Doctors and terminally ill patients are travelling for hours within states that have voluntary-assisted-dying laws to avoid breaching commonwealth legislation that prohibits discussions about suicide through telehealth services.
The federal legislation existed before voluntary assisted dying laws commenced firstly in Victoria and then Western Australia. Similar laws are due to commence in Tasmania, South Australia and Queensland in 2022-2023.
But the Commonwealth Criminal Code Act 1995 can result in a fine for individuals of up to $222,000 and $1.1 million for a corporation for using a carriage service (such as telephone, email or internet) for counselling or inciting, or providing instruction on a method of suicide.
Dr Katrine Del Villar, from Queensland University of Technology’s Australian Centre for Health Law Research, told The Mandarin the federal government had not shown any intention to review the legislation despite WA, Queensland and Victoria pushing for change.
“It just makes access to assisting dying more difficult than it needs to be for people who are already in a very difficult situation,” Del Villar said.
“We are talking about people with less than six months to live; they may be in considerable pain, and it actually ends up being an access issue or a burden for people who don’t live in metropolitan areas.”
Del Villar is among four QUT researchers who have authored a critique of the federal laws in the Medical Journal of Australia following concerns the legislation is putting clinicians under an “unintended grey cloud”.
Victoria’s Voluntary Assisted Dying Review Board, in its most recent report, heard from a medical practitioner who said a patient was required to make an up to 12-hour return trip to Melbourne to see a specialist.
“This is unfair and undignified. I understand and support the need for a consulting practitioner’s opinion, but the ban on the use of telehealth creates an unfair and onerous burden,” the practitioner said.
Victorian guidelines, which were introduced first in Australia, require all voluntary assisted dying consultations and assessments to occur face to face.
Del Villar said the WA guidelines were more nuanced, with the state wanting to use telehealth because of the greater distances clinicians covered.
WA guidelines allow for telehealth to be used at certain points in the process but advise clinicians not to “advocate, encourage, incite, promote or teach” how to undertake the procedure.
“Consultations at the point of making the administration decision definitely need to occur in person to avoid breaching the code,” Del Villar said of the WA advice.
“Any consultations which describe the process of assisted dying in any detail would need to occur in person.”
She said some governments and groups calling for change wanted the laws to change to make it clear voluntary assisted dying was not suicide, while others simply wanted reassurance from the commonwealth there would be no prosecutions.
“The commonwealth hasn’t been enthusiastic about either of those options,” Del Villar said.