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ACT Government to provide clarity on VAD eligibility

The ACT Government will provide a clearer definition of the terms 'advanced' condition and ‘last stages of life’ in its voluntary assisted dying bill, but stands firm on not including a specified timeframe to death.

The government has responded to the recommendations of a Select Committee inquiry, which asked for better definitions of the “subjective and ambiguous” eligibility terms.

Human Rights Minister Tara Cheyne told the Legislative Assembly the intention of the amendments was to give flexibility to practitioners and recognise the range of different illness trajectories. 

In a departure from the ‘Australian model’ for VAD in other jurisdictions, the ACT bill allows a person to be eligible for VAD even if they don’t have a 12-month timeframe to death. However, they must still have a condition that is ‘advanced, progressive, and expected to cause the person’s death’. 

Ms Cheyne said the policy intent was that “an advanced condition is not limited to the final days, weeks or months of a person's life and that a person may be considered to be eligible for voluntary assisted dying even if it is uncertain whether their relevant conditions will cause death within a 12-month period.”

Read the ACT Government response to the inquiry here 

The phrase ‘last stages of life’ will be replaced with ‘approaching the end of life', which is associated with the final year of life in end-of-life care settings.  

Further clarification on the meaning of 'advanced' and 'approaching the end of life' would be provided through clinical guidelines developed in consultation with health practitioners during the implementation period.

Dr Linda Swan, Go Gentle’s CEO, welcomed the government’s clarification of the eligibility terms. This was important in light of the absence of a timeframe to death, which was supported in Go Gentle Australia’s submission to the inquiry.

 “It has become clear that timeframes are arbitrary and do little to enhance the purpose of VAD, which is to offer end-of-life choice to people who are dying and suffering intolerably,’’ she said.

“The government's clarification, in concert with the other eligibility criteria, will provide the greatest flexibility and palliative benefit to terminally ill people who make this choice.” 

Read the Go Gentle Australia submission to the inquiry here

The government agreed in part with the inquiry’s recommendation to increase the time period in which practitioners must accept and lodge a VAD request in the system, from two working days to four. However, in the event of conscientious objection, a strict requirement to refer the patient to the care navigation service within two days would remain. 

There was agreement in principle to remunerate health practitioners who undertake mandatory VAD training, but it would be "subject to future budget consideration". 

There was also agreement to consult with palliative care specialists and disability advocates during the development of VAD training materials. 

The government rejected a recommendation to shorten the time period for people to return any unused VAD substances following a death. This would remain at 14 days to avoid putting undue pressure on families at an already difficult time. Instead, a reminder process would be put in place.

The government agreed in part or in principle to 25 of the parliamentary inquiry's 27 recommendations.

The ACT parliament is expected to begin debate on the Voluntary Assisted Dying Bill 2023 in the current sitting period, with debate on amendments in June.

The bill is expected to be passed this year, with VAD to be available to eligible Canberrans by the end of 2025. 

The ACT Government has set up a Voluntary Assisted Dying Implementation taskforce to prepare the health system to deliver VAD services once the law has passed. 

 

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