Euthanasia referendum: 124 Australians access assisted dying in first year – Stuff.co.nz

There were 124 confirmed deaths in the first year assisted dying was permitted in the Australian state of Victoria, new figures show.

Victorias Voluntary Assisted Dying Act 2017 came into force last June, allowing terminally ill adults with less than six months to live the option to request medication to end their life.

On October 17, New Zealanders will get to vote on a piece of legislation which would allow this for Kiwis over the age of 18 in a binding referendum.

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On October 17, New Zealanders will vote in a binding referendum on whether to pass the End of Life Choice Act into law.

Ahead of the referendum, Stuff analyses what New Zealands closest neighbour has seen in its assisted dying scheme which is largely similar to what has been proposed here in its first year.

READ MORE:* Euthanasia referendum: How assisted dying laws work around the world* Five applications to die lodged each week under Australian state's new euthanasia laws* Assisted dying: How Victoria's euthanasia laws will work in Australia* Euthanasia referendum: What drugs are used in assisted dying, and how do they work?

This week, the independent Voluntary Assisted Dying Review Board released its third report on activity under the Act, and the first comprehensive look at the year in review.

It showed access to voluntary assisted dying is growing, with eligible applications increasing by 50 per cent from June-December 2019 to January-June 2020.

Between June 2019 and June 30, 2020, 348 people were assessed for eligibility to access voluntary assisted dying in Victoria, which has a population of 6.3 million.

At the first assessment, 341 were found eligible, while seven were deemed ineligible to access the scheme.

At the consulting assessment, where a medical practitioner receives and accepts a referral from the coordinating medical practitioner, 297 people were deemed eligible and four were ineligible.

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New Zealand's End of Life Choice Act would allow terminally ill adults with fewer than six months to live to end their lives by taking lethal medication.

In the first year, 154 cases had lethal medication dispensed for self-administration this sharply increased over the year, from 57 dispensings in the first six months to 97 between January and June.

Of the confirmed deaths where medication was administered, 104 took the lethal dose typically a drink themselves and 20 had it administered by a practitioner.

The Registry of Births, Deaths and Marriages Victoria shows there were 42,115 deaths from July, 2019 to June, 2020 the month of June 2019 was no longer available meaning those who accessed assisted dying made up fewer than 0.3 per cent of all deaths.

The average age of the 124 Australians who died from taking the prescribed medications was 71, however applicants ranged from 32 to 100 years old.

Almost four out of five had terminal cancer, including lung (17 per cent), breast (15 per cent) and gastrointestinal tract cancer (10 per cent) making up the majority of cases.

Others had motor neurone disease (15 per cent), while seven per cent had diseases such as pulmonary fibrosis, cardiomyopathy or chronic obstructive pulmonary disease.

The majority of applicants were men (55 per cent), while 44 per cent were women. One per cent selected self-described as their sex.

The majority of applicants spoke English at home, and nine required an interpreter to attend appointments.

Close to two thirds (62 per cent) lived in a metropolitan area, while 38 per cent lived in regional or rural Victoria.

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

Once an assisted dying application is complete, either because the applicant has died or chosen to withdraw, the Voluntary Assisted Dying Review Board reviews all information submitted to determine if the case complied with the Act.

The board found compliance with the Act was at 99 per cent.

One application was deemed non-compliant due to an issue with the paperwork, not related to the eligibility of the applicant, they found.

The board received feedback from applicants, contact people and medical practitioners about a number of issues.

These included expanding voluntary assisted dying services to be accessible seven days a week; making it easier to access medical practitioners who have already completed the training; and allowing online appointments.

It also outlined access issues to those in regional parts of the state, with the board saying there was a need for more specialists in regional areas.

The number of medical practitioners trained and registered for assisted dying was also growing, increasing by 30 per cent from the first six months.

More than 420 medical practitioners in Victoria had registered for the mandatory training, of which 76 per cent were registered in the portal where forms and permit applications must be submitted.

Of those registered in the portal, 50 per cent were GPs. Sixteen per cent specialised in oncology, five per cent in neurology and three per cent in palliative care medicine.

Under Australian law, it is an offence to use online or telephone services for suicide-related material, which includes voluntary assisted dying.

Some applicants and their families said the Covid-19 pandemic created additional stress for people who were vulnerable and trying to self-isolate as well as going through the assisted dying process.

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Victorias Voluntary Assisted Dying Review Board received reports of issues with access to the scheme from those living in regional or rural parts of the state, and others complaining the process was too protracted.

One contact person said there was a wait-time of a month to see a specialist, and the person had to go to Melbourne as there was no specialist involved in the programme locally.

This was too much. It was a terribly long day, and she was in considerable pain. She was exhausted by the end of it, they said in the report.

Others felt they had to wait far too long to receive their lethal medication.

Another contact person said their loved one was in a facility which was not supportive of voluntary assisted dying, so had to move to another one.

This was very stressful at the time; however, the new facility gave him a private room in the most beautiful setting and were very supportive, they said.

Victoria was the first state in Australia to pass voluntary assisted dying laws a move followed by Western Australia in December.

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New Zealands proposed law is similar to that passed in Australia, including that only those who are likely to die from a terminal illness within six months could be eligible.

Under Victorian law, only those suffering from an incurable, advanced and progressive disease, illness or condition who are experiencing intolerable suffering that cannot be relieved in a manner the person considers tolerable can access voluntary assisted dying.

The persons condition must be assessed by two medical practitioners to be expected to cause death within six months.

This is almost identical to the Act going to referendum in New Zealand in October.

Mental illness or disability alone are not grounds for access to voluntary assisted dying, but people who meet all other criteria, and who have a disability or mental illness, will not be denied access under Victorias law.

Voluntary assisted dying must be voluntary and initiated by the person themselves, and will usually be self-administered.

In New Zealand, assisted dying is defined in the End of Life Choice Act as a doctor or nurse practitioner giving a person medication to relieve their suffering by bringing on death, or, the taking of medication by a person to relieve their suffering by bringing on death.

To be eligible for assisted dying under the Act, a person must be suffering from a terminal illness likely to end their life within six months.

They must have significant and ongoing decline in physical capability, and experience unbearable suffering that cannot be eased in a manner that the person finds tolerable.

They must initiate the topic with their healthcare professional, and two doctors must agree they meet the criteria.

A person would not be eligible if the only reason they give is that they are suffering from a mental disorder or mental illness; have a disability of any kind; or because of their advanced age.

For more Stuff coverage on the euthanasia referendum, click here.