Parliamentary inquiry recommends voluntary assisted dying in Queensland

A long-running parliamentary inquiry into end of life related issues has recommended that a scheme to allow voluntary assisted dying is legislated in Queensland.

 

The recommendation is included in a report tabled on 31 March 2020 by the Parliament’s Health Committee.

 

Committee chair, Mr Aaron Harper MP, said the report followed over a year of extensive community consultations and public hearings as part of the Inquiry into Aged Care, End-of-Life and Palliative Care and Voluntary Assisted Dying.

 

“The committee believes that any such scheme should only be available to a person who has been diagnosed by a medical practitioner as having an advanced and progressive terminal, chronic or neurodegenerative medical condition that cannot be alleviated in a manner acceptable to the person, and that the condition will cause their death,” Mr Harper said.

 

“We have also recommended a number of safeguards that would further limit who may be able to access any such scheme,” Mr Harper said.

 

“The majority of Queenslanders who engaged with the inquiry supported the introduction of voluntary assisted dying and our recommendation to the parliament reflects this,” Mr Harper said.

 

“We believe citizens should have the choice to access voluntary assisted dying if they fit the strict eligibility criteria and if this is a choice made by them,” Mr Harper said.

 

“This is now a matter for the Queensland Government to consider,” Mr Harper said.

 

The tabling of the report on voluntary assisted dying follows the tabling last week of the committee’s report on aged care, end-of-life and palliative care from the same inquiry.

 

“In late 2018, the Queensland Parliament tasked the committee with examining the delivery of aged care, end-of-life and palliative care as well as looking into whether there was community support for introducing voluntary assisted dying in Queensland.”

 

“The inquiry engaged with thousands of Queenslanders. We held 41 hearings across the state and received 4,729 written submissions. The views and experiences of submitters and over 500 witnesses informed our findings and recommendations,” Mr Harper said.

 

“Today’s deadline for completing this inquiry was set by the parliament long before the current COVID-19 pandemic. The committee had no option to delay this report beyond the current crisis.” We are conscious that the release of this report at this time may cause some people distress, and ask the media to consider this when reporting on the committee’s findings,” Mr Harper said.

 

The Government has three months to table a written response to the committee’s report and recommendations.

 

The committee encourages anyone who may feel distressed about its report on voluntary assisted dying to seek counselling from support services such as:

  • Lifeline Crisis Support – phone 13 11 14 (24hours/7 days)
  • Beyond Blue Support Service – phone 1300 224 636 (24 hours/7 days)

 

The Committee's March 2020 reports:

 

RECOMMENDATIONS OF THE INQUIRY

The following recommendations regarding voluntary assisted dying were agreed by the majority of the Committee.

 

1. Willmott and White draft legislation

The committee recommends the Queensland Government use the well-considered draft legislation submitted to the inquiry by Professors Lindy Willmott and Ben White as the basis for a legislative scheme for voluntary assisted dying.

 

2. Limit eligibility to over 18s

The committee recommends that any voluntary assisted dying scheme in Queensland limits eligibility to adults aged 18 years or older.

 

3. Limit eligibility to Australian citizens ordinarily residing in Queensland

The committee recommends that any voluntary assisted dying scheme in Queensland limits eligibility to Australian citizens or permanent residents ordinarily resident in Queensland.

 

4. Eligibility linked to diagnosis

The committee recommends that any voluntary assisted dying scheme in Queensland requires that, to be eligible to access voluntary assisted dying, a person must be diagnosed by a medical practitioner as having an advanced and progressive terminal, chronic or neurodegenerative medical condition that cannot be alleviated in a manner acceptable to the person, and that the condition will cause death.

 

5. No precise timeframes for a person’s anticipated death

The committee recommends that any voluntary assisted dying scheme in Queensland should not propose precise timeframes for a person’s anticipated date of death within which voluntary assisted dying may be accessed due to the complex, subjective and unpredictable nature of the prognosis of terminal illness.

 

6. Eligibility limited to people with decision-making capacity

The committee recommends that any voluntary assisted dying scheme in Queensland limits eligibility to people with decision-making capacity.

