When it passed in the Victorian parliament in 2017, the Voluntary Assisted Dying Act must have been one of the most controversial pieces of legislation in Australian history. Lobbying on both sides was intense; the debate in the lower house lasted an extraordinary 24 hours over three days; the upper house passed it after a marathon 28-hour sitting.
The new law came into effect in June 2019. After some interim reports, the first annual report, covering the year to June 30, has just been published. Wall-to-wall coverage of the results, right?
Wrong. It was barely mentioned in the media, and not at all in The Age, one of the state’s leading voices in favour of legalising assisted suicide and euthanasia.
A similar uptick in road deaths in Victoria last year prompted headlines and breast-beating. “Shock number of people killed on Victorian roads,” was the headline in the Herald-Sun. But when a shock number of people were killed in Victorian beds, the government and the media ignored them.
Premier Daniel Andrews and his ministers have boasted constantly about the 68 safeguards in their legislation. But the best safeguard of all is the sunlight of media scrutiny. And there has been precious little of that.
Should we be alarmed? Yes. The number of Victorians using voluntary assisted dying increased by 31 percent in a single year, despite the Covid-19 pandemic. In the year to June 2022, 269 people died, compared to 204 in the previous year. A total of 594 people has died through assisted suicide or euthanasia since the commencement of the state’s legislation in 2019.
However, the chairman of the Voluntary Assisted Dying Review Board, Julian Gardner, was delighted with the results. “The number of people seeking to access voluntary assisted dying continues to increase,” he wrote in an introduction to the Board’s annual report. “This is a further indicator of the success of the system.”
A steady increase in the number of deaths is a strange metric of success. Does this mean that, hypothetically, 100,000 deaths would constitute success beyond his wildest dreams?
The Premier also described the Act as “the safest scheme in the world, with the most rigorous checks and balances” before it was passed. So it is unsettling to read that Mr Gardner parrotted these reassurances before admitting that four deaths were technically non-compliant with the legislation, although he was confident that they were “clinically appropriate”. Three contact people did not return substances left over from the procedure to authorities quickly enough and one person had signed for the medication as both the applicant and witness.
Is this the “rigorous checks and balances” trumpeted by the Premier Andrews? In his state, not so long ago, police were arresting and handcuffing people for not wearing Covid masks. But errors in the procedures for killing people don’t even merit a rebuke.
And the figures in the report are still incomplete, as there is no information on six people who died after obtaining their permit – and it is not clear whether they died a natural death or whether it was self-administered or practitioner-administered.
Mr Gardner’s optimism about the latest figures contrasted with an observation by a trenchant critic of the Victorian legislation, the Australian Care Alliance: “Deaths by euthanasia and assistance to suicide in the twelve months July 2021 to June 2022 represent 0.58 percent of all deaths in Victoria for that period. It took Oregon 22 years to reach that rate!”
The Premier has also boasted that the Victorian legislation was drafted with the help of “world experts”. What qualifies a person to be a “world expert” in euthanasia is a mystery, but two local experts at the University of Melbourne argued in 2020 that Victoria’s vaunted safeguards create barriers to equal access.
“While safety is undoubtedly ethically important, our analysis indicates that a legislative focus on maximizing safety comes at the expense of equal access,” they declared. In other words, you can have rigorous safeguards or you can have equal access, but you can’t have both.
And right on cue, Mr Gardner complains in the annual report that safeguards are preventing equal access. At the moment, under a Federal law forbidding giving advice about suicide, Victorian doctors are banned from tele-consulting for assisted dying. “The law as it exists creates barriers to access to care and, in some cases, imposes unreasonable travel demands on people suffering from life-ending medical conditions,” Mr Gardner wrote. “A change to the law will enhance access for all Victorians, regardless of their location or mobility.”
The issue of location will be a lever for reducing the number of safeguards. It would take a rare MP to oppose more equal access in today’s political climate.
The report says that 37 percent of applicants for assisted dying lived in regional Victoria, even though only 22 percent of Victorians live there. It seems unfair that they cannot access assisted dying as easily as city folks. And in fact, just as the local experts predicted, a regional MP, Stuart Grimley, grumbled last year that “there are too many safeguards in place, too many steps that a person must take to access the voluntary assisted dying scheme, too many hurdles for them to overcome.”
Coinciding with the release of the report on assisted dying was a report on the state of palliative care in Victoria by KPMG, an independent consultant. According to Palliative Care Victoria, “Demand for palliative care services has increased by 11.9% over the last 5 years, due to the growing and ageing of Victoria’s population. Meanwhile, funding increased by only 10.2% in the same period. The shortfall in funding for service delivery is expected to reach A$91.2 million by 2025.”
What are the odds that safeguards will be relaxed even further to offer regional Victorians assisted dying because no palliative care is available for people in great distress?