Canadian Doctors speak out against initiating requests for euthanasia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Victoria Australian legislature will be voting on a bill to expand their euthanasia law. The original legislation, included several "safeguards" including a requirement that only patients could initiate a request for euthanasia.

The Victoria euthanasia law expansion includes enabling physicians to initiate requests for euthanasia.

This video features three Canadian doctors, who explain how doctors initiating the request for euthanasia can lead to coercion.

Dr David D'Souza

Dr David D'Souza, who is a family physician and a pain specialist in Ontario said:

If a physician is suggesting euthanasia as an option or a treatment option for their pain or their suffering, then that is a very serious thing. As a patient is more likely to take this option given that a health professional has suggested it.

I think it does severe harm to the doctor patient relationship when physicians are now allowed and even suggesting euthanasia as a means to end their suffering.

Dr Will Johnston

Dr Will Johnston, a family physician in Vancouver British Columbia said:

Promises were made that no doctor would ever be coerced to participate in euthanasia, no doctor or nurse would ever lose their job because they wouldn't cooperate with euthanasia. No hospital would have to do it. No nursing home, no palliative care unit would be forced to host doctors killing patients who wanted to die. All of that was a complete fiction. All of those things have now happened.

Dr Catherine Ferrier

Dr Catherine Ferrier, Division of Geriatric Medicine, McGill University Health Centre, Montreal Quebec said:

I can tell you about a member of my family who had cancer. It was in his brain, the cancer, so it was influencing his thinking to some degree.

The first doctor that saw him said well we can do euthanasia or we could do palliative sedation and didn't give him any other options, like psycho-social support to help him to want to live, and things like that, and so I actually insisted and said what else can you offer him. He needs psychological help, psychiatric help. So he referred him to a psychiatrist and the psychiatrist said, all he was interested in was knowing whether he was competent to make the decision or not and not whether there were other ways to address his suffering, which is like the essence of looking after people in a situation like that is how to address the suffering besides death. These two doctors were guys his age and I'm convinced that they looked at him and said: "I wouldn't want to be in his shoes so he's better off dead and he is competent to make this decision.

Previous articles about the Victoria Australia euthanasia law (Articles Link).

Doctor speaks out on initiating requests for MAiD (euthanasia).

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Victoria Australia legislature will be voting on a bill to expand their euthanasia law. Nearly every jurisdiction that has legalized euthanasia or assisted suicide has expanded their law. The original legislation, in Victoria, included several "safeguards" including the requirement that only patients could initiate a request for euthanasia.

Dr. Ramona Coelho, is a Family Physician in Ontario; a Senior Fellow of Domestic and Health Policy at the Macdonald-Laurier Institute and a Member of Medical Assistance in Dying Ontario (MAiD) Death Review Committee (MDRC). 

Dr Coehlo responds to doctors initiating requests for euthanasia:

I had a patient whose mother was offered medical assistance in dying, like many times, and they took her home because they didn't feel comfortable being in the hospital. Even after she died naturally the MAiD team apparently called the house to see if she had changed her mind.

I have been contacted by people who are concerned about family members who have been offered medical assistance in dying every day during the hospitalization in a way that it seem like they were just checking up on them.

Article: Canadian doctors speak out against initiating requests for euthanasia (Link).

Victoria Australia Assisted Dying Expansion Bill

Alex Schadenberg

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition.

Victoria Australia, like Canada, currently permits both euthanasia and assisted suicide. Therefore, the Victoria law already permits doctors to kill their patients by lethal injection or by prescribing the same lethal poison cocktail that the person would self-administer.

When Victoria Australia debated euthanasia and assisted suicide in 2017, in order to get support for the bill, they agreed to several "safeguards" including a 6 month terminal illness prognosis, which is similar to most US assisted suicide laws, and the requirement that doctors cannot initiate the discussion around euthanasia.

Similar to Canada where euthanasia and assisted suicide were legalized in 2016 under the term (MAiD), the provisions of the law were expanded in 2021 by eliminating the "terminal illness" requirement, eliminating the 10-day waiting period and permitting euthanasia for mental illness as the sole criteria, a provision that the Canadian government has delayed until March 17, 2027.

Every jurisdiction, that is currently debating euthanasia or assisted suicide, need to realize that nearly every jurisdiction that have legalized these acts, within a few short years, have expanded their laws.

How does the Victoria Assisted Dying Amendment Bill expand the law?:

• Currently doctors are not able to ask a patient if they want an assisted death, only patients can initiate the conversation. This bill enables doctors to initiate the question of an assisted death.
• Currently health practitioners who have a conscientiously objection don't need to refer or provide information, this bill requires them to refer or provide information to patients.
• Currently a person qualifies for an assisted death if they have a terminal prognosis of less than six months, this bill expands approval to people with a terminal prognosis of 12 months for all conditions.
• Currently a third medical assessment is required for neurodegenerative patients, this bill will reduce it to two medical assessments.
• Currently the two requests for an assisted death must be at least 9 days apart, the bill will reduce the second request to at least 5 days from the first request.
• Currently a person must be a citizen or permanent resident to be approved for an assisted death, this bill will not require the person to be a citizen or permanent resident but to have lived in Australia for at least 3 years.
• Currently a person must be a resident of the state of Victoria, this bill adds a "compassion" exemption to people who live in New South Wales or South Australia. This is a funny change since both New South Wales and South Australia permit euthanasia.
• This bill changes practitioner eligibility to make it easier for qualified doctors to participate.
• This bill simplies the permit to participate and creates a new administrative practitioner role to enable medical professionals who are not doctors to participate in the act.
• This bill allows interpreter flexibility when accredited ones are unavailable. In other words, the stringent requirement that someone fully understands the nature of the act has been weakened.

So let's be clear, Victoria Australia's euthanasia and assisted suicide law came into effect in June 2019.

The expansion bill changes the law by not requiring a person to be terminally ill but rather to have a terminal condition. People with a terminal condition and have a "12 month prognosis" are not dying and with treatment may recover or live a much longer life. Doctors cannot effectively determine a 12 month prognosis.

The expansion bill allows medical professionals to sell death. In Canada, MAiD teams approach peopl who have not offered any interest in being killed, but because of their medical condition, they are being harrassed into considering MAiD.

The expansion bill enables medical professionals who are not doctors to participate in the act. The same expansion is happenig in other jurisdictions based on the fact that very few doctors are willing to be killers, so they expand the catagory of who can be a killer.

In nearly every jurisdiction that has legalized euthanasia and/or assisted suicide, soon after, expand their law. Expansions are either done legislatively, as in Victoria Australia, or through interpretation of the law or both.

