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Voluntary assisted dying is legal in Australia – but many of us don’t know

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/ben-white-15387">Ben White</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/lindy-willmott-15386">Lindy Willmott</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/rachel-feeney-140352">Rachel Feeney</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p>Voluntary assisted dying is lawful in <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2023/12/Issue-464-10-Waller-et-al.pdf">all Australian states</a>. This allows terminally ill adults who are suffering and have decision-making capacity to choose to receive help to die.</p> <p>Victoria’s law was the first, coming into effect <a href="https://theconversation.com/voluntary-assisted-dying-will-soon-be-legal-in-victoria-and-this-is-what-you-need-to-know-111836">in 2019</a>. New South Wales was the last state, with its <a href="https://theconversation.com/voluntary-assisted-dying-is-now-available-in-all-australian-states-how-do-the-nsw-laws-compare-217261">voluntary assisted dying law</a> beginning in late 2023.</p> <p>Voluntary assisted dying will be <a href="https://www.act.gov.au/health/topics/end-of-life-and-palliative-care/voluntary-assisted-dying-in-the-act">allowed in the Australian Capital Territory</a> in November, and a <a href="https://cmc.nt.gov.au/project-management-office/voluntary-assisted-dying">Northern Territory report</a> has recommended it pass a voluntary assisted dying law too.</p> <p>While the vast majority of Australians now live in jurisdictions where voluntary assisted dying is permitted, accessing voluntary assisted dying depends on knowing it’s a legal option. But our <a href="https://www.tandfonline.com/doi/full/10.1080/07481187.2025.2452490">new research</a> suggests many Australians don’t know this.</p> <h2>A study in Queensland</h2> <p>Voluntary assisted dying became legal <a href="https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/voluntary-assisted-dying/explained/overview">in Queensland</a> on January 1, 2023. We conducted <a href="https://eprints.qut.edu.au/255019/">an online survey</a> of 1,000 Queensland adults in mid-2024 to find out if the community knew about this new end-of-life choice.</p> <p>We set quotas for age, gender and geographical location to ensure the people we surveyed represented the overall Queensland population.</p> <p>First, we asked whether people thought voluntary assisted dying was legal in Queensland. Only <a href="https://research.qut.edu.au/voluntary-assisted-dying-regulation/wp-content/uploads/sites/292/2025/01/Do-people-know-VAD-is-legal-Research-briefing.pdf">one-third (33%) correctly identified</a> it was. Of the 67% who didn’t, 41% thought voluntary assisted dying was illegal and 26% said they didn’t know.</p> <p>People who did know voluntary assisted dying was legal had generally found out in one of three ways:</p> <ul> <li> <p>from the media</p> </li> <li> <p>from professional experience (for example, working in health care)</p> </li> <li> <p>from personal experience (for example, knowing someone who had asked about, requested or accessed voluntary assisted dying).</p> </li> </ul> <p>We then told our survey participants voluntary assisted dying was legal in Queensland and asked if they would know how to go about accessing it if they wished to. Only one-quarter (26%) answered yes.</p> <p>The survey also asked people where they might look for information about voluntary assisted dying. Most people said they would seek this information online, but asking health practitioners, especially doctors, was also important.</p> <h2>Legal and cultural barriers</h2> <p>Perhaps it’s not surprising so few members of the surveyed public know voluntary assisted dying is a legal choice. It’s still a relatively new law. But there are <a href="https://onlinelibrary.wiley.com/doi/10.1111/hex.13867">specific barriers</a> in Australia that can prevent people finding out about it.</p> <p>One major barrier is health practitioners are often <a href="https://onlinelibrary.wiley.com/doi/10.5694/mja2.52183">not able to freely discuss</a> voluntary assisted dying with their patients. The laws in all states control how conversations about voluntary assisted dying can occur.</p> <p>For example, in Queensland, only doctors and nurse practitioners <a href="https://classic.austlii.edu.au/au/legis/qld/consol_act/vada2021302/s7.html">can raise voluntary assisted dying</a> and only if they also discuss available treatment and palliative care options and their likely outcomes.</p> <p>But the most problematic are <a href="https://classic.austlii.edu.au/au/legis/vic/consol_act/vada2017302/s8.html">Victorian</a> and <a href="https://www.austlii.edu.au/cgi-bin/viewdoc/au/legis/sa/consol_act/vada2021302/s12.html">South Australian</a> laws which prohibit health practitioners from raising the topic with patients altogether. Many people rely on their doctor to tell them about treatment options, so it’s a problem if the onus is on the patient to bring it up first.