Assisted dying: ‘the key word here is voluntary’

3 people holding hands

The Government won’t facilitate the approval of lethal medicines used in voluntary assisted dying, the Health Minister says

And a spokesperson for the Pharmacy Guild says that the key word regarding the legislation is “voluntary”.

As debate over Victoria’s Voluntary Assisted Dying Bill – which has passed the state’s lower house but is yet to clear its upper house – divides the country, Greg Hunt has told The Australian that the Government won’t support any request for legislation to approve the use of “specific euthanasia drugs”.

National political editor Simon Benson writes that “Health Minister Greg Hunt says the federal government would not legislate to ‘facilitate’ specific euthanasia drugs, which at present would be unlikely to gain approval from the federal regulatory body”.

“This is a matter for the states to determine under the Constitution,” Mr Hunt said.

“There appears to be considerable uncertainty as to what pathway it would follow if (this bill) is passed. But the commonwealth will not be seeking to change laws to either facilitate or thwart any matters before the TGA, which will follow the usual process.”

The Victorian Government may “go around” federal legislation by using a number of different, already-approved drugs in a “cocktail” in voluntary assisted dying, Victorian Health Minister Jill Hennessy reportedly hinted.

However Mr Benson writes that this could mean off-label prescribing of drugs in higher-than-approved doses, which would then interact with other drugs in the “cocktail”.

“This presented a ‘medico-legal’ issue for doctors, who would need to be confident they were acting within the law, in the best interests of patients, and within the scope of their medical practice,” he writes.

Pharmacists on assisted dying

Pharmacy Guild of Australia – Victorian branch president Anthony Tassone told the AJP today that the Guild is still formulating its position regarding voluntary assisted dying.

“There are a range of views expressed, from members who are supportive of the initiative, and some who are not supportive,” Mr Tassone says.

He said the Guild was “mindful” of the implications outlined in the Australian article, but “we don’t want to speculate as to what the medicine could be, or where it may have to be supplied from, in what form… there is a lot more discussion to take place, and we will be an interested stakeholder throughout the process.”

He said it was a key point that pharmacists and other health professionals be able to follow their own conscience regarding the legislation, if implemented.

“The key word here is ‘voluntary’,” Mr Tassone says.

“It’s voluntary from the patient’s perspective, the prescriber’s, and any practitioner, such as a pharmacist, that’s involved in the supply of the medicine.”

“I think what would be considered is that where a prescriber does prescribe the treatment for a patient, there be a means to be able to identify a pharmacy that’s nominated themselves as an access point for getting the treatment, so that patients can confidently go to a pharmacy, or other authorised outlet, to receive treatment and not experience any duress in having to be turned away or referred to other professionals without a confident understanding of whether they are in a position to provide the supply.

“The Guild believes that there should be support for those pharmacists wishing to participate, that there be appropriate training and achievable criteria to be able to provide the service if they wish to.

“However, pharmacists should not be compelled to provide the medication for voluntary assisted dying if they do not wish to.”

He pointed out that with 68 safeguards built into the legislation, the voluntary assisted dying framework would be the most conservative of its type in the world.

What do doctors say?

AMA president Dr Michael Gannon has continued his public opposition to voluntary assisted dying, tweeting a link to a Daily Telegraph article titled “Euthanasia is beginning of end”.

The AMA’s position on the legislation is to oppose interventions which have the termination of life as their primary intention.

Dr Gannon told Sky News’ Helen Dalley late last week that “we have great concerns about whether or not you can build the appropriate protections into this”.

“This is against centuries of medical ethics, it’s against the thing you get taught on day one of medical school, that you do not take a patient’s life,” he said. “Your job is to respect the sanctity of human life.”

Former Prime Minister Paul Keating has also waded into the debate, writing that “voluntary euthanasia” is a threshold moment that Australia should not cross.

However the Greens’ South Australian branch has followed the success of the Bill in Victoria’s lower house by pledging to bring the debate interstate to South Australia.

Greens lead state election candidate Tammy Franks MLC said that the Victorian Parliament had taken one step closer to compassion.

“Compassion is edging ever closer and politicians are starting to show the courage to allow the choice for those who want it,” Ms Franks says.

“The Greens believe that dying with dignity should be a basic human right. We also have the courage to take the debate into the Parliament for a decision.

“In SA, the Greens have introduced multiple voluntary euthanasia bills, which have been defeated by the narrowest of margins.

“We will put that to the test once again in the new parliament and we will persevere until we have compassion in SA, because the Greens vision is for a society that respects and values an individual’s right to choose.”

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