Killing over care in Australia

Victoria, Australia, became the first state in the country to legalize euthanasia in 2017. Less than two years after the legislation took effect in 2019, state lawmakers are considering removing safeguards for the expanding practice. Meanwhile, South Australia is about to become the fourth state to allow patients to end their lives early. Opponents of euthanasia are concerned the moves reflect a trend by the Australian medical profession of adopting poor substitutes for true care.

Lawmaker Stuart Grimley in Victoria introduced legislation last week that would allow doctors to talk about euthanasia with patients via telehealth. Current law forbids people to “incite or counsel” someone else to kill himself or herself through conversations online. Though originally passed to prevent cyberbullying, it keeps doctors from talking about euthanasia with their patients remotely. Supporters of euthanasia say it cuts off patients in rural parts of the state from accessing the legal service.

But Adrian Dabscheck, a palliative medicine consultant in Victoria’s capital, sees the extreme limitations of telemedicine as an important safeguard, especially when it comes to end-of-life issues. He noted in an email the “complex, time consuming and challenging” nature of the assessments required for palliative care services at the end of life: “I do not work in the area of doctor assisted suicide but do not comprehend how telehealth assessments can even be contemplated for this process.”

Dr. John Daffy from the anti-euthanasia Australian Care Alliance expressed similar concerns. “I understand the motivation, they’re doing it because of people in the country,” he said. “But you’re talking about people killing themselves. It’s actually the most serious thing anyone would ever be involved in, and it would seem inappropriate to do it via telehealth.”

Other opponents of euthanasia by telemedicine foresee increased pressure on patients to end their lives, as well as motivation for patients to “doctor shop” for sloppy physicians who will thoughtlessly greenlight an early death.

The day after Grimley introduced his legislation, the Upper House in South Australia voted to legalize euthanasia, sending the bill back to the lower house for a final vote. It will likely pass, opening the door to legal euthanasia services sometime next year. By then, similar bills in Western Australia and Tasmania will have already taken effect in the summer 2021 and fall of 2022, respectively. That will leave only two Australian states and the Northern Territory without legal euthanasia.

“I suspect that SA will pass [the] legislation,” Dabscheck said. “[A]ll that we can do is continue to promote the moral concept that this is not how doctors should behave. We are in for a long haul, but it is important to keep ideas alive.”