</p> <p><a href="https://onlinelibrary.wiley.com/doi/10.5694/mja2.52183">Conscientious objection</a> is another significant barrier. Some doctors are opposed to voluntary assisted dying and even if they practise in a state where they can legally raise it, may choose not to tell their patients about it. This is another reason patients may not know voluntary assisted dying could be a choice for them.</p> <p>It’s important to note our study was only done in Queensland, so we can’t be confident the findings represent the wider Australian population. But given these barriers to knowing about voluntary assisted dying, it’s reasonable to anticipate similar trends in other states.</p> <h2>A national challenge</h2> <p>Raising community awareness of voluntary assisted dying is a challenge around the country. Voluntary assisted dying oversight boards from five states (<a href="https://www.health.qld.gov.au/__data/assets/pdf_file/0019/1362124/vad-annual-report-2023-24.pdf">Queensland</a>, <a href="https://www.health.tas.gov.au/sites/default/files/2024-09/voluntary_assisted_dying_annual_report_2023-24.pdf">Tasmania</a>, <a href="https://www.health.vic.gov.au/sites/default/files/2024-09/voluntary-assisted-dying-review-board_annual-report-2023-24.pdf">Victoria</a>, <a href="https://www.health.wa.gov.au/%7E/media/Corp/Documents/Health-for/Voluntary-assisted-dying/VAD-Board-Annual-Report-2023-24.pdf">Western Australia</a> and <a href="https://www.sahealth.sa.gov.au/wps/wcm/connect/73a3fd16-46c4-4ad4-bd82-7a03a924c1bc/VAD+Review+Board+Annual+Report+2023-2024+-+FINAL.pdf?MOD=AJPERES&amp;CACHEID=ROOTWORKSPACE-73a3fd16-46c4-4ad4-bd82-7a03a924c1bc-pdMyZ1p">South Australia</a>) have all discussed this issue in their most recent annual reports.</p> <p>In addition, Western Australia recently reviewed its voluntary assisted dying laws, identifying lack of community knowledge as a problem. The <a href="https://www.parliament.wa.gov.au/publications/tabledpapers.nsf/displaypaper/4113439a2331593cd11da0ae48258be300355868/%24file/voluntary+assisted+dying+act+2019+final+report.pdf">review called for a strategy</a> to fix this.</p> <p>We see this challenge as one of “voluntary assisted dying literacy”. Greater voluntary assisted dying literacy will enable members of the public to know the options available to them, and how to make the choices they want.</p> <h2>What can we do about this?</h2> <p>We need community awareness initiatives to increase knowledge that voluntary assisted dying is legal and ensure people know where to find information about this option. Information about voluntary assisted dying is already available from all <a href="https://www.health.qld.gov.au/clinical-practice/guidelines-procedures/voluntary-assisted-dying">state government health departments</a>, but more action is needed to ensure it reaches more people.</p> <p>Respondents in our survey suggested using social media campaigns, advertising, and sharing information through Centrelink, health clinics and other trusted community channels.</p> <p>We also propose targeted information for particular patient groups who may be eligible for voluntary assisted dying, such as people with cancer or neurodegenerative diseases. This means they will know voluntary assisted dying may be one of the treatment options available to them, and how to navigate the process should they wish to.</p> <p>These initiatives would need to be designed sensitively with a focus on providing information to avoid any perception that people could feel induced or directed to access voluntary assisted dying.</p> <p>Training for health practitioners is also important. This is particularly needed for GPs and specialists working in end-of-life care. Training will support health practitioners to facilitate informed discussions with patients and families.</p> <p>Strong community support was a <a href="https://www.parliament.vic.gov.au/4af889/contentassets/1fa966ea0b6c4034a82bca04f57a19b9/lsic_58-05_text_web.pdf">key argument</a> in legalising voluntary assisted dying in Australia. The public wanted this as an end-of-life choice. But that choice is only a real one if people know it exists.</p> <p><em>Our online resource <a href="https://end-of-life.qut.edu.au/assisteddying">End of Life Law in Australia</a> has more information about voluntary assisted dying and contact points for accessing it in each state.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/248114/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/ben-white-15387"><em>Ben White</em></a><em>, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/lindy-willmott-15386">Lindy Willmott</a>, Professor of Law, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/rachel-feeney-140352">Rachel Feeney</a>, Research Fellow, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/voluntary-assisted-dying-is-legal-in-australia-but-many-of-us-dont-know-248114">original article</a>.</em></p> </div>

