Letters
Ethics
Volume 216 - Issue 4

Participating doctors' perspectives on the regulation of voluntary assisted dying in Victoria: a qualitative study

Authors:  Cameron J McLaren and Greg Mewett

Med J Aust 2022; 216 (4): 210-210. || doi: 10.5694/mja2.51419
Published online: 7 March 2022

In reply

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In reply: In their letter to the Editor,1 Harris and Cigolini make several points that call for correction. We echo concerns regarding the high practitioner caseload and encourage more doctors to complete voluntary assisted dying (VAD) training. Victorian legislation has been interpreted to require one assessing doctor to be a specialist in the patient’s medical condition. Few specialists completed VAD training in the early stages, which led to concentration of cases among these doctors. We applaud these doctors for their commitment to patients’ rights.

The article cited by Harris and Cigolini reports an association between an individual having a high wish to hasten death and their doctor being willing to assist in hastening death;2 however, this does not establish causation. Victorian doctors cannot initiate a discussion about VAD; it is difficult to conceive how doctors’ views would have an effect beyond facilitating access for those who request it.

The Victorian government cautions that the use of telehealth in VAD assessments may be a breach of sections of the Criminal Code Act 1995 (Cth) pertaining to suicide. Death certificates of patients who undergo VAD administration do not list suicide as the cause of death, therefore the applicability of the Criminal Code Act is unclear and yet to be tested in law. International evidence suggests that telehealth is being utilised in assisted dying assessments during the pandemic, and quality of care can be achieved.3,4

The claim that VAD is detracting from improvements in palliative care is equally unfounded. A report commissioned by Palliative Care Australia states: “If anything, in jurisdictions where assisted dying is available, the palliative care sector has further advanced.”5 The statement that palliative care needs “still remain largely unmet” is discordant with the Palliative Care Outcomes Collaboration report on patient outcomes in Victoria6 and fails to recognise the work of many dedicated Victorian palliative care clinicians.

We encourage robust discussion, but make the point that discussion must be based on unbiased analysis of best quality evidence. We reaffirm our call for more funding to develop the evidence base for these discussions.

 

Authors

  • Cameron J McLaren1,2
  • Greg Mewett3
  • 1. Monash University, Melbourne, VIC
  • 2. Monash Health, Melbourne, VIC
  • 3. Grampians Region Palliative Care Team, Ballarat Health Services, Ballarat, VIC

Correspondence: cameron.mclaren@monash.edu

Competing interests

No relevant disclosures.

References

Linked content

  • MJA Research: Participating doctors’ perspectives on the regulation of voluntary assisted dying in Victoria: a qualitative study

  • MJA Editorial: Update on voluntary assisted dying in Australia

  • MJA Letter: Participating doctors' perspectives on the regulation of voluntary assisted dying in Victoria: a qualitative study

  • MJA Letter: In reply

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