If your jurisdiction is debating euthanasia and assisted suicide, don't accept the arguement that the bill will not expand, if legalized. The language of the legislation to legalize these acts is determined by what it will take to legalize, not by what they intend, in the long term. Victoria Australia is a prime example since it tightened its original bill, to legalize the acts, and is, a few short years later, expanding the legislation, to enable more killing.

Assisted-Suicide Slippery Slope Keeps Slip-Sliding Away

This article was published by the National Review online on October 22, 2025.

By Wesley J Smith

When assisted suicide is first proposed for legalization, we are assured by death activists that strict guidelines will protect against abuse. But they don’t mean it. Once the laws pass, the supposed protections — which are always flaccid to begin with — are soon redefined by activists and the media as “barriers,” et voila, the laws are soon loosened. It’s all a con, but people seem to fall for it every time.

This pattern can be seen vividly playing out in Victoria, Australia. The state was the first in that country to legalize assisted suicide, and now the government is making more people eligible for legally hastened death. From the premier’s announcement:

The new legislation will remove unnecessary barriers to accessing VAD, improve clarity for practitioners, strengthen safety measures and make the system fairer and more compassionate.

See what I mean? “Strengthen safety,” (!!!) and “fairer and more compassionate,” really just means more people can become dead much sooner.

Here are some of the particulars:

There are 13 proposed amendments to the legislation, with proposed key changes to include:

• Removing the ‘gag clause’ so that registered health practitioners are allowed to raise VAD with their patients during discussion about end of life options

Doctors bringing up assisted suicide. Can you imagine anything more destructive of hope?

• Requiring registered health practitioners who conscientiously object to provide minimum information.

Doctors are often promised they can opt out. But then, the attacks on medical conscience begin.

• Extending the prognosis requirement (life expectancy limit for eligibility) from six months to 12 months.

Doctors often can’t accurately know who will die within six months. Having a one-year window just opens the door to more people to kill themselves who might not have died of their condition at all.

• For people with neurodegenerative diseases (like motor neurone disease), they’ll no longer need a third prognosis if their expected lifespan is between six and 12 months.

The second and third opinions are often provided by doctors recommended by euthanasia organizations.

• Introducing a new administering practitioner role to expand the workforce able to support VAD.

I suspect this means nurse practitioners will be able to participate in hastened death — as is allowed in other jurisdictions, including some here in the U.S. — because there can never be enough assisted suicide.

The premier excuses his loosening of eligibility requirements and other aspects of the law by claiming the changes are necessary to catch up with the slacker assisted-suicide laws in other Australian states. Talk about a race to the bottom!

The ultimate destination for all of this will be the creation of a fundamental right to be made dead, regardless of the reason, i.e., death on demand. Indeed, German and Estonian courts have already created a fundamental right to commit suicide and receive assistance in that act for whatever reason, or, for that matter, no reason at all.

In this, I am reminded of the Paul Simon lyrics:

Slip slidin’ away
Slip slidin’ away
You know the nearer your destination
The more you’re slip slidin’ away.

Links to previous articles about Victoria Australia's euthanasia law (Articles Link).

Victoria Australia debates expansions to it's euthanasia law.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Victoria Australia is considering legislation to expand their euthanasia law. Victoria was the first Australian state to legalize euthanasia in June 2019.

When Victoria was debating euthanasia, in order to get the bill passed, they agreed to a bill with several "safeguards" including a 6 month terminal illness prognosis and the requirement that doctors cannot initiate the discussion around euthanasia.

Similar to nearly every jurisdiction that has legalized euthanasia or assisted suicide Victoria is now considering expanding their euthanasia law to include a 12 month terminal illness prognosis, a reduction in the waiting period and allowing physicians to introduce the topic of euthanasia.

Callum Godde and Holly Hales reported for AAP news that:

A ban on Victorian health practitioners raising voluntary assisted dying (VAD) with terminally ill patients would be lifted under legislation set to be introduced to state parliament in 2025.

The government also wants to mandate practitioners' providing a bare minimum of information to patients if asked about the end-of-life process, even if they object.

Under the reforms, the life expectancy barrier for eligibility would be extended from six to 12 months for all patients, a third assessment requirement for neurodegenerative patients removed and the time between first and final VAD requests shortened from nine to five days.

A requirement would be added for people to be an Australian permanent resident for at least three years and an exemption for those who haven't lived in Victoria for 12 months to get access if they have a "substantial connection" to the state.

According to Godde and Hales, the Green Party believes that the proposal doesn't go far enough. The Green Party wants to eliminate the requirement of a terminal prognosis.

The Australian Care Alliance reports that as of June 30, 2024 there have been at least 1282 people who have died by euthanasia in Victoria Australia. Victoria Australia allows euthanasia and assisted suicide.

No safe way to legalise euthanasia

Kevin Yuill, emeritus professor of history at the University of Sunderland and CEO of Humanists Against Assisted Suicide and Euthanasia (HAASE), wrote an article, published in Spiked on June 18, 2024.

by Kevin Yuill

For the first time in history, both main candidates in a UK General Election are openly in favour of legalising assisted suicide or euthanasia (ASE). Whether Labour or the Conservatives win in July, the Suicide Act 1961 will likely be called into review.

Last week, prime minister Rishi Sunak was asked by reporters at the G7 summit in Italy if he would vote for a change in the law on ‘assisted dying’. He replied: ‘I’m not opposed to it, in principle, and it’s a question of making sure the safeguards are in place and are effective.’

This may be a moot point, given that Sunak is trailing Labour leader Keir Starmer by 20 points in the polls. Besides, Sunak’s position was carefully couched. Rather than giving his full-throated support, he said he is ‘not opposed’. But that didn’t stop Sarah Wootton, chief executive of Dignity in Dying, from being able to say that, whoever gets in, ‘neither are opposed to reform’ of the UK’s current ban on ASE.

Perhaps the one thing we know about the infamously slippery Starmer is that he has a track record of supporting ASE. In March this year, he said was personally in favour of legalisation and he promised that MPs would get a free vote on it in the next parliament. Still, even he said that any change in the law must be accompanied by ‘safeguards with teeth to protect the vulnerable’ from abuse. These imagined safeguards are certainly doing a lot of heavy lifting. But could they actually work?

Looking at the evidence, it is difficult to avoid the conclusion that the only ‘safeguard’ that really works or lasts is the present law, which prevents ASE entirely. In every country where ASE is legal, the safeguards have fallen rapidly and initially low numbers of assisted deaths have surged.

Just look at the example of Australia, where ASE is largely legalised. Since legislation was passed in 2017, we have heard a constant clamour for more ‘improvements’ in the law, as pro-euthanasia organisation Go Gentle Australia disingenuously phrases it. What this really means is expansions of the current eligibility criteria. Last week, Australian publication the Age complained that, in the state of Victoria, many of the 68 safeguards that had reassured Victorians that ASE would be safe ‘are now obsolete and severely limit access’. The Age insisted that doctors should be allowed to initiate conversations about euthanasia and called for the removal of other ‘unnecessary hurdles’ to ASE. It is not difficult to see how this could lead to vulnerable people being pressured into accepting an assisted death.

