Australia’s legislative laboratory for euthanasia

BioEdge

Michael Cook

The Labor-majority Parliament of the Australian state of Victoria passed assisted dying legislation in December 2017. This came into effect in June and the first patient has already died. Applications from a dozen or so Victorians have already been approved. Two other Labor states are also debating euthanasia – and it appears that their legislation will be even more permissive than Victoria’s.

According to critics of euthanasia interviewed by The Australian, this is “death creep”, the slippery slope in action.

“There is serious concern about this slippage,” the chair of the Australian Medical Association’s ethics and medico legal committee, Chris Moye, says. “A lot of this (change) was happening even before the Victorian law, which is only two months old, has actually been tested. At this point, we haven’t seen how assisted dying works in Victoria and yet the slippage is happening across these various jurisdictions. I think there are two reasons: people were always going to be looking at it (the Victorian law) and the tendency always is to relax legislation.”

Critics focus on details of a proposed bill in the parliament of Western Australia. In Victoria, doctors are not allowed to raise the topic of assisted dying. But in WA, doctors would be permitted to suggest the possibility of euthanasia and no specialist has to be involved.

Conscientious objection is more difficult as well. In Victoria, objecting doctors are not obliged to refer the person on; in WA they would be.

In Queensland, a parliamentary committee is studying draft legislation. This is even more permissive than Victoria’s or WA’s. There is no time requirement – only that the patient have an incurable terminal illness which is causing intolerable and enduring suffering.

However, Professor Ben White, who helped write Queensland draft bill,  dismisses fears of a “slippery slope”. “When people talk about a slippery slope in terms of the law, they are talking about law X in a particular state or country that is enacted and over time gets changed,” he says. “We live in a federation … and there are differences in laws from one state to another, reflecting a range of factors, including geography. What might be appropriate for a state like Victoria might … require different solutions in Western Australia or Queensland.”


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WA’s take on assisted dying has many similarities with the Victorian law – and some important differences

The  Conversation

Ben White, Katrine  Del Villar, Lindy  Wilmott, Rebecca Meehan

Western Australia may soon become the second Australian state to permit voluntary assisted dying, with the release on Tuesday of its Voluntary Assisted Dying Bill 2019.

As in Victoria, whose law is now just under two months old, the bill was the product of reviews by a parliamentary committee and ministerial expert panel. It’s expected to be debated in the Western Australian parliament in three weeks.

So how does what’s being proposed compare to the law in Victoria? . . . [Full text]

Euthanasia bill falls short on freedom of conscience

Objecting students unprotected, refusal may incur civil, criminal liability

Sean Murphy*

Western Australia’s Voluntary Assisted Dying Bill 2019 includes provisions intended to protect all registered health practitioners who refuse to participate for reasons of conscience. By virtue of the Health Practitioner Regulation National Law (Western Australia) this includes nurses, midwives, pharmacists, radiologists, psychologists and other professions.

However, the bill explicitly excludes students, probably to ensure that only non-student practitioners are permitted to accept and process requests, assess patients and provide euthanasia or assisted suicide (EAS).  Unfortunately, the effect of this exclusion is that nothing in the bill prevents students from being required to participate in all aspects of EAS delivery under the direction of a fully qualified registered health practitioner, or making such practical training a requirement for professional qualification.  This would be inconsistent with one of the guiding principles in the bill (Section 4(1)j), so it may be an oversight that will be corrected during the legislative process.

Fully qualified registered health practitioners may refuse to participate in the request and assessment process, prescription, supply or administration of lethal drugs, and to be present when the drugs are administered (Section 9(1)).  The bill further states that, by identifying these actions, it does not intend “to limit the circumstances in which a registered health practitioner may refuse” to do them (Section 9(2)).  This would seem to extend protection to include refusal to do do things not specified in the section, but obviously related to providing euthanasia or assisted suicide, like setting an intravenous line for administration of lethal drugs.  That interpretation is consistent with the definition of voluntary assisted dying, whichincludes “steps reasonably related to such administration.”  Clearly, this would include any of the actions explicitly required by the law, such as assessments, notifications, acting as a witness, dispensing lethal drugs, filing reports, etc., as well as setting intravenous lines and other technical preparations for providing EAS.

Sections 112 and 113 provide protection from civil and criminal liability and disciplinary proceedings for those involved in processing and fulfilling EAS requests if they act in accordance with the law. Section 113(4) extends this protection to omissions in accordance with the bill, but not to the refusals it permits.  Since “omission” does not mean “refusal”, this may reflect either an oversight in drafting or a deliberate decision to expose objecting practitioners to liability.

What could prove to be most contentious is the requirement in Section 19(5)b that an objecting physician give a patient “information approved by the CEO” of a public service department, perhaps a health department.  Whether this will be acceptable to objecting practitioners will depend entirely on the substance of the “approved” information.  It is unlikely to be problematic if it consists of general information about how to contact other physicians or health authorities.  On the other hand, resistance is likely if the “approved” information portrays euthanasia and assisted suicide as morally acceptable services or directs patients to EAS providers.  Objecting practitioners may refuse to comply if the law effectively compels them to express support for moral views they reject, or forces them to facilitate what they consider to be immoral or unethical acts by directing patients to EAS providers.