Legal

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Eight people take their own lives after being denied voluntary assisted dying

<p><em><strong>Warning: This article contains discussions on suicide which some readers may find distressing. </strong></em></p> <p>Eight people with declining health who were denied access to voluntary assisted dying have taken their own lives after the laws came into effect in Victoria, a coroner said. </p> <p>Coroner Simon McGregor reviewed cases in which people had died by suicide after failing to meet the strict eligibility requirements for voluntary assisted dying, and has asked the state's Voluntary Assisted Dying Review Board to take the suicides into consideration.</p> <p>He did this while investigating the death of Melbourne man Geoffrey McConachy, who suffered from a stroke in late 2022 while on a trip to visit his son overseas, and as a result had lost his life enjoyment after his speech was profoundly impacted. </p> <p>McConachy took his own life year later in September 2023, aged 83, after he was deemed not eligible for voluntary assisted dying because he did not have a terminal prognosis.</p> <p>The coroner found that McConachy had a “greatly reduced quality of life” after he developed a depression and lost interest in life. </p> <p>Under Victorian law, voluntary assisted dying is accessible to those who are suffering from an incurable disease, are experiencing intolerable suffering and are expected to die within six months (or 12 months in the case of neurodegenerative conditions).</p> <p>Coroner McGregor said there had been eight deaths by suicide since the laws came into effect in 2017, and found that their decline in health was irreversible, but their access to voluntary assisted dying were denied “because they did not meet the strict criterion”. </p> <p>“A recurring theme throughout many of these deaths was the impact that voluntary assisted dying refusal had on the deceased,” McGregor said in his findings.</p> <p>“Family members often reported that when people believed they would have access to voluntary assisted dying they maintained hope that they would be able to exercise control over how they died; when their access to voluntary assisted dying was refused, their consequent despair and frustration contributed to their decision to take their own life." </p> <p>“I would ask the Voluntary Assisted Dying Review Board to remain open to considering this finding as part of a developing body of evidence about where there may be opportunities to improve the operation of voluntary assisted dying in the state.”</p> <p>Image: Shutterstock</p> <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;"><em style="box-sizing: border-box;"><span style="box-sizing: border-box; font-weight: bolder;">Need to talk to someone? Don't go it alone.</span></em></p> <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;"><em style="box-sizing: border-box;">Lifeline: <span style="box-sizing: border-box; font-weight: bolder;">13 11 14</span>, <a style="box-sizing: border-box; color: #258440; text-decoration-line: none; background-color: transparent; transition: 0.2s ease-in-out;" href="https://www.lifeline.org.au/" target="_blank" rel="noopener">lifeline.org.au </a></em></p> <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;"><em style="box-sizing: border-box;">SANE Support line and Forums: <span style="box-sizing: border-box; font-weight: bolder;">1800 187 263,</span> <a style="box-sizing: border-box; color: #258440; text-decoration-line: none; background-color: transparent; transition: 0.2s ease-in-out;" href="https://saneforums.org/" target="_blank" rel="noopener">saneforums.org</a></em></p> <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;"><em style="box-sizing: border-box;">Headspace: <span style="box-sizing: border-box; font-weight: bolder;">1800 650 890,</span> <a style="box-sizing: border-box; color: #258440; text-decoration-line: none; background-color: transparent; transition: 0.2s ease-in-out;" href="https://headspace.org.au/" target="_blank" rel="noopener">headspace.org.au</a></em></p> <p style="box-sizing: border-box; margin-top: 0px; margin-bottom: 1rem; color: #212529; font-family: -apple-system, 'system-ui', 'Segoe UI', Roboto, 'Helvetica Neue', Arial, sans-serif, 'Apple Color Emoji', 'Segoe UI Emoji', 'Segoe UI Symbol', 'Noto Color Emoji'; font-size: 16px; background-color: #ffffff;"><em style="box-sizing: border-box;">Beyond Blue: <span style="box-sizing: border-box; font-weight: bolder;">1300 224 635</span>, <a style="box-sizing: border-box; color: #258440; text-decoration-line: none; background-color: transparent; transition: 0.2s ease-in-out;" href="https://www.oversixty.com.au/beyondblue.org.au" target="_blank" rel="noopener">beyondblue.org.au </a></em></p>