Even in the US state of Oregon – which proponents of ASE like to hold up as evidence that safeguards work – the minimum period between a request for an assisted suicide and a patient’s death was reduced from 14 days to 48 hours in 2021.

Everywhere that ASE has been legalised, the eligibility criteria has ended up expanding. As psychiatrists Mark Komrad and Annette Hanson note in the Psychiatric Times this month, ASE legislation begins ‘with the “low-hanging fruit” of end-stage or terminal illness and gradually broadens’ to encompass other non-physical illnesses or conditions.

In Colorado, there have been cases where people have been helped to die because of anorexia. Dutch law similarly allows ASE for a variety of non-physical ailments, extending even to allow the killing last month of a physically healthy 29-year-old who suffered from severe depression. In the Netherlands in 2010, there were two cases of ASE involving psychiatric suffering. In 2023, there were 138, making up 1.5 per cent of the 9,068 euthanasia deaths.

In Canada, ASE was legalised in 2016 under the medical assistance in dying (MAID) programme. This was initially only intended for people whose deaths were ‘reasonably foreseeable’. But a court decision forced the government to expand its criteria effectively to all those with a permanent disability.

Safeguards simply do not work, even when they supposedly have ‘teeth’. When legalised, ASE rapidly turns death into a form of treatment for anyone deemed to be living an ‘inconvenient’ life – from the mentally unwell to the physically disabled.

The only good news is that, after 4 July, there will be a debate both in and outside of parliament. We should use this opportunity to counter the emotional appeals of our political class with the tragic realities of places where ASE is legal. Legalising assisted suicide is not so much a slippery slope as a moral precipice.

Increase in euthanasia deaths in Victoria Australia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The Annual report of the Voluntary Assisted Dying Review Board in Victoria, Australia was released indicating that the number of euthanasia and assisted suicide deaths in Victoria Australia (July 1, 2022 - June 30, 2023) increased by 11% to 306 assisted deaths and the number of applications for assisted death increased by 6%.

There are significant differences between the Canadian (MAiD) euthanasia law and the Victoria Australia euthanasia and assisted suicide law which have led to a much higher percentage of assisted deaths in Canada as compared to Victoria Australia.

Both jurisdictions legalized euthanasia (physician administered homicide) and assisted suicide (self-administered) but in Canada nearly all of the deaths are euthanasia while in Victoria Australia, in the latest report, 84% of the deaths were assisted suicide and 16% were euthanasia.

In Canada the person approved to be killed does not need to be terminally ill, he/she only need to have an "irremediable medical condition." In Victoria, Australia the person who is approved for an assisted death needs to have an incurable disease with at least a six month prognosis for death.

In Canada the person is approved for euthanasia when two doctors (or nurse practitioners) agree that the person fits the criteria of the law. In Victoria, Australia a permit must be issued by the Secretary of the Department of Health and Human Services after the application has been submitted.

In Canada the person who is approved for euthanasia is not required to try effective treatments for their physical or psychological condition whereas in Victoria the person is required to try effective treatments.

There are more differences between the Canadian (MAiD) euthanasia law and Victoria, Australia's euthanasia and assisted suicide law, nonetheless, the killing or prescribing of lethal drugs that causes 306 people in Victoria, Australia to die is not a form of freedom but rather an abandonment of people at their time of need.

Suicide deaths have increased in Victoria Australia since assisted death was legalized

This speech was given in the Victoria Australia Parliament on June 21, 2023.

Hon. Damien Tudehope

The Hon. DAMIEN TUDEHOPE (21:31): It is four years ago tomorrow that euthanasia became legal in Victoria. It was claimed during the parliamentary debate that this would prevent 50 suicides each year. Not only has there been no such decline, but there were 62 more suicides in Victoria in 2022 than in 2017, when this claim was made. The suicide rate among those aged over 65 years increased in Victoria between 2019 and 2022 by 42 per cent—five times the increase in New South Wales. It is over a year since this House voted 23‑15 to create an exemption to the laws on murder, and on aiding and counselling suicide, to allow the supply and administration of a lethal substance to a person for the purpose of causing his or her death.

The misnamed Voluntary Assisted Dying Act 2022 will come into effect on 28 November 2023. NSW Health is busily preparing for this State-sanctioned killing by setting up pharmacy services to supply the deadly drugs and a "care navigator service" to connect people with medical practitioners willing to end their lives. Expressions of interest for the Voluntary Assisted Dying Review Board have closed and appointments are expected to be made shortly. The members of this board are being given the ultimate power over the lives of vulnerable people. Under the Act, only the board can issue a voluntary assisted dying substance authority—a VADSA—the legal authorisation for a specified medical practitioner to terminate the life of a named person with a specific lethal substance. Who can want this power over the lives of others so much as to seek appointment to this death board? We will see.

It is clear from the Victorian data that State-approved suicide for some evidently leads to more suicide overall. As the first State to legalise euthanasia and assisted suicide, Victoria included some restrictions to win over the final votes needed for the legislation to pass, including a default practice of self-administration, with practitioner administration permitted only when self-administration was not possible. There was also a complete prohibition on medical practitioners suggesting voluntary assisted dying before a patient initiated a request for information on it. Western Australia abandoned those restrictions, with predictable results: In the first year, 190 people had their lives ended—147 by administration of a lethal poison by a medical practitioner and 43 by self-administration of a lethal poison. Those deaths accounted for 1.14 per cent of all deaths in Western Australia, nearly double the rate of 0.58 per cent in Victoria in its third full year of legalisation.

If the same impact is seen in New South Wales, around 2,175 deaths can be anticipated under the Voluntary Assisted Dying Act in its first year of operation. Rather than offering death by lethal substance to vulnerable people, we should be saying, "We respect you, we value you, we love you and we will wrap around you all those services that see out your dying days in a proper and dignified manner."

Victoria Australia euthanasia deaths increase by 31%

This article was published by Mercatornet on September 30, 2022

Michael Cook

By Michael Cook, the editor of Mercatornet

When it passed in the Victorian parliament in 2017, the Voluntary Assisted Dying Act must have been one of the most controversial pieces of legislation in Australian history. Lobbying on both sides was intense; the debate in the lower house lasted an extraordinary 24 hours over three days; the upper house passed it after a marathon 28-hour sitting.

The new law came into effect in June 2019. After some interim reports, the first annual report, covering the year to June 30, has just been published. Wall-to-wall coverage of the results, right?

