‘To die, to sleep’ – assisted dying legislation in Victoria: A case study

Abstract

Background: Assisted dying remains an emotive topic globally with a number of countries initiating legislation to allow individuals access to assisted dying measures. Victoria will become the first Australian state in over 13 years to pass Assisted Dying Legislation, set to come into effect in 2019. Objectives: This article sought to evaluate the impact of Victorian Assisted Dying Legislation via narrative view and case study presentation. Research design: Narrative review and case study. Participants and research context: case study. Ethical considerations: This legislation will provide eligible Victorian residents with the option to request access to assisted dying measures as a viable alternative to a potentially painful, protracted death. Findings: This legislation, while conservative and inclusive of many safeguards at present, will form the basis for further discussion and debate on assisted dying across Australia in time to come. Discussion: The passing of this legislation by the Victorian parliament was prolonged, emotive and divided not only the parliament but Australian society. Conclusion: Many advocates for this legislation proclaimed it was well overdue and will finally meet the needs of contemporary society. Protagonists claim that medical treatment should not provide a means of ending life, despite palliative care reportedly often failing to relieve the pain and suffering of individuals living with a terminal illness.

Voluntary assisted dying in Victoria: Why knowing the law matters to nurses

“…4 The next two criteria, however, deserve more detailed consideration. First, although Gilbert and Boag state that Chloe had ‘legal capacity to make decisions’ (p. 1978), 14 to be eligible Chloe must, in fact, have decision-making capacity in relation to VAD (see Box 2) (s9(1)(c)). 4 That is, the assessment of whether a person has decision-making capacity is specific to the decision that needs to be made.…”

“…There are important points to clarify in relation to Chloe’s prognosis. Gilbert and Boag state that a person must be ‘diagnosed with a terminal illness and likely to die within 12 months’ (p. 1978) 14 to be eligible for VAD. However, it is only if a person is diagnosed with a neurodegenerative condition, which brain cancer is not, that this 12-month time frame applies (see Box 2) (s9(4)).…”

“…We know that Chloe ‘discussed assisted dying’ with her general practitioner, Dr Heslop (p. 1978). 14 What is not known is whether the conversation about VAD was initiated by Chloe or Dr Heslop. This is important because the Act prohibits all registered healthcare practitioners from initiating discussions about VAD with their patients (s8).…”

“…I know it’s legal now, and I want you to help me get the drugs so I can die’, this would constitute a clear request for VAD. The statement in the case study that Chloe ‘discussed assisted dying’ with Dr Heslop who ‘agreed to her request’ (p. 1978) 14 does not provide enough detail to determine whether the legislative requirement of a first request was satisfied. This distinction is critical because without it, the VAD process cannot start.…”

“…12,13 Despite substantial interest among nurses in the topic of VAD, 10,11 their knowledge of the law that underpins it may be limited. A recent article by Gilbert and Boag that sought to ‘evaluate the impact of Victorian Assisted Dying Legislation’ (p. 1976) 14 is a salient example. While purporting to describe the operation of the Act by applying it to a fictional case study, the article contains errors that could mislead nurses about this law.…”