'Just so grateful': Assisted dying operating as intended in Tasmania

Sixteen terminally ill Tasmanians chose medical assistance to die in the first six months of the state's voluntary assisted dying (VAD) law, a new report reveals.

Diagnosed with stage 4 colorectal cancer, John Street battled to stay alive for as long as possible. But when his suffering became too great he knew he wanted to die on his own terms.

The Huon Valley man with a passion for bikes, woodwork, and social justice, chose to access Tasmania's voluntary assisted dying (VAD) law in February after 17 months of treatment and cancer management. He was one of 16 Tasmanians who chose to end their suffering using the VAD law in its first six months of operation.

John died at his home with his loved ones by his side.

"He drank the substance and had some apple juice to wash away the bitterness," his wife Mary-Kate said. "John was calm as he waited for the drug to take effect. We held hands and I felt calm for him and for me. This is what he wanted and the alternative of more illness and helplessness was simply not an option for him. 

"We were both so grateful that this was possible."

Read John's full story here. 

The first six months

Tasmania's End-of-Life Choices (Voluntary Assisted Dying) Act 2021 is operating effectively and as intended, the independent VAD Commission said in its first official report.

VAD became available in Tasmania on 23 October 2022. In its first six months, 90 people contacted the VAD Navigation Service enquiring about VAD for themselves or another person. 

Of these, 65 per cent had a primary diagnosis of cancer and 12 per cent had a primary diagnosis of neurodegenerative disease. Some 47 people went on to make a first request to be assessed for eligibility and 16 people died after the administration of a VAD substance.

Of the people who made a first request, the median age was 73 years, with ages ranging from 42 to 90 years. Twice as many males as females made a first request (28 compared with 14). 

The safeguards applied through the legislation were effective, the Commission said, noting that no notifications of contraventions of the Act had been received.

Louise Mollross, VAD Executive Commissioner, said “it is apparent … that the Act is operating effectively”.  

“This has largely been possible due to the incredible support and assistance provided to patients across the state by a small group of medical practitioners and registered nurses.”

Concerns about the Commonwealth Criminal Code

However, the Commission raised concerns about two short sections in the Commonwealth Criminal Code that makes it illegal to use a “carriage service” such as telephones, email and the internet to discuss 'suicide-related materials'. This has been interpreted to also include discussions of VAD.

“The need for certain communication around voluntary assisted dying to be conducted in person so as to avoid the potential consequences under the Criminal Code has significant practical consequences for registered health practitioners, people wishing to access voluntary assisted dying, and their families,” the report said.

“The Commission urges amendments to the Criminal Code to expressly exclude participation in voluntary assisted dying in accordance with state legislation from the scope of sections 474.29A and 474.29B of the Criminal Code and encourages the Tasmanian Government to continue to advocate strongly on this issue.”

Demand increasing

The Commission also noted that the number of Tasmanians accessing VAD was steadily increasing with the possibility that numbers would exceed predictions once the Act had been in operation for 12 months.

The number of practitioners who had successfully completed VAD training had also exceeded expectations, the report said. 

The Commission identified other challenges, including concerns about adequate funding and proper remuneration of VAD healthcare professionals. 

"The Commission supports the equitable remuneration of medical practitioners and registered nurses who provide voluntary assisted dying services to remove barriers to practitioner participation in the voluntary assisted dying processes and to ensure that regional residents have same level of access to voluntary assisted dying as metropolitan residents."   

The stats

In the first six months since the Act commenced:

• 90 people contacted the VAD Navigation Service for themselves or another person
• Of these, nearly three-quarters were receiving palliative care services 
• There were 47 first requests to access VAD with 38 deemed to be eligible
• Twice as many males as females made a first request
• There were 28 final requests with 100% deemed to be eligible
• 16 people died after administration of the VAD substance
• The average time from a person’s first request to their final request was 14 days.  
• 63 healthcare professionals have successfully completed the VAD training.

Read the full report here.