Wrong. It was barely mentioned in the media, and not at all in The Age, one of the state’s leading voices in favour of legalising assisted suicide and euthanasia.

A similar uptick in road deaths in Victoria last year prompted headlines and breast-beating. “Shock number of people killed on Victorian roads,” was the headline in the Herald-Sun. But when a shock number of people were killed in Victorian beds, the government and the media ignored them.

Premier Daniel Andrews and his ministers have boasted constantly about the 68 safeguards in their legislation. But the best safeguard of all is the sunlight of media scrutiny. And there has been precious little of that.

Should we be alarmed? Yes. The number of Victorians using voluntary assisted dying increased by 31% in a single year, despite the Covid-19 pandemic. In the year to June 2022, 269 people died, compared to 204 in the previous year. A total of 594 people has died through assisted suicide or euthanasia since the commencement of the state’s legislation in 2019.

However, the chairman of the Voluntary Assisted Dying Review Board, Julian Gardner, was delighted with the results. “The number of people seeking to access voluntary assisted dying continues to increase,” he wrote in an introduction to the Board’s annual report. “This is a further indicator of the success of the system.”

A steady increase in the number of deaths is a strange metric of success. Does this mean that, hypothetically, 100,000 deaths would constitute success beyond his wildest dreams?

The Premier also described the Act as “the safest scheme in the world, with the most rigorous checks and balances” before it was passed. So it is unsettling to read that Mr Gardner parroted these reassurances before admitting that four deaths were technically non-compliant with the legislation, although he was confident that they were “clinically appropriate”. Three contact people did not return substances left over from the procedure to authorities quickly enough and one person had signed for the medication as both the applicant and witness.

Is this the “rigorous checks and balances” trumpeted by the Premier Andrews? In his state, not so long ago, police were arresting and handcuffing people for not wearing Covid masks. But errors in the procedures for killing people don’t even merit a rebuke.

And the figures in the report are still incomplete, as there is no information on six people who died after obtaining their permit – and it is not clear whether they died a natural death or whether it was self-administered or practitioner-administered.

Mr Gardner’s optimism about the latest figures contrasted with an observation by a trenchant critic of the Victorian legislation, the Australian Care Alliance: “Deaths by euthanasia and assistance to suicide in the twelve months July 2021 to June 2022 represent 0.58 percent of all deaths in Victoria for that period. It took Oregon 22 years to reach that rate!”

The Premier has also boasted that the Victorian legislation was drafted with the help of “world experts”. What qualifies a person to be a “world expert” in euthanasia is a mystery, but two local experts at the University of Melbourne argued in 2020 that Victoria’s vaunted safeguards create barriers to equal access.

“While safety is undoubtedly ethically important, our analysis indicates that a legislative focus on maximizing safety comes at the expense of equal access,” they declared. In other words, you can have rigorous safeguards or you can have equal access, but you can’t have both.

And right on cue, Mr Gardner complains in the annual report that safeguards are preventing equal access. At the moment, under a Federal law forbidding giving advice about suicide, Victorian doctors are banned from tele-consulting for assisted dying. “The law as it exists creates barriers to access to care and, in some cases, imposes unreasonable travel demands on people suffering from life-ending medical conditions,” Mr Gardner wrote. “A change to the law will enhance access for all Victorians, regardless of their location or mobility.”

The issue of location will be a lever for reducing the number of safeguards. It would take a rare MP to oppose more equal access in today’s political climate.

The report says that 37 percent of applicants for assisted dying lived in regional Victoria, even though only 22 percent of Victorians live there. It seems unfair that they cannot access assisted dying as easily as city folks. And in fact, just as the local experts predicted, a regional MP, Stuart Grimley, grumbled last year that “there are too many safeguards in place, too many steps that a person must take to access the voluntary assisted dying scheme, too many hurdles for them to overcome.”

Coinciding with the release of the report on assisted dying was a report on the state of palliative care in Victoria by KPMG, an independent consultant. According to Palliative Care Victoria, “Demand for palliative care services has increased by 11.9% over the last 5 years, due to the growing and ageing of Victoria’s population. Meanwhile, funding increased by only 10.2% in the same period. The shortfall in funding for service delivery is expected to reach A$91.2 million by 2025.”

What are the odds that safeguards will be relaxed even further to offer regional Victorians assisted dying because no palliative care is available for people in great distress?

101 euthanasia deaths in 6 months in Victoria Australia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

Kaitlyn Offer reported for Australia's AAP that there were 101 assisted deaths in the first 6 months of 2021. Nine were administered by a medical practitioner (euthanasia) and 92 were self-administered (assisted suicide). There were 94 assisted deaths in the last 6 months of 2020.

The report indicated that 132 lethal doses were obtained in the first 6 months of 2020, meaning that many of these people will die in the second half of 2021.

There is already pressure to expand Victoria's euthanasia law.

Offer stated that the euthanasia report highlighted that the legislation prevented consultations happening via telehealth, describing it as undermining quality of care and lacking compassion.

Offer also reported that the inaugural chair of Victoria's Voluntary Assisted Dying Review Board, Betty King, is stepping down from the role.

According to the data, from legalization (June 19, 2019) to June 30, 2021, there have been 325 deaths by Victoria Australia's euthanasia law with 276 dying by assisted suicide and 46 dying by euthanasia.

For more information about the Victoria Australia euthanasia law go to the Australian Care Alliance website (Link).

Euthanasia by telehealth is being pushed in Australia.

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

An article by Charles Corke, Associate Professor of Medicine at Deakin University and the Deputy Chair of the Victorian Voluntary Assisted Dying Review Board, that was published in the Conversation states that (Assisted Dying) euthanasia has been legal in the Australian State of Victoria since June 2019 but the law does not permit euthanasia approvals by telehealth. Corke writes:

Unfortunately, while Victorians have the right to request voluntary assisted dying under Victorian law, a Commonwealth legal impediment makes it unduly difficult to access this service.

Commonwealth law makes it a crime to use a “carriage service” for the purposes of conveying “suicide related material”.

Corke explains that the law prohibiting the conveying of suicide related material via a carriage service was passed in 2005 to prevent things such as incitement to commit suicide by cyber bullies or the promotion of suicide methods to those who are vulnerable and depressed. 

Corke is not completely accurate. The 2005 law was also to prevent Dr Philip Nitschke from promoting assisted suicide via the internet. Nonetheless Corke states:

But in relation to voluntary assisted dying, the practical effect is that using modern communication to respond to a patient who requests voluntary assisted dying is a potential Commonwealth crime — even though it may be legal under state law. When laws conflict, federal legislation trumps state law.