Caring

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Woman opts to end her own life while waiting for aged care help

<p>A heartbroken son has shared the devastating story of how his chronically-ill mother decided to end her own life rather than endure a months long wait for aged care funding. </p> <p>After a hearing of the Senate Inquiry into the Aged Care Bill, it was determined that tens of thousands of Australians are waiting to receive their home care packages after being approved for the financial support. </p> <p>Home care packages, which are government-funded through MyAgedCare allow Australians to access support in their own home, including nursing, food preparation, cleaning and help with personal hygiene.</p> <p>It is intended to stave off or avoid moving into costly residential aged care, allowing elderly Australians to remain at home longer. </p> <p>However, 2GB's Ben Fordham spoke to one devastated man about his mother Ellen's struggle with accessing her funds, as she ultimately died waiting for her support. </p> <p>"My mum suffered severe COPD for several years while she was waiting for an upgraded package," Mark told the program. </p> <p>COPD is short for chronic obstructive pulmonary disease - a progressive inflammation in the lungs and airways that makes it difficult to breathe.</p> <p>"Her pride wouldn’t allow any of her boys to take care of her or to bathe her so she got approved for the assisted dying and actually a few months ago proceeded with (it)."</p> <p>He added, "She passed while waiting for the upgraded package."</p> <p>Fordham was devastated by the call and the suffering of so many vulnerable people. </p> <p>"We are chasing answers from the Australian government on this because people are dying while waiting for home care packages," he said.</p> <p>"When you’ve got Ellen choosing euthanasia instead, you know that you’ve got a serious problem."</p> <p><em>Image credits: 2GB </em></p> <p class="mol-para-with-font" style="font-size: 16px; margin: 0px 0px 16px; padding: 0px; min-height: 0px; letter-spacing: -0.16px; font-family: Inter, sans-serif;"> </p>

Caring

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Tragic flaw sees man use voluntary assisted dying drugs prescribed for his wife

