On 16 September 2021, the Queensland Government passed the Voluntary Assisted Dying Bill (2021). Initially, the legislation will set up a Review Board to conduct research and make preparations for the new laws, which officially come into effect on 1 January 2023.
The purpose of the legislation is to minimise suffering at the end of a person’s life, by providing a framework for an informed decision to be made about someone voluntarily ending their own life. The legislation allows health care workers (including a doctor or nurse practitioner) to have meaningful (and now lawful) conversations about voluntary assisted dying, as part of discussions about other treatment or palliative care options.
And if the patient brings up voluntary assisted dying themselves, then the health care worker can talk to them about it without any issues. Any health care workers who conscientiously object to the legislation can refuse to provide this information, but they must provide details of someone else who is likely to assist.
Requirements to access end of life treatment
To access the voluntary assisted dying program, there are a number of strict requirements. Firstly, the person must have an advanced and progressive medical condition which is causing “intolerable” physical or mental suffering and which is likely to cause death within 12 months. They must also have decision-making capacity and be at least 18 years old. Only Queensland residents who are Australian citizens or permanent residents can apply, unless an exemption has been granted.
If those criteria are satisfied, then the person has to jump through a number of hoops:
- They make a “first” request to their doctor, which is assessed within 2 business days. This doctor becomes the “coordinating” practitioner, who conducts a health assessment to determine if the person meets the criteria. During this process, the doctor has to provide the person with information about their diagnosis, prognosis, and treatment options, as well as outline the (very obvious) risks of receiving drugs to end their life;
- After this, another doctor is called in (a “consulting” practitioner), who verifies the person is eligible for voluntary assisted dying;
- A “second” request is then made, by completing an approved form, which has to be witnessed by 2 eligible witnesses (who can’t be beneficiaries under the will such as a family member, or someone else who might benefit from their death);
- Once that has been done, a “final” request is made, which has to be at least 9 days after the first request, unless death or loss of capacity is imminent. This final request can be done either orally or by some other means (such as a gesture, or by typing a text, for example);
- The initial (coordinating) doctor then completes the necessary paperwork, and prescribes the end of life drugs to be given to the person, who can self-administer them or ask someone else to administer them.
Obviously, given the potency of these drugs, and the consequences of misuse, there are a raft of penalty provisions for non-compliance with the legislation. Some of the offences include:
- Unauthorised administration of the substance — maximum 14 years imprisonment;
- Inducing a person to request, or revoke their request for, voluntary assisted dying — maximum 7 years imprisonment;
- Inducing someone to self-administer the substance — maximum 7 years imprisonment;
- Giving the Review Board false or misleading information (e.g. from a doctor or nurse), or falsifying documents — maximum 5 years imprisonment.
Given the start date for voluntary assisted dying is still quite some time off, it is of course extremely important that doctors and other health practitioners continue to comply with the existing laws when it comes to palliative care. Any loosening of attitudes towards end of life care could result in the intervention of police, which would be a tragic outcome. That said, the legislation is very welcome in the current climate, where tightening restrictions in other areas of our lives seem to be the norm.