Background information on assisted dying laws 2021

Here is some useful background information for you to consider when preparing a letter to your member of parliament:

Why we need these laws?

  • Too many terminally ill people are dying bad deaths, denied the choice to decide when they have suffered enough at the end of life.
  • Even the best palliative care cannot relieve all suffering for terminally ill patients.
  • Doctors and nurses are delivering inadequate pain relief to dying patients for fear of breaking the law.
  • Family and friends are being traumatised as they watch loved ones die prolonged and agonising deaths.
  • Doctors are breaking the law to assist patients suffering untreatably to die – but having to do so in secret, without consultation, oversight, or regulation.
  • Some elderly and terminally ill people are taking their lives, alone and often in horrific circumstances.

Why is now the right time?

  • Victoria passed their Voluntary Assisted Dying Bill in 2017 and it came into effect in June 2019.
  • Western Australia followed Victoria’s lead, passing a similar VAD law in December 2019 that comes into effect on 1 July 2021.
  • In March 2021, Tasmania became the third state to pass a VAD law and their law comes into effect in mid 2022.
  • South Australia is the latest state to debate VAD laws.
  • Queensland will debate VAD legislation in August or September.
  • Polling indicates that people living in NSW want the same compassionate, end of life choices.
  • Alex Greenwich MP, the Independent Member for Sydney, is currently drafting VAD legislation.
  • A draft VAD Bill is likely to be released in July with the parliamentary debate expected in September.

Each member of parliament must make their own decision about how they will vote when assisted dying legislation is next debated in NSW. When making that decision, they should consider the views of the community and their constituents.

Current laws in NSW do not protect us against unnecessary suffering

In NSW today, it is legal, if you are dying and suffering beyond medical help, to end your suffering by taking their own life.

It is legal to refuse all medical treatment, including food and water, and die slowly of starvation and dehydration while your disease takes its course.

It is legal for a doctor to slowly drug you into a coma while your family waits for days, or weeks, for you to die. This can happen without your consent.

But in NSW, it is not legal if you are dying and suffering beyond medical help to end your suffering painlessly and quickly with the help of a doctor.

As a patient, you do not have any legal right to insist that a doctor gives you more, or faster, pain relief. That decision is entirely up to the doctor whose personal beliefs you may not share.

This is why we need a law. So that we all have a legal right to be protected from unnecessary suffering at the end of life – so doctors have a legal right to help us – and so there can be more compassionate choices if we’re dying and suffering than starving ourselves to death, being slowly drugged into a coma, or taking our own lives, violently and alone.

A voluntary assisted dying law protects the vulnerable

Some organisations, like Right to Life and others, assert that voluntary assisted dying laws are not safe. They warn of vulnerable people being coerced to end their lives for other peoples’ gain.
Numerous independent inquiries have found no evidence that this has occurred. These include:

  • Australian palliative care physician, Dr Linda Sheahan whose 2012 Churchill Fellowship study of how these laws work overseas concluded: “The slippery slope in terms of risk to vulnerable groups has not been demonstrated by the data.”
  • The Victorian Parliamentary Inquiry Into End of Life Choices in 2015: “We found no evidence of institutional corrosion or the often cited ‘slippery slope’”.
  • The Journal of the American Medical Association in 2016, which concluded: “In no jurisdiction was there evidence that vulnerable patients have been receiving euthanasia or physician-assisted suicide at rates higher than those in the general population.”
  • The Western Australian Inquiry into End of Life Choices in 2018: “The ‘slippery slope’ is not a valid argument against assisted dying” and there is no evidence that vulnerable groups, including people with disabilities, are at heightened risk of assisted dying.”

Representatives of peak elderly and disability groups in Belgium, The Netherlands and Oregon also report no abuse of their members under these laws.

Voluntary Assisted Dying laws that would be considered in NSW are designed for those at the end stage of a terminal illness whose suffering is beyond meaningful, medical help. It is very hard to coerce a vulnerable person into a terminal illness they don’t have. Even harder to coerce two doctors whose work will be subject to review, to agree with them. That’s why the safeguards work.

