Pharmacists take on crucial new service

The Alfred Hospital’s pharmacy service will become the sole site for storing and dispensing voluntary assisted dying medications across Victoria

In late 2017 Victoria’s Parliament passed the Voluntary Assisted Dying bill, which will see pharmacists involved in the euthanasia process.

The legislation has been undergoing an 18-month implementation period before it comes into effect in June 2019.

On 5 January this year, the Victorian government announced that The Alfred hospital’s pharmacy service will become the sole service for dispensing voluntary assisted dying medications across the state.

Acting Minister for Health Martin Foley says that The Alfred Hospital’s pharmacy department would be responsible for importing, storing, preparing and dispensing medications for Victorians who make the choice to access voluntary assisted dying.

“The Alfred is one of Victoria’s leading hospitals. Having a single point of access for voluntary assisted dying is just one of the ways we’re making sure the model is the safest and most conservative in the world,” says Minister Foley.

A single point of access will ensure medicines are kept and dispensed securely, that patients are provided clear information regarding administration, and ensure unused medications are returned and destroyed if not used – in line with the stringent controls, he adds.

Professor Michael Dooley, as Director of Pharmacy at Alfred Health, will be overseeing the service.

“My perspective is that it’s imperative that the most appropriate care and high-quality care is provided to patients,” Professor Dooley tells AJP.

“This is a very specialised area and consequently the development of a specialised state-wide pharmacy service is something that will certainly make sure that it’s implemented in the best way possible.

“The Alfred is a major teaching hospital network that provides a range of state-wide services and has the capacity to provide such a specialised service.”

Several measures will be put in place to ensure the service is safely and appropriately rolled out, he says.

“Part of the Health Department approach has been to develop a structured formalised medication protocol,” Professor Dooley tells AJP.

“There will be a very defined protocol that’s put in place that the Health Department will approve.”

While the service will be located at The Alfred Hospital, it will be available to all Victorians, Professor Dooley emphasises.

“It’s a service that will be provided for Victorians wherever they are. Patients don’t come to us – we go to patients.”

The Victorian government has confirmed the following safeguards will be put in place to ensure the voluntary assisted dying model is safely implemented:

  • Only adults with decision making capacity, who are suffering and have an incurable, advanced and progressive disease, illness or medical condition that is likely to cause death within six months (or 12 months for people with neurodegenerative conditions) can access the scheme;
  • A person may only access voluntary assisted dying if they meet all of the strict eligibility criteria, make three clear requests and have two independent medical assessments that determine they are eligible;
  • The request must always be initiated by the person themselves, with health practitioners who are treating the person and raise the issue subject to unprofessional conduct investigations.

“All of the guidelines are now in place for voluntary assisted dying to begin in June – and ensure people with a terminal illness who wish to end their lives with dignity can do so,” says Minister Foley.

Professor Dooley highlights that the legislation that has been passed in Victoria has “clear support” for conscientious objection for those that don’t want to participate.

“If any pharmacist doesn’t want to participate, they don’t have to,” he says.

There will be a “dedicated” team of pharmacists that have volunteered to be a part of the service, he says.

You may be interested in reading:

A matter of life and death

Voluntary Assisted Dying Bill passed

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