The Tasmanian Voluntary Assisted Dying Bill 2016 is based on thorough ongoing research. These are some of the major resources from independent reputable sources which have been taken into account – 1. websites, 2. reviews, 3. official reports and associated material, 4. Canadian Medical Association material, 5. Academic and respected viewpoints, 6. Material relating to particular issues of importance in the debate on voluntary assisted dying.
We will add to this page as new material comes to our attention.
End of Life Law in Australia – an initiative of the Australian Centre for Health Law Research. It is designed to be used by patients, families, health and legal practitioners, the media, policymakers and the broader community to access information about Australian laws relating to death, dying and decision-making at the end of life. These laws are very complex, particularly in Australia where the law differs between States and Territories, and where areas of uncertainty about the law exist. This website provides you with a broad introduction to these laws. It can also help you stay up to date with Recent Developments in the end of life area.
All major recent reviews by independent reputable bodies have found consistently in favour of voluntary assisted dying legislation.
- Victorian inquiry into end of life choices, June 2016. This link takes you to the site where you can find the Report as well as over 1,000 submissions, transcripts of evidence provided at hearings and the Government’s response.
- Medical Assistance in Dying: A Patient-centred Approach, Report of the Special Joint Committee on Physician-Assisted Dying, Canadian Parliament, February 2016
- Consultations on Physician-Assisted Dying, Final Report, External Panel on Options for a Legislative Response to Carter v. Canada, December 2015
- Carter vs Canada, Canadian Supreme Court, unanimous 9 – 0 judgement in February 2015
- Report of the Select Committee on Dying with Dignity, Quebec Parliament, March 2012
- End of Life Decision Making, Royal Society of Canada, November 2011
- The current legal status of assisted dying is inadequate and incoherent …, The Commission on Assisted Dying, UK; 2011. Associated briefing papers are available. They include:
- The Commission on Assisted Dying Briefing Paper: Key Research Themes (Louise Bazalgette and William Bradley)
- Report to the Commission on Assisted Dying: Demos Research with Vulnerable Groups (Louise Bazalgette and Phillida Cheetham)
- The Effectiveness of Legal Safeguards in Jurisdictions that Allow Assisted Dying (Penney Lewis and Isra Black)
3. Official reports and associated material
- Annual Reports, including the latest report for 2016, the 19th year of operation
- Data collection form. This is the form completed by the Attending Physician and provides the data for the Annual Reports. Please note: data is not collected from patients. Please also note Question 15 on page 3. Physicians do not provide information that patients “feel a burden” and claim that is why they have requested an assisted dying prescription, but whether the patients have expressed “a concern about … the physical or emotional burden on family, friends, or caregivers”.
- Annual Reports – the latest report in English is for 2013.
- Latest report in the five-yearly longitudinal academic study on end of life decisions including euthanasia. The latest report is for the year 2010 and includes comparisons with 2005, 2001, 1995 and 1990.
- Biennial Reports are published only in French – latest report for 2014 – 2015.
4. Canadian Medical Association
The Canadian Medical Association has demonstrated responsible, professional and principles-based policy and action on voluntary assisted dying, in consultation with its own members, academic experts and the wider community. It has played an active and positive role in the development of Government policy and legislation and in community education and awareness. Its policy, reports and other publications are of very high quality, soundly based on principles, facts and thorough analysis.
The Tasmanian Voluntary Assisted Dying Bill 2016 is probably closest to this approach to assisted dying, including consistency with foundational principles: respect for persons, equity, respect for physician values, clarity, dignity, protection of patients, accountability, solidarity, and mutual respect.
The ‘eligible medical condition’ requirement in the Tasmanian Bill is similar to the CMA recommendation on the medical condition of the person for eligibility for assisted dying. However, the Tasmanian Bill has some important additional requirements to ensure that eligible people are at the end of their lives:
Section 11 of the Tasmanian Voluntary Assisted Dying Bill 2016 – “For the purposes of this Act, an eligible medical condition –
(a) is the advanced stages of a serious incurable and irreversible medical condition, whether caused by illness, disease or injury, as diagnosed by a medical practitioner who has specialised qualifications, or experience, in diagnosing and treating the medical condition; and
(b) the person’s medical condition, or associated medical treatment, or complications resulting from the medical condition or treatment –
(i) is causing persistent suffering for the person that is intolerable for the person; and
(ii) there is no reasonably available medical treatment or palliative care options that would, having regard to both the treatment and any consequences of the treatment, relieve the person’s suffering in a manner that is acceptable to the person; and
(c) there is no reasonable prospect of a permanent improvement in the person’s medical condition.”
There is also the ‘last resort’ provision in S22 (2) and (3). S22(2) states that the person’s doctor (the primary medical practitioner)
“must discuss with the eligible person whether there are any relevant treatment options available that may adequately and to the satisfaction of the eligible person – (a) improve the eligible person’s medical condition; or (b) relieve the eligible person’s suffering”.
S22(3) requires the doctor to provide assisted dying only “If the eligible person and the eligible person’s primary medical practitioner are satisfied there are no relevant treatment options available as discussed [under S22(2)]”.
The CMA recommendation is based on the Canadian Supreme Court decision but adds some details. The recommended requirements are that it has to be serious or severe, constant and enduring, not able to be cured, causing severe physical or psychological suffering that is intolerable to the patient, is not amenable to further treatments or interventions that are acceptable to the patient, or it is not remediable by other means acceptable to the patient, and that patients and doctors make a joint decision about assisted dying in a deliberative process of decision-making, supported by the physician’s disclosure of all available standard of care interventions or possible therapies.
The CMA supported the Canadian legislation which ended up with a more restrictive approach to eligibility with the additional requirement that the person’s death “has become reasonably foreseeable taking into account all of their medical circumstances, without a prognosis necessarily having been made as to the specific length of time that they have remaining“.
Other CMA documents:
A Canadian Approach to Assisted Dying: CMA Member Dialogue, Summary Report, 2015
Euthanasia and Assisted Death policy, update 2014
End-of-life Care: A National Dialogue, June 2014
5. Academic and respected viewpoints
Professor Michael Ashby, How We Die: A View from Palliative Care , QUT Law Review Vol 16, Issue 1, pp 5-21. This was also part of Professor Ashby’s submission to the Inquiry into Palliative Care being conducted by the House of Assembly Standing Committee on Community Development and available with other submissions here. His evidence in a public hearing in the transcript of the afternoon of 8 August 2016.
Dr Neera Bhatia, Professor Ben White and Professor Luc Deliens, How should Australia respond to media-publicised developments on euthanasia in Belgium?, Sept 2016, Journal of Law and Medicine, Vol. 23, p. 835, 2016 (also Deakin Law School Research Paper No. 16-34)
Hal Swerissen and Stephen Duckett, Dying Well, Grattan Institute, September 2014. Professor Swerissen also gave evidence in a hearing for the Victorian inquiry into end of life choices on 25 July 2016.
6. Material relating to particular issues of importance in the debate on voluntary assisted dying.
The Impact of Increased Cost of Death with Dignity Medications. There are major problems occurring in the US because of poor accessibility of affordable and suitable drugs for self-administration by those whose doctors have decided they are eligible for an assisted dying prescription. This has been caused by the US medical system in which the patients must bear all the costs and the profiteering action of pharmaceutical companies increasing the cost of relevant drugs to over 7 times what the cost was in 2010.