As demand increases for voluntary assisted dying, MP urges improvements

Laws being reviewed as demand for voluntary assisted dying in Tasmania increases In short: Tasmania's voluntary assisted dying laws are being reviewed to assess whether they are still operating as intended and to determine what improvements might be needed. Since voluntary assisted dying was legalised in Tasmania in 2022, demand for it has increased significantly. What's next? The reviewers are due to hand their report to the state government by November 1. Night shift in a hospital isn't for everyone, but for former Launceston midwife Gaye Crick, there was nothing quite like it. "She'd work night duty and just come home on a high from delivering all the babies of Launceston," her daughter Laura Crick said. Laura said her mother was a "warm and lovely person" who had a passion for travel. "She was my best friend." In early 2023, Gaye was diagnosed with terminal bowel cancer. From the middle of last year, the cancer progressed rapidly, causing her constant pain and robbing her of her quality of life. Last October, Gaye died after accessing voluntary assisted dying (VAD). "Those initial conversations [about VAD] were really difficult and confronting," Laura said. "But once she had the approval in place, it gave her a great sense of relief and agency in a situation where she had none." Requests, assisted deaths increase Tasmania's voluntary assisted dying laws came into effect in 2022. Since then, demand for VAD has increased significantly. The VAD Commission's latest annual report showed a 71 per cent increase in the number of first requests made to the regulatory body in 2024-25. There were 109 reported voluntary assisted deaths, a 73 per cent increase on the year before. Independent review underway An independent review into Tasmania's VAD legislation is currently underway to assess if it is still working as intended, and what improvements are needed. It is being led by three experts — lawyer and former governor Kate Warner, end-of-life law expert Ben White, and palliative care specialist Michael Ashby. A final report will be handed to the government by November 1. The Tasmanian branch of the Australian Medical Association contributed to the review. President Meg Creely said that, overwhelmingly, medical practitioners involved with VAD found it "a really rewarding part of their medical career". However, she said there was an administrative and financial burden on doctors that needed to be addressed. "What we hear from our members is that legal access and practical access are not necessarily the same thing," Dr Creely said. "The way the system's currently set up relies a lot on unpaid overtime of unrecognised work done by the health professionals involved." In its annual report, the VAD Commission recommended better utilisation of semi-retired medical practitioners: "Many practitioners approaching retirement have suggested that they would be interested in working [in VAD] on a part-time basis after leaving private practice but that that the costs of maintaining registration as a medical practitioner and professional indemnity insurance, along with the time commitments required to keep up to date with continuing professional development requirements render this untenable." The state government has previously committed to implementing an online portal to streamline the necessary paperwork filed by practitioners. The health department said it expected the portal would be fully implemented by early next year. It said the VAD Commission "continues to recommend that the Medicare Benefits Schedule (MBS) be reformed" to establish "voluntary assisted dying specific MBS items". "VAD practitioners have repeatedly referred to the rewarding nature of their voluntary assisted dying work," a spokesperson said. "Work is underway to develop a workforce plan for medical staffing needs." Telehealth changes needed, AMA says Dr Creely said the AMA also supported patients being able to access VAD through telehealth. A provision in the Commonwealth Criminal Code prevents doctors from using phone, video or email to discuss VAD with patients. It has been the subject of national debate, with attempts made in federal parliament this week to change it. "We very much don't want to see the region somebody lives in be a reason that there is a difference in their ability to access care," Dr Creely said. Tasmania's VAD Commission has repeatedly recommended the Criminal Code be amended to remove the limitation on providing VAD information by way of a carriage service. Tasmanian health minister Bridget Archer said the state government also supported this. Enduring pride over legislation Independent MLC Mike Gaffney introduced Tasmania's VAD legislation into state parliament. He said while he had always been proud of that, it was important the legislation be reviewed three years in. "There are legislative issues that we can improve on, and there's probably implementation of the legislation that can be improved." Mr Gaffney said some restrictions were put on who could access VAD in order to get the legislation through parliament. "I think it's time for us to readdress some of those issues," he said. To make a formal request to access VAD in Tasmania, a person must be an Australian citizen, permanent resident, or have lived in Australia for at least three continuous years. They must also have been living in Tasmania for at least a year and be at least 18 years old. Mr Gaffney said the review was a chance to reconsider those restrictions. "It's a discussion we need to have,"he said. 'Important' to start conversations early Laura Crick said she hoped sharing her family's experience would broaden the public's understanding of assisted dying, and all the decision-making that is involved, even after that approval is granted. She said the decisions included when and where someone's death will happen, who would be there, and what it means for the palliative care they may still be receiving. "These conversations … it's not just a one-off. "They take time … and it's in a situation where the entire family network is also actively grieving the upcoming loss. "So it's important for people to start talking about it as soon as it's a possibility. "To give someone the opportunity to die with dignity, to give them some agency where they have very little, is incredibly important."