December 2, 2023
Voluntary assisted dying becomes available in New South Wales
Voluntary assisted dying becomes available in New South Wales for eligible patients from Tuesday after legislation was passed last year reports Laurence Karacsony of SkyNews
NSW is the last state to allow VAD since the passing of the Voluntary Assisted Dying Act in May 2022.
Eligible patients who suffer from terminal illnesses will be able to volunteer for an assisted death from 6am on Tuesday November 28.
Patients must be at least 18 years old with an advanced or progressive disease diagnosis which is expected to lead to death within six months, or 12 months for neurodegenerative diseases.
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Voluntary assisted dying becomes available in New South Wales
The Act states a “person’s autonomy, including autonomy in relation to end of life choices, should be respected”.
In terms of dementia patients being eligible for VAD, Ms Hackett said it was a universal requirement everywhere else in the world for patients to have a “decision making capacity at all stages of the process”.
Additionally, the patient must not be under pressure from another person and have a decision-making capacity to understand the “matters involved in a voluntary assisted dying decision”.
After a final review, the eligible patient may opt to self-administer the VAD substance, or they may have a registered nurse or practitioner administer the medication.
Dying With Dignity NSW President Penny Hackett has said the experience in the other states has been “exactly as we expected” with a limited number of patients signing up who “clearly meet the eligibility criteria”.
“In all instances the patient must have, in all stages, decision making capacity and the process requires assessment by two doctors to confirm eligibility,” she said.
Ms Hackett said she was “heartened” to hear the VAD Boards in the other states were reporting a safe and effective implementation of the regimes with most of the patients coming forward suffering from cancer, followed by motor neurone disease (MND) and other neurodegenerative diseases, as well as chronic obstructive pulmonary disease (COPD).
“It is not something which we see as politically feasible any time soon, and so there’s not any prospect to any changes in the law,” she said.
Medical practitioners who accept the eligible patient’s request to have them administer the substance will have undergone specialist training.
The VAD substance under the Act will be a Schedule 4 or Schedule 8 poison approved by the Health Secretary. Among these “Controlled Drugs” are fentanyl, morphine and barbiturates, and may be administered in a mixture at a dosage to cause death.
The Act also states a person who dies as the result of administering the life-ending drugs is not committing suicide, and the health practitioner is not to initiate the discussion about VAD.
The patient must speak to a doctor with VAD training via the NSW Voluntary Assisted Dying Care Navigator Service.
The Act also outlines a few safeguards to ensure the patient is not coerced or under duress when deciding they would like to volunteer for an assisted death.
These include the patient’s ability to stop the process at any moment without a reason, three separate requests must be made to end their life, a family member or friend cannot make the request and a VAD Board will oversee and monitor all decisions.
It is an offence, punishable by a maximum five-year term of imprisonment, to pressure a patient into requesting or accessing VAD under section 41C of the Crimes Act 1900.
Healthcare workers may conscientiously object to participating in VAD and may refuse to administer or prescribe the medication, participate in the request or assessment process and may refuse to be present at the time of administration under section 9 of the Act.