The Voluntary Assisted Dying Act 2017 (Vic) will come into force in June 2019, becoming the first law in Australia in 20 years to permit voluntary assisted dying (VAD). This paper considers how other Australian states and territories are likely to respond to this development. It analyses three key factors that suggest that law reform is likely to occur in other parts of Australia: (1) the growing international trend to permit VAD; (2) social science evidence about how VAD regimes operate; and (3) changes to the local political environment. The paper argues that these three factors, coupled with the effect of Victoria changing its law, suggest that other VAD law reform is likely to occur in Australia. It also considers the different types of laws that may be adopted, including whether other states and territories will follow the very conservative Victorian approach or adopt more liberal models.

https://apo.org.au/sites/default/files/resource-files/2018-11/apo-nid207976.pdf

Future of assisted dying reform in Australia

/pdf/bridging-the-gap-between-rhetoric-and-reality-can-the-law-txiix37b9g.pdf

Bridging the gap between rhetoric and reality: can the law enforce quality patient-centred care in Australia?

Angels of Death: Exploring the Euthanasia Underground

This interesting book is written by two Dutch ethicists, although neither is now working in the Netherlands. It is well researched with excellent information on the various legal cases that have been instrumental in the development of the euthanasia legislation and is well referenced.

Any publication looking at this difficult subject area involves consideration of complex issues, where there are strongly held arguments on both sides. This book argues against the development of medically procured death (MPD) – including both euthanasia and physician-assisted suicide.

There is discussion of the development of the rationale for MPD, which they argue came from concerns within society about the over intervention in the terminal phases of disease and abandonment by the medical profession of the dying. Within the Netherlands, a country with liberal views and a culture of tolerance, there was increased consideration of the ending of life – with the aim of ending a life that was ‘unbearable'. This arose as society became more secularised with increased emphasis on care at home through general practice and the increase in the anthropological approach to medical care. Initially, doctors who ended a patient's life at their request were prosecuted but received only a suspended sentence or no conviction at all. These cases are discussed in detail leading up to the change in the law in 2001 in the Netherlands – legalising euthanasia-stating the requirements of care to which physicians must abide to avoid prosecution and delineates the reporting procedures.


The prime aim of this book seems to be to discuss the development of the legal changes and expose the flaws that the authors see in the arguments – both legal and ethical – supporting the use of MPD. They suggest that one of the prime arguments for MPD is patient autonomy. However, this raises serious concerns as to how patients make these decisions 


Are they given sufficient and clear information?


Are some physicians suggesting MPD as a way of coping with unbearable symptoms?


Is there a progression to non-voluntary termination of life, when patients are killed without their competent request, such as for infants and demented?




Moreover, as not all requests for euthanasia are complied with – only about one-third of request result in assisted death – it would seem that patient autonomy is not always paramount. In fact, the authors argue that the physician becomes even more powerful and is put in the position of passing judgement on a patient's life and quality of life. Thus, in response to the medicalisation of death and the abandonment of the dying, physicians are now medicalising the decisions about MPD. Autonomy is not always respected, although this is used by many of the protagonists as a justification for MPD.

This book argues cogently against MPD and presents good evidence for this position. Although there is little counterargument presented for someone wanting to consider the ethical issues involved, this book will provide much food for thought.

/pdf/death-and-medical-power-an-ethical-analysis-of-dutch-5ddddelgnk.pdf

Death and Medical Power: An Ethical Analysis of Dutch Euthanasia Practice

Many submissions made by individuals to an Australian Parliamentary inquiry into end-of-life care which supported assisted dying used narratives of bad deaths of family or friends, or included stor...

Pathos, death talk and palliative care in the assisted dying debate in Victoria, Australia

On 7 May 2015 the Legislative Council agreed to the following motion: That pursuant to Sessional Order 6 this House requires the Legal and Social Issues Committee to inquire into, consider and report, no later than 31 May 2016, on the need for laws in Victoria to allow citizens to make informed decisions regarding their own end of life choices and, in particular, the Committee should — assess the practices currently being utilised within the medical community to assist a person to exercise their preferences for the way they want to manage their end of life, including the role of palliative care; review the current framework of legislation, proposed legislation and other relevant reports and materials in other Australian states and territories and overseas jurisdictions; and consider what type of legislative change may be required, including an examination of any federal laws that may impact such legislation

Nina Springle

Papers

Inquiry into end of life choices: final report