The Voluntary Assisted Dying bill has passed Victoria’s upper house, with some amendments
The amendments included changes to the time frame for patients to use the scheme: previously, patients would have been eligible if they had 12 months or less to live, but this has been reduced to six months, with some exemptions.
Because of the changes, the Bill will need to be ratified again by the Lower House before the legislation can be enacted.
Pharmacists will have a key role in providing access to the scheme, and will supply medicines to eligible patients in a locked box.
The Australian Medical Association’s Dr Michael Gannon has been vocal in his opposition to the bill, and told Radio National’s Fran Kelly today that he is disappointed in the decision.
He queried claims by Victorian Premier Daniel Andrews that doctors are already assisting patients to die.
“To me, that suggests the Premier still possibly doesn’t understand the very clear ethical differences between what used to be called—the old terminology is passive euthanasia, and active euthanasia,” he said.
“Withdrawal of care is not unethical. Not initiating or not continuing futile care is not the same as euthanasia.
“The law that is very close to being passed in Victoria now is euthanasia, it’s physician-assisted suicide, it’s at odds with established medical ethics and our concerns about it remain.”
He told Ms Kelly that it is an “absolute myth” that doctors are assisting patients to die every day.
Told @frankelly08 @RadioNational how upset I was to hear @DanielAndrewsMP asserting #Euthanasia PAS already happens regularly. It's just not true! Better understanding/codification 'double effect', improved #PalliativeCare is what's really needed #auspol https://t.co/pBi8DsXVXQ
— AMA President (@amapresident) November 22, 2017
The Australian and New Zealand Society of Palliative Medicine acknowledged Victoria’s decision, but urged stakeholders not to stop the focus on end-of-life care with the assisted dying legislation.
“Yesterday’s decision by the Victorian Parliament should not detract attention away from the significant deficits in the provision of palliative care in Australia, including in Victoria,” says ANZSPM president Professor Meera Agar.
Pharmacy appears to be split on the issue. A recent AJP poll showed that 32% of pharmacists would refuse to participate in the scheme, were it implemented in their state, while 5% said they supported the legislation but would not participate.
Another 22% of readers wanted more information before making a decision, while 41% said they would supply the medicines under these circumstances.
At the time, ethics in pharmacy expert Dr Betty Chaar called the results disappointing.
“Being a professional means you may need to provide services that you might not entirely believe are useful or therapeutic et cetera: for example the harm minimisation policy and provision of needle exchange services or methadone.”
PSA president Dr Shane Jackson told the AJP that it is vital that pharmacists are able to participate in the scheme, or not, according to their own conscience.
“We’ve been following this very closely, and the Victorian branch of PSA has been doing a significant amount of work with the Victorian Government and Health Department around providing feedback on the numerous amendments that have been proposed,” he says.
“If the Bill passes the Lower House for the second time, as a professional organisation we’re focused on making sure that the rights and obligations of pharmacists are absolutely protected for those individuals who conscientiously object to providing medicines for voluntary assisted dying – just as they’re able to conscientiously object to supplying other types of medicine.
“We also need to make sure that appropriate processes are in place in regards to oversight of the medicines – what happens with excess supply of the medicine, what happens with the return of medicines, what information is provided to individuals.
“A key component of that is the need to make sure, in this time of often quite significant distress for the individual and family members, that they know which pharmacies are willing and able to do this.”
Dr Jackson says there is a significant amount of detail that needs to be worked through on these issues.
“We need to make sure the complexity in the process is minimised,” he says.
— JillHennessyMP (@JillHennessyMP) July 25, 2017