Dying Act 2017, which has led to it being described as “the most cautious, the safest, scheme for assisted dying anywhere in the world”.
To be eligible for an assisted death in Victoria, a person must:

• Be aged 18+
• Have been a resident of Victoria for at least 12 months
• Have decision-making capacity
• Have been diagnosed with a terminal illness and be expected to die within 6 months (or within 12 months if the person has a neurodegenerative disease like motor neurone disease (MND))
• Make three separate requests for assisted dying
• Self-administer the life-ending medication themselves, unless they are physically unable to, in which case their doctor must apply for a permit to administer the medication for them

A person’s eligibility is independently assessed by two doctors. One of these doctors must have expertise in the person’s terminal illness.

While there is an ‘Australian model’ of assisted dying based on Victoria’s legislation, each Australian state has carefully considered the views of its citizens, organisations and healthcare professionals, as well as the Victorian experience, to craft their own safeguarded assisted dying legislation.

The inquiries and committees set up in the Australian states to look at assisted dying and related issues found a wealth of evidence that their blanket bans on assisted dying were unsafe and denied dying people choice, and that palliative care was not able to relieve all the suffering experienced by dying people.

“To maintain the status quo risks ignoring the evidence of the harm that occurs within it.
In light of the evidence submitted, the Committee has determined that this is not an acceptable outcome. The status quo is, if not causing, then facilitating or allowing great pain.
The Committee does not wish this to continue.”

The first person have an assisted death in Victoria was Kerry Robertson, 61, who had metastatic breast cancer. She was diagnosed with breast cancer in 2010 and over time, it metastasised into her bones, lungs and brain. Her daughters, Nicole and Jacqui, said she was given the empowered death she wanted:

 “Mum has always been brave – a real ‘feel the fear then do it anyway’ mentality to life – it’s the legacy she leaves with us. That was the greatest part, knowing we did everything we could to make her happy in life and comfortable in death.

Her body was failing her and she was in incredible pain. She’d been in pain for a long time.

Palliative care did their job as well as they could. But it had been a long battle. She was tired, the pain was intolerable and there was no quality of life left for her.

We were there with her; her favourite music was playing in the background and she was surrounded by love. She left this world with courage and grace, knowing how much she is loved.”

There has been no evidence of abuse of the law or people being coerced to use it.

Dr Charlie Corke, Acting Chair of the Victorian Voluntary Assisted Dying Review Board, said coercion had not emerged as an issue in Victoria and that in fact “we do observe coercion for patients not to engage with it, from their family members and from medical staff they come into contact with”.

 A key factor in ensuring safe and effective implementation was that groups that support older and disabled people contributed to the various parliamentary inquiries.

Prominent members of the disability community were appointed to the Advisory Panels by the responsible Ministers to ensure that the voices of people with disabilities were included in the consultations and in the drafting of legislation.

“The concerns of the disability community have been met, through the inclusion in the bill that merely having a disability will not meet the eligibility criteria, an acknowledgment that all lives have equal value and that we have the same rights and responsibilities as other Victorians.”
- Tricia Malowney, a disability activist and a member of the Victorian Ministerial Advisory Panel on assisted dying.

Where assisted dying has been implemented, evidence demonstrates that palliative care and assisted dying work effectively together.

A clear pattern has emerged of investment in palliative care alongside assisted dying law change in Australia.

This trend is in line with what has happened in other countries that have changed the law.

A report commissioned by Palliative Care Australia which examined assisted dying around the world reported in 2018 that it found “no evidence to suggest that palliative care sectors were adversely impacted by the introduction of legislation. If anything, in jurisdictions where assisted dying is available, the palliative care sector has further advanced.”

“Mum received the most amazing care from the palliative care team. They had already had four people access assisted dying, so they knew everything about how to help us. The nurse said to us, the more she saw of assisted dying, the more convinced she was of everyone being able to access it.”
- Feedback given to the Assisted Dying Review Board

“If push came to shove, I would consider going to Australia to use their assisted dying law. It’s good to know it’s there, where my son is. But why can’t I have that choice at home in Scotland?”

- Jackie Roberts, who has Stage IV breast cancer.

The UK has a lot to learn from Australia. Its rigorous legislative processes have resulted in safe, effective assisted dying laws across the country, which are supported by the general public and take into account questions and concerns raised along the way.

The process in Victoria set off a chain reaction. Other states were able to look to and learn from Victoria and replicate its detailed inquiry process, carefully considering of the needs of people in their own communities and the limitations of the status quo.

In recent polling of people in England and Wales, 81% said they supported assisted dying being legalised and 82% want to see the House of Commons debate legislation within the next 2 years. 72% supported political parties making manifesto commitments for a debate and free vote. 

This reflects public opinion in Scotland, where 76% of responses to the public consultation on Liam McArthur MSP’s assisted dying proposals were supportive of a change in the law. In another poll of people across Great Britain, when told about Australia passing assisted dying legislation, the majority said they feel more positively about Australia because of this; only 7% said it made them feel less positive.

The message from the general public is clear: parliaments in Westminster and Holyrood must act now.