April 20th 2019

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Articles from this issue:

COVER STORY Budget 2019: The dark side of 'back in the black': no vision

EUTHANASIA FYI: How to navigate the voluntary assisted 'dying' process

CANBERRA OBSERVED Take your tax cuts and be merry, for tomorrow ... is another day

FOREIGN AFFAIRS New Middle East alliance will challenge Saudis

LIFE ISSUES ALP abortion policy blithely tramples all our consciences

SOCIETY AND TECHNOLOGY Will Artificial Intelligence do the walking for you?

LIFE ISSUES Trump, Shorten and Morrison on abortion

GENDER POLITICS Women abused at Women's Day March

NATIONAL AFFAIRS Bill Shorten's bizarre electric car policy

FAMILY AND SOCIETY Revitalising marriage and family: an especially lay apostolate

ASIAN AFFAIRS Entire nations going out without a baby's whimper


MUSIC 1+1=Sublimity: Explanations are like the back side of a tapestry

CINEMA Shazam!: Ambitious teen finds out what's in a name

BOOK REVIEW What will be left us after the deluge?

BOOK REVIEW Author puts some great minds to work



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FYI: How to navigate the voluntary assisted 'dying' process

by Terri M. Kelleher

News Weekly, April 20, 2019


  • Voluntary assisted “dying” is to get some pre-publicity
  • Two VAD “navigators” are to be ensconced in the Peter Mac
  • The Alfred Hospital is to dispense the poisons statewide
  • The drugs administered give no guarantee of a peaceful death

When the Victorian Voluntary Assisted Dying (VAD) Act was debated, it was presented as a private choice made by the individual patient, who is facing death within months and suffering intolerably, in consultation with their doctor.

Now it seems assisted suicide is being institutionalised. Ahead of the Voluntary Assisted Dying Act commencing operation in June, an assisted suicide advice or enabling service is being established – “a statewide navigator service to support people who want access to voluntary assisted dying and connect them with participating health professionals and services.”

The first of four VAD care navigator roles has been advertised. Once appointed, the successful applicant will be tasked with setting up the service across the state in consultation with stakeholders.

Under the Act, doctors are not directly to raise the issue of VAD with a patient. This is prohibited by section 8 of the Act. Now there are to be paid “VAD navigators” to assist and direct people in making for requests for VAD. Will they be allowed to raise the issue of VAD directly with patients? If not, how are they to assist patients to “navigate” the request process?

The Alfred Hospital is to be actively involved in assisted suicide/euthanasia by agreeing to be the government-funded Statewide Pharmacy Service to dispense and deliver the lethal substance(s) for that purpose. Surely this violates The Alfred’s commitment to care and healing and will undermine the trust of vulnerable patients and their families and the general public in this esteemed medical institution!

Similarly, people will be dismayed to learn that the Peter Mac (as the Peter McCallum Cancer Centre is affectionately known) is actively to engage in the assisted suicide/euthanasia process under the Voluntary Assisted Dying Act by having two “VAD navigators” based at the hospital. They are to support people who request access to VAD, including connecting people with participating medical practitioners or health services.

Such active involvement will undermine the trust of vulnerable and fragile patients, their families and the general public in this esteemed public hospital, which has a reputation as a sign of hope in what is a very frightening medical diagnosis.

Aged care is another social institution that is advised to prepare for the implementation of VAD by, among other initiatives, establishing VAD working groups and considering protocols for managing assisted suicide requests.

What other social/health service ins­titutions will be involved in providing advice on VAD? Disability services? Social services (DHS)? Elderly citizens’ clubs? RSLs? Will palliative care services be involved?

Involvement in the request process will undermine public trust in the hospital and aged-care, palliative-care and government-services sectors.

Is this how the VAD Act was meant to operate? Will “navigators” embedded in our social institutions that provide services for vulnerable and fragile people effectively advertise VAD as a service available? This development can only undermine the trust of vulnerable people, their families, and ultimately the general public in those institutions.

Training of health professionals who want to participate in VAD, including medical practitioners who will be involved in prescribing the medication, was to begin in March. The Victoria Health Association says it is unclear what the uptake will be: “It might start up slow and, as doctors test the water, more might sign up; or they might chose to do it for a particular patient.”

However, the Victorian Government has produced Five short videos to train doctors taking medical practitioners through the process as required under the Act; and the Department of Health and Human Services is holding a VAD Implementation Conference for health services, health practitioners and consumers on May 8–10.

The first of the training videos is an example of the initial discussion with a patient who has asked for information about assisted suicide. Doctors cannot directly raise VAD as an option with a patient, but this aspect doesn’t arise in the video dramatisation as the patient raises it directly with the doctor. The other four videos deal with discussing ineligibility, assessing decision-making capacity, identifying coercion, and explaining to the patient how to administer the fatal dose.

In the video discussing with a patient how to take the lethal dose, the death is described in rather gentle terms: after usually about 10 to 15 minutes, you will fall asleep; after that it will deepen into a coma; and after that, usually 30 to 60 minutes, your heart will stop beating. It is extremely unlikely, quite rare, for something to go wrong in countries overseas where VAD has been legal for some time. If a health practitioner is present they can help – to support you and make you comfortable through the process.

But a gentle or peaceful death cannot, in fact, be guaranteed. As a recent study in the Journal of Law and Biosciences (September 28, 2017) on the lethal substances used for assisted suicide/euthanasia (and executions) says: “The pervasive belief that these, or any, noxious drugs are guaranteed to provide for a peaceful and painless death must be dispelled; modern medicine cannot yet achieve this.”

The reality is that in Victoria assisted suicide/euthanasia is legal. What shouldn’t happen is that hospitals or palliative-care services, or social institutions such as aged care be in any way involved in the request process.

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April 4, 2018, 6:45 pm