Based on these issues Corke wants the Commonwealth law either overturned or ignored. He writes:

It seems clear the Commonwealth Criminal Code needs to be amended, but this will take time. In the interim the Commonwealth Director of Public Prosecutions needs to issue a guideline that, where a person is acting in accordance with state voluntary assisted dying legislation, offences in the Commonwealth Criminal Code will not be prosecuted. To date, requests by Victoria that this assurance be provided have proved unsuccessful.

The problem with approving euthanasia (assisted death) by telehealth is that the physician approves death by lethal drugs for a person the doctor has never examined and likely never met.

 
Considering the problem of medical misdiagnosis and the fact the some people experience suicidal ideation, the facts are that allowing euthanasia by telehealth undermines the supposed safeguards that claim to prevent abuse of the law.

Whether the law concerning the delivery of suicidal material is amended or not, euthanasia should never be approved via telehealth.

Victoria Australia suicide rate jumps 21.2% since legalizing euthanasia.

The following article was published by the Australian Care Alliance on March 6, 2021.

In 2017 there 694 cases of suicide in Victoria. In 2020 there were 842. This is an increase of 21.2%. What has led to this startling increase?

From 19 June 2019 Victorians wishing to commit suicide could arrange to have a lethal dose of pentobarbital delivered to them by the Statewide Pharmacy Service based at the Alfred Hospital. All they needed was a VADSAP - a suicide permit - issued by the Secretary of the Department of Health and Human Services.

A VADSAP is a 'voluntary assisted dying self-administration permit".

When arguing for the legalisation of State-approved and funded assistance to suicide, the Minister for Health and Human Services, the Hon Jill Hennessy, claimed that:

Evidence from the coroner indicated that one terminally ill Victorian was taking their life each week.

The Voluntary Assisted Dying Act 2017, which she introduced on behalf of Dan Andrews' Government, excluded deaths by self-administration of a "voluntary assisted dying substance" [the substance is a 15 g lethal dose of pentobarbital] for the purpose of causing a person's death from being considered as caused by suicide.

By a legal fiction such deaths are recorded as caused by the disease, illness or medical condition cited by a doctor in the application for a VADAP.

On this basis we could have expected a decrease of around 50 deaths by suicide each year now that these terminally ill Victorians had a State-approved and State-funded way to intentionally cause their own deaths by ingesting a lethal poison.

However, according to the Coroners Court of Victoria there were 694 deaths by suicide in Victoria in 2017.

There were slightly more - 698 - 2020, the first full calendar year in which State issued suicide permits (VADSAPSs) and the State-funded uber poison service were in operation.

So no decrease of 50 deaths by suicide each year.

Moreover for those who resist the Humpty Dumpty approach of words meaning whatever Humpty Dumpty says they mean, there were an additional 144 suicides - officially recorded by the Voluntary Assisted Dying Board as "Confirmed deaths - Medication [sic] was self-administered".

Adding these 144 State-approved, State-funded suicides by the ingestion of State-supplied lethal poison to the 698 suicides without such State approval and facilitation gives a real total of 842 - an increase of 21.2% on 2017.

This confirms earlier evidence that legalising assistance to suicide increases the overall suicide rate

Additionally, 31 Victorians were killed by injection of State-funded and supplied lethal poisons by a doctor who had been issued a VADPAP, a voluntary assisted dying physician administered permit, by the Secretary of the Department for Health and Human Services, specifically authorising the doctor to administer the poisons in order to cause the death of the person.

If these are added to the count of suicides - insofar as they are at least purported to be performed at the request of the person with the intention of causing that person's death - then the total for 2020 would be 873 - a 25.8% rise since 2017.

Other jurisdictions considering legalising assistance to suicide and euthanasia should consider this evidence and not be fooled by claims that this will prevent suicides.

If you or anyone you know needs help contact Lifeline on 13 11 14

Australia and 'assisted dying'

This article was published by Bioedge on May 8, 2021

Michael Cook

By Michael Cook
Editor of Bioedge

South Australia. SA’s Upper House voted for the legalisation of euthanasia and assisted suicide this week. The bill will be debated in the Lower House in the coming weeks. If it succeeds, South Australia will become the fourth Australian state where “voluntary assisted dying” will be legal, after Victoria, Western Australia and Tasmania.

The Health Minister, Stephen Wade, is backing the bill. Mr Wade said there was significant value in having national consistency of voluntary assisted dying legislation in Australia. "Consistency would support access, it would support quality and safe practice and it would reduce the pressure for what is sometimes called medical tourism," he said.

Victoria. Euthanasia became legal in the state of Victoria only about two years ago, but its supporters are already seeking a major amendment to broaden access. A Federal law currently prevents doctors from discussing euthanasia with their patients online or on a phone. It was originally passed to discourage the most vicious kind of cyberbullying. However, Justice Party MP Stuart Grimley wants to treat “voluntary assisted dying” advice as a kind of telehealth.

Euthanasia deaths almost double in Victoria Australia.

This article was published by the Australian Care Alliance on March 4, 2021.

The State of Victoria in Australia legalised both assistance to suicide by prescribing a lethal poison and euthanasia by lethal injection from 19 June 2019.

The third six monthly official report on this deadly practice, released on 3 March 2021, shows a rapid rise in the incident of euthanasia from 11 deaths by lethal injection in the six months January to June 2020 to 20 such deaths in the following six months July to December 2020 - an 81.8% increase or nearly double.

Total increase in deaths

The total number of deaths by euthanasia or assistance to suicide in July to December 2020 was 94 - almost double the 49 deaths by these means in July to December 2019.

A total of 175 people were assisted to suicide or euthanased in 2020 - already above the 100 to 150 deaths per year Premier Daniel Andrews projected the rate would stabilise at after only 12 such deaths he anticipated in the first 12 months (it was 1000% of that figure - 120 deaths).

Whose keeping count of the dead?

There have now been three different figures given for deaths by assistance to suicide - "medication was self-administered" in each successive report from the Board for the period 17 June 2019- 31 Dec 2019: 43, then 37, now 40.

This highlights the complete lack of a requirement for a witness at the time of the supposed suicide.

If we can't even get a reliable count how can we possibly know that the lethal poison was self-administered by a competent person with full knowledge?

Board promotes a think euthanasia first approach to a terminal diagnosis

The Voluntary Assisted Dying Review Board "continues to encourage people to initiate conversations about voluntary assisted dying [sic = euthanasia or assistance to suicide] early after being given a terminal diagnosis. Voluntary assisted dying is not an emergency medical procedure and, as previously reported, the application process takes time.

Starting early provides greater opportunity to complete the process without additional stress or worry."

This is an extraordinary position to take.

The Voluntary Assisted Dying Act 2017 section 9 sets out a set of criteria for eligibility to access assistance to suicide or euthanasia under that Act. These criteria include that a condition is expected to cause death "within weeks or months, not exceeding six months".