 

7. Research into improving options for people who do not have decision-making capacity

The committee recommends that any voluntary assisted dying scheme in Queensland requires further research, consultation and examination to be undertaken with respect to improving end of life options for people who do not have decision-making capacity, particularly in relation to ensuring Advance Health Directives are fit for purpose and effective.

 

8. Assessments, qualifications, medications and protections from liability

The committee recommends that any voluntary assisted dying scheme in Queensland includes: controls on the qualifications required for participating practitioners; the requirement that two independent medical practitioners assess any person wishing to access voluntary assisted dying; rigorous governance of systems for prescribing, dispensing and disposing of any voluntary assisted dying medications; protections from liability for practitioners and patients participating in the scheme; and thorough documentation and reporting requirements.

 

9. Education campaigns

The committee recommends that any voluntary assisted dying scheme in Queensland includes comprehensive education campaigns to inform health practitioners and the general public about the scheme, its eligibility requirements and the rights and responsibilities of health practitioners.

 

10. Eligibility for people with mental illness

The committee recommends that any voluntary assisted dying scheme in Queensland provides that a person who is otherwise eligible to access the scheme not be rendered ineligible only because the person has a mental health condition, provided that the person has decision-making capacity.

 

11. Medications not be specified

The committee recommends that any voluntary assisted dying scheme in Queensland does not limit or prescribe the medications that may be used for voluntary assisted dying.

 

12. Self-administration of substance or administration by a practitioner

The committee recommends that any voluntary assisted dying scheme in Queensland stipulates that the coordinating practitioner may determine whether self-administration of the substance or administration by the practitioner is the method best suited to the patient.

 

13. Insurance implications of VAD

The committee recommends that safeguards should be included in any voluntary assisted dying scheme in Queensland to ensure that participation in voluntary assisted dying does not nullify life insurance, funeral or health insurance held by a person accessing voluntary assisted dying.

 

14. Counselling should not be mandatory

The committee recommends that any voluntary assisted dying scheme in Queensland does not require that every person seeking access to voluntary assisted dying receives counselling as a condition of their eligibility.

 

15. Assessment of applicants where doctors are not available

The committee recommends that the Minister should consider including flexibility in any voluntary assisted dying scheme in Queensland for applicants in rural and remote areas of Queensland where a doctor or second doctor are not available, to permit a registered nurse who meets the training and other requirements to participate in the scheme to assess an applicant for voluntary assisted dying and to administer the voluntary assisted dying medication.

 

16. Discussion to be instigated by the person wishing to access VAD

The committee recommends that any voluntary assisted dying scheme in Queensland stipulates that discussion with a medical practitioner about accessing voluntary assisted dying can be instigated only by the person wishing to access voluntary assisted dying.

 

17. Conscientious objection rights for medical practitioners

The committee recommends that any voluntary assisted dying scheme in Queensland provides health practitioners who may have a conscientious objection to participating in voluntary assisted dying to opt not to participate, provided that the rights of the patients to access the scheme are also protected.

 

18. Accessibility of VAD where available doctors conscientiously object

The committee recommends that any voluntary assisted dying scheme in Queensland ensures that voluntary assisted dying is genuinely accessible to people with a life-limiting condition whose local doctor has a conscientious objection to voluntary assisted dying.

 

19. Establishment of a review body to oversight the scheme

The committee recommends that any voluntary assisted dying scheme in Queensland provides for the establishment of a review body similar to the Victorian Voluntary Assisted Dying Review Board to provide oversight of the scheme.

 

20. Mandatory training of practitioners

The committee recommends that any voluntary assisted dying scheme in Queensland requires that health practitioners involved in administering or conducting assessments for voluntary assisted dying complete mandatory training developed by the Department of Health in conjunction with peak health professional bodies.

 

21. Review of the scheme after 3 years

The committee recommends that any voluntary assisted dying scheme in Queensland includes a requirement that the scheme be reviewed within three years from the date of proclamation to ensure the legislation is effective and working appropriately.

 

1 April 2020.