It shouldn’t be a crime for a doctor to help a dying patient to die peacefully

It is well known that some doctors already practice unlawful assisted dying, but they do so ‘without regulation, support, transparency or accountability’ according to the 2015 Victorian Parliamentary Inquiry.

For those doctors currently faced with the agonising choice of helping a patient to die and breaking the law – or abiding by the law and leaving that patient to die with great suffering – a voluntary assisted dying law provides protection. More than protection, it provides guidance and the opportunity to consult with colleagues and also the family of the person who is dying.

Assisting a dying person to die is not ‘patient killing’

Those who oppose this law sometimes refer to voluntary assisted dying as ‘patient killing’ or ‘state sanctioned killing’.

This dishonestly avoids the central fact that the law is to help those already being killed by an incurable disease. Being voluntary, it is entirely up to the patient whether or not they choose to end the suffering caused by that disease.

Neither are doctors being asked to ‘kill’ a patient. In reality, what they’re being asked to do is what they already do – make a careful diagnosis that a patient’s condition is terminal and their suffering intolerable and go through with them their treatment options.

If the patient meets the legal requirements for assistance to die, they write them a prescription for a life-ending medication. After that, it is up to the person whether or not they use it. Only one person is being asked to make a life and death decision. The person who is dying.

Palliative care is great but it can’t help everyone

Australia has one of the best palliative care systems in the world. However, it is a fact that they can’t help everyone. In Palliative Care Australia’s own words: “Even with optimal care not all pain and suffering can be relieved”.

By their own estimates, the numbers of people truly beyond their help are about 4%. Their suffering can be severe and very distressing for the patient and their loved ones.

This is no criticism. It simply reflects the reality of modern medicine, which can keep us alive longer but which still has no cure for diseases like cancer and Motor Neurone Disease.

The question is: why should those who palliative care can’t help, be left to suffer when we have the means to help them?

In the words of the ‘father’ of Australian palliative care, professor Ian Maddocks: “If compassionate and loving care towards patients and families is what palliative care is all about then assisted dying is part of that. It is time the profession dealt with it”

Voluntary assisted dying is also about better palliative care

While even the best palliative care cannot relieve all suffering, the benefits of palliative care are profound and it is important that good palliative care is available to everyone in NSW.

An assisted dying law should work hand-in-hand with increased resources for good palliative care. We strongly support that.

Voluntary assisted dying is not intended to replace palliative care. It is adding one more end of life option alongside palliative care for doctors and their patients to explore.

The laws that have passed in Victoria, Western Australia and now Tasmania are based on the regime which has been in place for over 23 years in Oregon where, nine out of ten patients who choose a doctor’s help to die are also enrolled in hospice care.

This is a law which respects doctors’ choice

According to the Australian Medical Association’s code of ethics, doctors are obliged to: “Respect the right of a severely and terminally ill patient to receive treatment for pain and suffering, even when such treatment may shorten a patient’s life”

Some doctors object to voluntary assisted dying on the basis of the Hippocratic Oath which instructs ‘do no harm’. Others see leaving a dying patient to suffer as the opposite of ‘do no harm’.

A voluntary assisted dying law is voluntary for everyone. It respects and protects the rights of those doctors who object. Just as it protects and respects the rights of those doctors with a different ethical view.

Are faith based arguments against voluntary assisted dying being made in good faith?

The extreme rhetoric being used by Right to Life and other faith-based objectors – such as ‘patient killing’ and ‘murder’ – is designed to inflame emotions. It does not acknowledge, or address, the clear evidence of suffering in the community.

The rhetoric being used by Right to Life and others seeks to trivialize the genuine suffering and trauma being faced by people suffering a terminal illness.

This is an issue which requires thoughtful and respectful debate based on facts and not fear. Opposing voluntary assisted dying simply on religious grounds and with emotive language is not an answer to this suffering.

For more information about voluntary assisted dying see our Key Questions section.