Additionally, the condition must be "causing suffering to the person that cannot be relieved in a manner that the person considers tolerable".

The Board ignores these matters in its advice urging Victorians when first given a terminal diagnosis to start thinking about obtaining a lethal poison to commit suicide or arranging for a doctor to give them a lethal injection.

There is a callousness to this advice that disregards important issues.

What about first getting a second opinion to confirm the validity of the diagnosis and prognosis? Even euthanasia enthusiast Andrew Denton concedes doctors get these wrong? Or available treatment the doctor giving the terminal diagnosis may not be aware of?

What about seeking information about palliative care?

Naturally many people suffer from depression when first given a terminal diagnosis. Is this really the right moment to be encouraging a person to think about suicide or euthanasia?

People with a disability may experience being given a "terminal" diagnosis several times in their lives. Others around them, including doctors, may consider them "better off dead"!

The Board's callous and ghoulish encouragement to think about euthanasia or suicide "early after being given a terminal diagnosis" could reinforce this prejudiced and discriminatory attitude, leading to demoralisation and despair.

Suicide by telemedicine

The Victorian Government appointed Board continues to lobby the Commonwealth Government to change its excellent law prohibiting instruction in the means of suicide and encouragement to suicide over a carriage service (telephone or internet).

If you or anyone you know needs help contact Lifeline on 13 11 14

Do euthanasia drugs cause a painful death?

Alex Schadenberg
Executive Director, Euthanasia Prevention Coalition

The question of a painful euthanasia / assisted suicide death is important as recent news articles and the euthanasia lobby promote death by lethal drugs as a death with dignity.

Hannah Martin writing for Stuff News published an article concerning the New Zealand euthanasia referendum where she quotes Dr Cameron McLaren, an oncologist in the Australian state of Victoria who states that he has assisted more than 80 people to access assisted death drugs. McLaren is the most active euthanasia doctor in Victoria, as the recent statistics indicate that 124 people died by an assisted death in the first year of its euthanasia law.

Cameron's comments should be questionned since a death by lethal drugs that does not go as planned would lead to opposition to euthanasia. Nonetheless, Martin reports McLaren as stating:

There is no chemical reason why a person taking these medications would feel any pain, as they are simply sedatives, he says. 

When a person is put into that level of medically-induced coma, there is no reason to have pain. 

Even if there was pain, the body would be unlikely to register it because of the profound nature of the coma, he says. 

McLaren says of all the deaths he has been present at, the word which keeps coming up is ‘beautiful’.

A recent American court case concerning the use of euthanasia drugs for execution challenges the assertion that these drugs provide a pain free death. An article by Candace Sutton published by News.com.au reported:

An autopsy performed on (Wesley) Purkey ... revealed he suffered “severe bilateral acute pulmonary oedema” and “frothy pulmonary oedema in trachea and main stem bronchi”. 

This means fluid quickly entered Purkey’s lungs and trachea, causing “a near-drowning” sensation which a medical expert described as “among the most excruciating feelings known to man”. 

The information from the autopsy was made public by the legal team that was trying to prevent the capital punishment death of Keith Nelson. Sutton reported:

Dr Gail Van Norman, a medical expert retained by Nelson’s lawyers to interpret Purkey’s autopsy, said the flash flood-like filling of Purkey’s lungs could only occur when a person was still alive. 

“It is a virtual medical certainty, that most, if not all, prisoners will experience excruciating suffering, including sensations of drowning and suffocation from (the drug) pentobarbital,” she said.

This is not the first time that an article opposing capital punishment stated that Pentobarbitol caused a painful death. An article by Josiah Bates published by Time Magazine stated:

In 2014, Oklahoma used a combination of pentobarbital, potassium chloride and vecuronium bromide to execute convicted murderer Michael Lee Wilson. As the drugs were administered Wilson said, “I feel my whole body burning” before he died.

In February 2019 I published the article - assisted dying can cause inhumane deaths based on research by Professor Jaideep Pandit that was published in the British Medical Journal. Pandit researched complications with assisted suicide and capital punishment deaths which included:

difficulty in swallowing the prescribed dose (up to nine per cent) and vomiting in 10 per cent, both of which can prevent proper dosing. 

Re-emergence from a coma occurred in two per cent of cases, with a small number of patients even sitting up during the dying process, the authors said.  

After oral sedative ingestion, patients usually lose consciousness within five minutes. However, death takes considerably longer.  

But in a third of cases, death can take up to 30 hours.

Due to the cost and availability of Seconal and Pentobarbital, the assisted suicide lobby began to create new lethal drug cocktails for assisted suicide.

An article by JoNel Aleccia published by Kaiser Health News in March, 2017 examined the experiments by assisted suicide activists to find a cheaper alternative drug cocktail for assisted suicide. The article states:

The first Seconal alternative turned out to be too harsh, burning patients’ mouths and throats, causing some to scream in pain. 

The second drug mix, used 67 times, has led to deaths that stretched out hours in some patients — and up to 31 hours in one case. 

These lethal drug cocktail experiments were human experiments. Even though people suffered greatly from the lethal cocktail, the lethal drug experiments were done on 67 people.

An article by Jennie Dear published on January 22, 2019 in the Atlantic reports on the development of these lethal drugs cocktails.

I wrote about the drugs used for capital punishment since these are the same drugs that are used for euthanasia. The euthanasia lobby and the media want you to believe that euthanasia is a quick and peaceful death. The fact is that some of these deaths take many hours and are sometimes painful.
 
Dr Jacqueline Abernathy wrote an article on the connection between lethal injection and assisted suicide. She explains that: "Lethal injection supplies the same class of drugs as assisted suicide does. It uses the same means toward the same end: premature and imposed death."

Lethal drugs do not provide a dignified death and as I have previously stated assisted dying can be an inhumane death.

More articles on this topic:

• Washington State assisted suicide group: Death may take hours (Link).
• What's cruel for incarceration is cruel for the terminally ill. The connection between lethal injection and capital punishment (Link). 
• Complications with lethal drugs used for assisted suicide (Link).
• Many assisted suicide deaths are slow and painful (Link).
• Is lethal injection inhumane. Euthanasia execution drug controversy (Link).

Australia Care Alliance: Victoria's first year euthanasia report.

This article was published by the Australia Care Alliance on September 3, 2020.

On 19 June 2019 both assisted suicide and euthanasia became legal in Victoria. In a world first since ancient times, Victoria is experimenting with a system of permits for the State authorised suicide of a particular, named person using a specified lethal substance as well as permits for State authorised euthanasia of a named individual by a named doctor using a specified lethal substance (This was last done in Germany in the 1940s.)

