Victoria scraps ‘gag clause’ banning doctors from raising voluntary assisted dying with patients

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For Nick Carr, one of the toughest things to see as a doctor is patients with life-threatening illnesses in extreme pain and knowing that there's a way to ease their suffering, but being unable to bring it up.

“Times there’s been, I’ve had to sit there, just sit on me hands and shut me mouth, wanting to say to them, ‘Do you know there is the option of voluntary assisted dying?’ but I can’t.”

There's no other medical treatment where you're barred from informing someone about their legal and viable medical options. There's no other situation where the patient's required to know about their choices and a doctor's not allowed to advise them.

“It’s quite perverse.”

A Victorian government rule, which stopped doctors from discussing voluntary assisted dying unless asked by their patients, will be scrapped.

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The report, to be presented to parliament on Thursday, found that while Victoria's Voluntary Assisted Dying laws are "working as planned", some of the safety nets in place are making it harder for people to access the end-of-life choice.

The "gag clause" was brought in to address worries about being forced into ending their lives too soon.

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, which came into effect in 2019. Since then, all other states and territories, except the Northern Territory, have done the same.

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While the review looked at how the law operates, it made five suggestions, all of which the state government has agreed with. This included boosting community awareness of VAD and making it easier for Aboriginal and Torres Strait Islander people and multicultural communities to access it.

In its response, the government said it would also introduce legislation to parliament this year to "respond to lessons from the review" and "bring Victoria's voluntary assisted dying legislation more in line with other Aussie states".

The Health Minister, Mary-Anne Thomas, told the media that scrapping the gag law, which would let health professionals start conversations about Voluntary Assisted Dying, is a high priority.

“This will keep us in line with other states and make sure this vital end-of-life care option can be talked about between people who've got a life-shortening illness and their doctors,” Tom said.

The removal of the requirement for applicants to be Australian citizens and Victorian residents is also being proposed.

Carr, who's on the board of Dying With Dignity, reckons this is a "huge issue" for people who have been living in Australia for years but aren't citizens.

He remembered the case of Julian Bareuther, his first VAD patient, who took his own life after being deemed ineligible, as he was a UK citizen despite having lived in Australia for 40 years.

"He arrived eight days after the laws came into effect. He had pancreatic cancer, he wanted VAD (Voluntary Assisted Dying) but because he wasn't formally an Aussie citizen, he was refused the option," Carr said.

“It would be a massive and much-needed adjustment if the government were to scrap that requirement.”

The government is also looking to alter the six-month time frame for non-neurodegenerative diseases, to 12 months – as medical opinions often differ – scrap the need for a third assessment for patients with neurodegenerative conditions and reduce the time gap between the initial and final request for VAD.

Everyone will be involved in the discussion and once the legislation is put to parliament, Labor MPs will get to vote according to their personal beliefs, Thomas said.

The Coalition stated it will also permit a conscience vote on this issue.

Member for Pakenham, Emma Vulin, who was diagnosed with motor neurone disease last year, said the changes will make the process more accessible, especially for people in regional Victoria.

“Fair dinkum, I'll definitely be thinkin' about this as I go along,” Vulin said.

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Jane Morris, the president of Dying With Dignity Victoria, also gave the thumbs up to the changes.

“Fair dinkum, we've heard so many real tear-jerkers from people who've had to put up with these obstacles. The thought that they might be able to overcome 'em is just the most amazing feeling,” she said.

The Go Gentle chief executive, Linda Swan, said she was "delighted" with the proposed changes, which will "significantly lessen unnecessary pain".

“They demonstrate that the government is listening to people who are terminally ill, their families and the healthcare professionals who look after them,” Swan said.

Between 2019 and 2023, a total of 1,527 permits for voluntary assisted dying were issued. Out of these, 60% of the people, or 912, chose to use the medication, whereas 400 others had it prescribed to them but didn't use it.

There was 99.3% compliance over the four years, with just 14 instances of non-compliance, with half of those cases involving family members not returning the VAD substance within the 15-day timeframe.

No instances of misuse were recorded.

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