Andrew Denton investigates the stories behind Victoria’s landmark Voluntary Assisted Dying (VAD) law: Who seeks to use it, and why? Who are the doctors stepping forward to help them? And how does the Church continue to resist a law it describes as ‘evil’?
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Victoria’s Voluntary Assisted Dying law was written to allow an eligible, terminally ill patient to drink a lethal medication to end their suffering; choosing to drink being considered the ultimate voluntary act.
But the law allows, in exceptional circumstances, for a doctor to intravenously administer that medication to end their patient’s life.
Who would need such a thing? And what impact does it have on a doctor when they are asked to transgress the age-old commandment ‘thou shalt not kill’?
No group has done more to persuade politicians to oppose assisted dying in Australia over the last 20 years than doctors. Citing their Hippocratic Oath to ‘do no harm’, they argue that giving doctors the right to ‘kill’, instead of cure, will forever damage the doctor-patient relationship.
What they fight so fiercely to preserve is a world strongly influenced by Christian concepts of care, one where ‘doctor knows best’, even when it comes to the end of a person’s life.
Not all doctors feel this way. In this episode, we meet a number of physicians from very different backgrounds, who think the old paternalism is not always what’s best for their patients.
So much has been said by opponents about the people who choose Voluntary Assisted Dying: That they can't possibly know their own minds. That the burden of having life-ending medication is too great. That they risk being coerced by greedy relatives...
Why not let people with a terminal illness speak for themselves?
Imagine turning up to work one day to discover flyers outside your office accusing you of being a ‘death peddler’ and an ‘Uber service for poison’.
Professor Michael Dooley runs Victoria’s Statewide Pharmacy Service. When voluntary assisted dying became legal it was his job, and that of his team, to come up with medication that would effectively and painlessly end a terminally ill person’s life - and also also a way to safely get it to them.
Of all the doubts raised by MPs in the parliamentary debate about assisted dying, none was more frequent than the fear that a vulnerable person may be coerced to their death by heartless relatives through the VAD law.
In this episode, we meet Betty King – the “Guardian of the Safeguards’ – as well as doctors, palliative care physicians, pharmacists, VAD Care Navigators, and families of those who have been through the process to find out whether any of those fears have turned out to be true.
The key word in Victoria’s voluntary assisted dying law is the first one: ‘voluntary’. By law, any doctor, nurse, or other health professional who conscientiously objects can choose not to participate in a person’s request for voluntary assisted dying.
But how does an institution balance its employees legal right to conscientiously object with its obligation to care for its patients?
In September 2020, as Tasmania’s Upper House prepared to debate an Assisted Dying bill, an article appeared on the online publication Mercatornet. Above a picture showing a graph of a flatlining heartbeat superimposed over an elderly hand was a headline in big, bold letters: ‘Grandma took her life yesterday. Her doctors helped her.’ The article described a lonely, elderly woman, seemingly abandoned by her family in a Melbourne nursing home during COVID, encouraged by her doctors to end her life using Victoria’s Assisted Dying law.
Within days, it was being promoted by religious groups and The Australian Family Association as a warning to MPs about why they should vote down the Tasmanian bill. In this episode, we reveal the truth behind that story. Who was Grandma? Had her family really abandoned her? Was her decision to die her own, or was she encouraged?
At the heart of the political debate around voluntary assisted dying lies palliative care. On one side sits the argument that it can effectively deal with all pain and suffering, and that it should be made available to everyone before Assisted Dying is made legal.
On the other, a recognition that – for all its benefits – palliative care cannot help everyone, and that those beyond its help should not be left to suffer, or – as some do – take their own lives.
But beyond the political debate, within palliative care lies a much deeper argument. One about values.
The assisted dying debate in Australia has revealed two parallel universes. The conservative Christian universe, which believes our lives belong to God; that whatever happens at the end of life is part of His plan. And the other universe – embracing 80% of Australians (including a majority of Christians) – with a shared belief we should have some control over how we die.
Two different, but both entirely sincere, belief systems.
What happens when these parallel universes intersect? What can it mean to die in a system where you are disempowered, and whose values you don’t share?
Whether it is through the words of the pope, his representatives the bishops and archbishops, or its surrogates in the medical profession, the Catholic Church remains the most determined force against voluntary assisted dying in Australia In 2020, The Vatican released its latest encyclical on assisted dying and euthanasia. They called it Samaritanus Bonus – the Good Samaritan – and this is what it had to say about people who seek assistance to die.
When Victoria’s VAD law was passed in 2017, it was touted by Premier Daniel Andrews as ‘the most conservative in the world’. This was true. Its 68 safeguards made it a far more daunting law for terminally ill people to access than similar laws in other countries. But was it too daunting? Much was said in parliament by opponents about the law’s ‘unintended consequences’. What if there are wrongful deaths? What if the doctor-patient relationship is damaged? Palliative care diminished? None of these fears have turned out to be true. But that doesn’t mean there have been no unintended consequences.….
Victoria’s Voluntary Assisted Dying law came into effect in June 2019. The first of its kind in Australia and touted as the most conservative in the world, the passing of Victoria’s law was a watershed moment for end-of-life care in this country More than eighteen months on, in April 2021, what effect is this law having on end-of-life care for terminally ill Victorians? Is the law working as planned? And is there room for improvement? The final episode of Better Off Dead season two centres on a recording of the Wheeler Centre’s Last Words: Voluntary Assisted Dying panel discussion.