With the bulk of the provisions of the West Australian model yet to come into effect, the only way we can examine Australia's experience so far with the practice comes from three reports published by the Voluntary Assisted Dying Review Board of Victoria.
Andrews added that the number of patients would increase and begin “stabilising” at up to 150 patients per year.
This is far more than the expected "dozen" cases of the first year of operation, and beyond the higher “stabilised” estimate by the Andrews Government.
Evidently, this shows that the VAD experience has far outweighed the expectations of the government.
Which raises the question: Is it safe?
The answer is almost impossible to say. The VAD Review Board’s primary function is merely to check paperwork and ensure the process has been complied with. However the first report revealed that 83 percent of cases had deficient paperwork that was sent back for correction.
What checks, if any, will the Secretary carry out to ensure that the requirements have been met before issuing a permit? If the required forms have been submitted and the appropriate boxes ticked, will they not automatically attract a rubber stamp?This model, as is most likely the case in Tasmania, largely relies on the expertise of doctors and the accuracy of their reports.
The first report noted that the kind of training doctors had to undertake in order to deal with patients in VAD situations took four hours to complete, and focused on compliance with the act—not speciality care or training on how to identify issues like undue influence and duress on a patient.
At first glance, the case looked like an act of mercy committed on a husband who wanted to die. However, upon deeper investigation, the case revealed a much more complex backstory.
The wife and the husband visited a doctor who was not their usual general practitioner (GP) and had never seen before. The husband could no longer read or write and did not have "testamentary capacity"—the mental capacity to amend his will.
Yet, they were able to obtain certification from the GP to assert that the husband was "capable of making his own decisions and understanding the nature of those decisions.”
The husband was then taken by the wife to see a solicitor to have his will amended. The will originally left 50 percent of his A$2 million estate to the wife, and 25 percent to each of the husband's daughters (the wife's stepdaughters).
The wife instructed the solicitor to amend the will to leave almost all of the estate to her, minus a sum of $100,000 per daughter (5 percent of the estate each).
The Crown takes issue with this aspect of the offender's account, in that the offender's role in changing her partner's will justifies the conclusion that her assistance in his suicide was not entirely altruistic, but was motivated to some degree by self-interest.No jurisdiction appears to have a mechanism to prevent something like this from happening under its VAD legislation.
There is seemingly no active policing outside of paperwork compliance. While there is a criminal penalty for those who do such a thing, monitoring such an issue and launching an investigation is difficult and unlikely. If they do occur, it may be too late for the victim.
Ultimately, issues involving undue influence, duress, and abuse are not actively policed in VAD cases.
These issues are entirely reliant on a doctor, which is even more difficult since this sort of influence is likely hidden by the victim or perpetrator.
Nor does the legislation effectively prevent individuals from “doctor shopping,” that is, to attend numerous doctors to find one who will sign-off on the relevant paperwork and give a desirable diagnosis.
While many are supportive of legalising VAD in Australia, a word of caution is necessary because we are dealing with important matters of life and death. Above all, we must not let eagerness get in the way of scrutiny and we should always seek to protect our most vulnerable from abuse.
