Putting aside the moral arguments, the fact is that Voluntary Assisted Dying legislation was passed in Queensland on 16 September 2021 and is currently due to come into operation on 1 January 2023. Whilst an uncomfortable topic, the legislation aims to ease the distress of a very small number of people who have been diagnosed with and are experiencing a disease, illness or medical condition that is causing intolerable suffering.
Putting any personal views aside, the purpose of this article is to briefly summarise the anticipated operation of the Voluntary Assisted Dying regime being implemented in Queensland.
So who would be eligible for Voluntary Assisted Dying?
For obvious reasons, there are strict criteria for any person to be able to access Voluntary Assisted Dying under the forthcoming Queensland regime. The eligibility requirements (contained in section 10 of the Voluntary Assisted Dying Bill 2021) specify that a person can only access Voluntary Assisted Dying if they can satisfy all of the following criteria:
The person is 18 years of age.
The person is an Australian citizen, permanent resident or has been ordinarily resident in Australia for at least 3 years prior to requesting Voluntary Assisted Dying.
The person has been ordinarily resident in Queensland for at least 12 months prior to requesting Voluntary Assisted Dying.
The person has decision making capacity and is acting voluntarily.
The person has been diagnosed with a disease, illness or medical condition that:
(a) is advanced and will cause death; and
(b) is expected to cause death within 12 months; and
(c) is causing suffering that the person considers to be intolerable.
What is likely clear from the above restrictions is that Voluntary Assisted Dying will not be readily available to the public at large, and it would be restricted to only a small number of eligible terminal patients.
Safeguards
In addition to those restrictions, the regime also sets out a number of safeguards that are to be implemented for Voluntary Assisted Dying. As expected, a large number of these safeguards revolve around the issue of voluntariness (and the absence of coercion). Public debate prior to passage of the laws outlined obvious concerns that Voluntary Assisted Dying would become a recommendation made to patients, but the regime specifically mandates that the patient themselves must initiate the requests for Voluntary Assisted Dying - the request cannot come through an attorney or family member.
Not only must the patient clearly and unambiguously make the request for Voluntary Assisted Dying, but they are required to re-request access to Voluntary Assisted Dying (i.e. reconfirming their decision) twice again - once in writing, and then later again with the third and final request, which must be at least 9 days after the first request was made. As part of these procedures, medical professionals are required to assess and determine the patient's decision making capacity and ensure that they understand the gravity of their decision, as well as to ensure that the patient is making the decision freely and voluntarily, in the absence of any possible coercion. This is intended to safeguard against both persons with impaired capacity (such as those suffering from dementia) as well as against encouragement from any other persons - the obvious concern here was patients being encouraged to access Voluntary Assisted Dying by those who might benefit under their will and estate, or from those who are currently responsible for (and might feel 'burdened' by) their care.
As would also be expected, a patient is free to change their decision at any point of the process - and in fact, the patient is required by law to be reminded of this possibility.
Medical Professionals & Conscientious Objections
The bill contains what appears to be stringent requirements for the access to Voluntary Assisted Dying, as well as containing conscientious objection provisions for treating medical professionals - so no medical practitioners who object to Voluntary Assisted Dying on moral and conscientious grounds are required to perform the procedure (though if a request for Voluntary Assisted Dying has been made to them and they cannot assist, then they are required to refer the patient on to a medical professional who can assist).
Conclusion
If a patient can satisfy all of these criteria, only then would they be able to access Voluntary Assisted Dying in Queensland, with the final decisions including arranging the time for the procedure, who might be present when the procedure occurs, as well as how the procedure will take place - that is, either through self-administration of the substance, or administration by the treating doctor.
With the scheme still being implemented, some of the practicalities are still unknown but it is hoped that no matter how the procedures may be implemented, that it is done so with careful regulation and close oversight, and in a responsible and suitable manner when dealing with such critical care issues.
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