Assisted suicide and euthanasia become legal in Victoria on June 19, 2019 when the Voluntary Assisted Dying Act 2017, which passed the Legislative Council on 22 November 2017 by just two votes (22-18) came in to full operation.

Regulations were gazetted in September 2018.

Numbers

The Voluntary Assisted Dying Review Board’s Report of operations January to June 2020 reports that 104 people died by assisted suicide following ingestion of a prescribed lethal substance and 20 people were killed by euthanasia by a physician - 124 people in total – between 19 June 2019 and 31 December 2019. Of these 78 died in the second six months period - up 70% from the 46 in the first six months.

This represents approximately 0.38% of all deaths in Victoria for the period January-June 2020. It is worth noting that it took sixteen years of legalised assisted suicide before Oregon got to this rate in 2015.

A further 50 people were prescribed and supplied with a lethal substance before June 30, 2020 but had not yet been reported as having ingested it by that date; and 47 additional people were given VADSAPs – a permit for a doctor to prescribe a lethal substance for a person to use to commit suicide – but had not yet been dispensed the lethal substance.

10 additional people had received VADPAPs – a permit for a doctor to kill a person by lethal injection – but had not yet been killed by June 30, 2020.

41 permits were not issued when first applied but all were subsequently issued after a further application.

Eligibility criteria

The core eligibility criterion is set out in Section 9 (1) (d) of the Act:

• the person must be diagnosed with a disease, illness or medical condition that—
• is incurable; and 
• is advanced, progressive and will cause death; and 
• is expected to cause death within weeks or months, not exceeding 6 months; and 
• is causing suffering to the person that cannot be relieved in a manner that the person considers tolerable.
  

The first three elements of this criterion are to be assessed by two doctors, one of whom is required to “relevant expertise and experience in the person's disease, illness or medical condition”, the nature of such expertise and experience to be stated on Form 1 or Form 2 as set out in Schedule 1 of the Act.

None of the terms used in this provision are further defined in the Act nor any guidance given in the Regulations as to how they are to be assessed.

During debate on the Bill it became clear that there are uncertainties around the meaning of “incurable” and “will cause death” so that, for instance an insulin dependent diabetic who declines to take insulin may qualify under this criterion.

It was also accepted that there are misdiagnoses and errors in prognosis so that there will inevitability be some wrongful deaths.

It is important to note that the fourth element in the criterion relating to “suffering” is specifically NOT to be assessed by the two doctors. It is entirely subjective and therefore entirely meaningless. A person is suffering in the required sense simply if the person asserts that this is the case.

This approach applies in Canada but notable not in the Netherlands or Belgium where the objective nature of the suffering – and the incapacity to relieve it – is a matter for professional assessment by the physician, including a relevant specialist.

There is no definition of suffering and therefore nothing to exclude forms of existential suffering such as loss of autonomy, lack of capacity to enjoy former hobbies, feeling a burden on family or financial concerns to be the only suffering experienced. There is absolutely no requirement for the person to be experiencing pain or other physical symptoms.

Mental illness

Section 9 (2) of the Act provides that:

A person is not eligible for access to voluntary assisted dying only because the person is diagnosed with a mental illness, within the meaning of the Mental Health Act 2014.

The force of the word “only” is the key to understanding the limited usefulness of this provision in protecting persons with mental illness.

It does not preclude a person with a profound mental illness but who also has another “a disease, illness or medical condition” that meets the criterion set out in section 9 (1) (d) of the Act from accessing assisted suicide or euthanasia.

Nor does it explicitly preclude a mental illness from itself being considered to be “a disease, illness or medical condition” that meets the criterion set out in section 9 (1) (d) of the Act. For example, a person with anorexia who is expected to die within 6 months as a result of refusing treatment could qualify or even a person with treatment resistant suicidal ideation. It remains to be seen whether the Act will be applied in this way.

Sections 18 (1) and 27 (1) provide respectively that if the co-ordinating medical practitioner or the consulting medical practitioner:

is unable to determine whether the person has decision-making capacity in relation to voluntary assisted dying as required by the eligibility criteria, for example, due to a past or current mental illness of the person, [he or she] must refer the person to a registered health practitioner who has appropriate skills and training, such as a psychiatrist in the case of mental illness.

It is entirely up to the assessing doctors to form their own view as to their expertise in assessing decision-making capacity. This provision is weaker than the corresponding provision in Oregon which refers to “impaired judgement” rather than a lack of “decision-making capacity” which is defined in section 4 in purely cognitive terms, taking no account of the effects, say, of depression or demoralisation on a person judging what is truly in his or her best interests.

The evidence from Oregon shows that even with this stricter approach “as many as 150 people with depression may have been helped to commit suicide without any such referral”.

Under section 36 of the Act the two people witnessing the signature on the written declaration must certify in writing “that, at the time the person signed the declaration, the person appeared to have decision-making capacity in relation to voluntary assisted dying”. This hardly adds any extra assurance to the process as the witnesses do not need to have any expertise or prior knowledge of the person.

There is a provision in section 68 of the Act for a person who is considered by VCAT (Victorian Civil and administrative Tribunal) to have “a special interest in the medical treatment and care of the person” assessed as eligible for assisted suicide or euthanasia to apply to VCAT for a review of the decision that the person has decision-making capacity.

Disability

Section 9 (3) of the Act provides that “A person is not eligible for access to voluntary assisted dying only because the person has a disability, within the meaning of section 3(1) of the Disability Act 2006.”

Once again the key word is “only”. Nothing precludes a person with a disability – physical or intellectual – from accessing assisted suicide or euthanasia provided the person meets the other eligibility criteria. Nothing precludes the person’s disability from being considered as “a disease, illness or medical condition” expected to cause death within 6 months.

Nor are there any explicit provisions to protect people with disability from discriminatory assessment under the required processes by doctors who would consider a person with a particular disability as “better off dead”.

People with disability are more likely to experience undiagnosed depression especially following initial acquisition of a disability or adverse developments in their physical, psychological or social condition.

The Act explicitly provides for requests for assisted suicide or euthanasia to be made by gestures. It is not made explicit in the Act whether or not an accredited interpreter is required in this case. A recent court case in the Netherlands determined that “hand squeezes, nods, eye blinking and crying were all sufficient signs of” a request for euthanasia.

Coercion

The Act requires the two assessing doctors, as well as the witness to an administration request in the case of euthanasia, to certify that the person requesting assisted suicide or euthanasia is “acting voluntarily and without coercion”.

Assessing doctors are required to complete training approved by the Secretary of the Department of Health on “identifying and assessing risk factors for abuse or coercion”.

However, this training consists of just ten minutes of slides and videos as a small part of the online mandatory training that most doctors are completing in four hours or less[1]. Ten minutes of training cannot guarantee that assessing doctors never miss the signs of coercion or abuse given the well-documented evidence of failure by professionals in Australia to identify elder abuse.[2]

There is no provision for anyone to seek a review at VCAT of an assessment by the two doctors that a person is acting “voluntarily and without coercion” in requesting assisted suicide or euthanasia. A family member or friend who becomes aware that a person is being coerced has no formal recourse under the Act at all.

State issued permits

Form 3 in the Regulations sets out what a VADSAP or “voluntary assisted dying self-administration permit” looks like.

“This self-administration permit in respect of Mary Brown authorises Dr John Smith for the purpose of causing Mary Brown death, to prescribe and supply the substance specified in this permit to Mary Brown that is able to be self-administered; and is of a sufficient dose to cause death”.

The permit will be signed by the Secretary of the Department of Health and Human Services or his or her delegate.

The permit will also directly authorise Mary Brown to “use and self-administer the substance” specified in the permit in order to cause her death.

This is clearly not just State sanctioned suicide but – in a world first since ancient times – State authorised suicide of a particular, named person using a specified lethal substance.

Form 4 in the Regulations sets out what a VADPAP or “voluntary assisted dying practitioner administration permit” looks like.

“This practitioner administration permit is issued to Dr John Smith … this practitioner administration permit in respect of Jim Brown for the purpose of causing Jim Brown death, authorises Dr John Smith to administer the substance to Jim Brown.”

This is State authorised euthanasia of a named individual by a named doctor using a specified lethal substance. It was last done in Germany in the 1940s.

The Regulations specify that the Secretary of the Department of Health and Human Services or his or her delegate will have 3 business days from receiving a VADSAP or VADPAP application form (accompanied by five other forms) to either issue the permit or refuse to do so. 68% of applications are processed in just two business days - unheard of public service efficiency - all in the service of poisoning Victorians.

All that the Secretary or his or her delegate will do is to check that two doctors have ticked the right boxes and filled in the blanks on the six forms.

None of this checking of ticked boxes can possibly guarantee that the person who the Secretary or delegate will authorise to commit suicide or to be killed by euthanasia really:

• has the alleged condition; 

• actually has only six months to live; 

• is not being coerced overtly or subtly by impatient heirs or weary caregivers; 

• is not depressed; 

• is not missing out on effective treatment; 

• is not being discriminated against due to disability; and 

• could not have had their suffering relieved with appropriate palliative care.

Assisted suicide

The processes for assisted suicide are deeply flawed.

The “poison or controlled substance or a drug of dependence specified in a voluntary assisted dying permit for the purpose of causing a person's death” approved by the Secretary, prescribed by the doctor and issued by a pharmacist to the person will be 20g of sodium pentobarbital.

On 5 January 2019 the Minister for Health, Martin Foley, announced that The Alfred Hospital pharmacy would be "the sole service for dispensing" the lethal cocktail across Victoria. "For people too sick to travel, the pharmacy service will deliver them their medication and provide information on administration".

The notion of a kind of "uber-poison" service to country Victoria - where there is a chronic shortage in ready access to palliative care medicines as needed - is particularly disturbing.

There is no requirement for any doctor or other health practitioner to be present when the poison is ingested.

In Oregon, under a similar scheme, in 2019 for two out of three people there was no physician or other healthcare provider known to be present at the time of ingestion. In one out of ten cases where a health care provider was present they reported that the person either had difficulty ingesting or regurgitated the lethal dose, or had other complications. In previous years, complications have also included seizures. Eight people have regained consciousness and died subsequently from the underlying illness.

The interval from ingestion of lethal drugs to unconsciousness was as long as four hours while the time from ingestion to death was as long as 104 hours with one person in 2019 taking 47 hours to die.

Imagine these complications occurring for a person who is home alone when they ingest the poison.

The Act does not require any assessment of decision-making competence or absence of coercion at the time of ingestion nor does it set any time limit on the length of time between the poison being prescribed under a VADSAP and it being ingested. In Oregon the longest duration between initial request and ingestion recorded is 1009 days (that is 2 years and 9 months).

There is no provision for the Voluntary Assisted Dying Review Board to collect or report data on complications or time between ingestion and unconsciousness or ingestion and and death.

The Regulations provide the specifications for the locked box in which the Act requires the lethal poison issued under a VADSAP to be stored. It must be made of steel. It must be “not easily penetrable”. It must be “lockable with a lock of sturdy construction”.

The last two requirements are entirely subjective. What counts as “not easily penetrable” or as a “lock of sturdy construction”? Who knows? Almost any steel petty cash box could be thought to qualify.

There are no requirements for where the box containing the lethal poison is to be kept. However, section 126 of the Act does specifically exclude it from the usual protective requirements for dangerous medication in aged care services - so it may have to be kept under grannie’s bed in her aged care room.

Nor are there any limits on how many keys there can be to the box or on who can have a key (or the code in case of a combination lock).

And of course if there is no witness we will never know if the person really self-administered the poison or if it was administered to them by a family member or other person under duress, surreptitiously or violently.

Euthanasia

Section 48 of the Act allows for euthanasia (practitioner administration of the poison) as an alternative to assisted suicide in the case where a single doctor certifies that he or she is satisfied that “the person is physically incapable of the self-administration or digestion of an appropriate poison or controlled substance or drug of dependence” and provides a reason for this incapacity in completing Form 8 of schedule 1 of the Act and Form 2 as set out in the Regulations .

In the first twelve months to 30 June 2020, some 16.1% (20 out of 124) of cases involved euthanasia by lethal injection.

The Board actively encourages recourse to euthanasia in its Report:

“While self-administration might be appropriate for the applicant initially, it may not always be when close to death. Coordinating medical practitioners can apply for a new practitioner administration permit if the applicant has lost the physical capacity to swallow or digest the medication. ‘I was worried she wouldn't be able to swallow the medication.’ – Contact person.”

The Report does not provide any data on how often, if ever, this has occurred to date.

It does indicate that the threshold for justifying euthanasia as the method of bringing about death is so low that vague concerns about an ability to swallow the (liquid) medication would be sufficient.

Comparative statistics between jurisdictions permitting only assisted suicide and those permitting both assisted suicide and euthanasia suggest that where euthanasia is available the overall rate of deaths from assisted suicide and euthanasia is significantly higher.

This may explain why Victoria has reached a death rate of 0.38% from prescribed lethal poisons in one year of legalisation sixteen times faster than Oregon which only permits assisted suicide.

Conclusion

On 19 June 2019 Victoria embarked on the fifteenth in a series of experiments in legalised euthanasia or assisted suicide begun in the Northern Territory in 1996. Each of these experiments has proved to be fatally flawed resulting in wrongful deaths. There is nothing in the design of the Victorian experiment or the data so far to justify any expectation of better results.