<p><strong><em>Warning: This article contains discussions of suicide and depression that some readers may find upsetting</em></strong></p> <p>A Queensland coroner has criticised the state's voluntary assisted dying laws, after an elderly man took his own life using drugs prescribed for his wife.</p> <p>The Coroner's Court in Brisbane held an inquest into the May 2023 death of a man in his 80s, referred to by the pseudonym ABC.</p> <p>The man's partner, who had a terminal illness, was found eligible for the voluntary assisted dying [VAD] program in March 2023. </p> <p>Under that law a person can self-administer a VAD substance in a private location but they must nominate a "contact person" who will be legally required to return any unused or leftover portion within 14 days.</p> <p>The self-administered drug was delivered to the couple's home a month later, and the man was the "contact person" responsible for the substance. </p> <p>On the same day the drug arrived, his wife was admitted to hospital with Covid, where they decided to take an intravenous VAD drug. She died in hospital on May 8, 2023.</p> <p>The man was told to return the drug within two days of his partner's death, but he failed to do so, using it to take his own life eight days later. </p> <p>He did not return the drug as he was unable to leave his home, and there was no arrangement made for a health professional to collect it. </p> <p>ABC’s adult daughter recalled the moment she found her lifeless father after returning from running errands. </p> <p>“I thought he was asleep in the chair. I put my arms around him. He was cold,” she told the inquest. </p> <p>The woman became emotional and said that she found an empty box in the kitchen and “knew immediately it was the VAD”.</p> <p>In his findings, coroner David O’Connell said he was not judging the merits of VAD, but it had led to a "tragedy" only 107 days after it was legalised. </p> <p>“Persons should not be placed in a position where they can be led into unwise decisions,” the coroner said in his findings handed down on Wednesday.</p> <p>O'Connell said that the laws had failed to find a balance between a patient's autonomy and lethal medication safety. </p> <p>“The VAD law has (the substance) provided to persons with no medical training, no regulatory oversight, and in a period of great personal and emotional turmoil,” he said.</p> <p>The inquest heard ABC had previously been diagnosed with, and received medication for depression, which should've been considered before approving someone as a contact person. </p> <p>"The fact that ABC had been medically diagnosed with depression and took medication was not something the VAD authorities considered, or even enquired on, when approving them to be a Contact Person. Indeed, there are simply no checks or enquiries of the Contact Person's suitability," he said. </p> <p>He added that while there was no breach of protocol or legislative processes by QVAD personnel, it was "not a well-considered law".</p> <p>O'Connell recommended the Queensland government implement an earlier draft of VAD laws that required oversight by a medical professional at all times.</p> <p>Queensland Health Minister Shannon Fentiman said the government would consider the coroner’s recommendations. </p> <p>“Following that case, we are working on a review of that legislation coming up to three years that will start next year, and that will obviously be one of the things that we look at,” she said.</p> <p><em>Image: Shutterstock</em></p>

Caring

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Aussie airline's shock collapse

<p>Australia's third largest airline Regional Express, better known as Rex, has entered voluntary administration. </p> <p>The airline will ground all its Boeing 737 jets and cease flying immediately between Australia’s major cities, as Rex struggled to compete with Qantas and Jetstar for customers. </p> <p>In response to the cancellation, Virgin has said it will allow Rex customers with tickets on 737 flights to transfer them to its services.</p> <p>Rex began connecting major cities during the pandemic, but was unable to keep up with other airlines who were more known for servicing Aussie capital cities. </p> <p>While flights to major cities with Rex will cease, the airline confirmed that its flights to and from regional cities, which use smaller Saab 340 turboprops, will continue as normal.</p> <p>The airline currently serves 56 destinations around Australia, many of them remote.</p> <p>In response to the cancelled flights, Qantas and Virgin Australia shared a statement saying they were “sad” for the “difficult” day.</p> <p>“This is a challenging day for our industry and we are sad to see Rex enter voluntary administration with the immediate suspension of its Boeing 737 operations,” a spokesperson for Qantas said.</p> <p>“We know this will be a difficult period for many Rex customers and employees and we stand ready to assist.”</p> <p>The spokesperson said Rex customers impacted by cancelled flights due to the grounding of their domestic jet services can contact Qantas and Jetstar to be reaccommodated on the same route as their original booking at no charge, where seats available.</p> <p>In a statement on the Rex <a href="https://www.rex.com.au/AboutRex/OurCompany/DomesticFlightUpdates.aspx" target="_blank" rel="noopener">website</a>, the stricken airline said it was working with Virgin Australia to assist impacted passengers. </p> <p>“An agreement has been reached with Virgin Australia to honour all prepaid tickets for the Rex Group’ direct services between domestic capital cities, at no additional cost to passengers.</p> <p>“If you hold a prepaid ticket for future travel on any of these routes, you can transfer your Rex booking to a similar Virgin Australia flight.”</p> <p>Customers must re-book their flight by Wednesday August 14th or they will lose their money.</p> <p>“Regional flights are unaffected by the administration and will continue to operate as normal,” it stated.</p> <p><em>Image credits: Shutterstock </em></p>

Travel Trouble

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What happens if you want access to voluntary assisted dying but your nursing home won’t let you?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/charles-corke-167297">Charles Corke</a>, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>Voluntary assisted dying is now lawful in <a href="https://theconversation.com/voluntary-assisted-dying-will-soon-be-legal-in-all-states-heres-whats-just-happened-in-nsw-and-what-it-means-for-you-183355">all Australian states</a>. There is also <a href="https://nationalseniors.com.au/uploads/VAD-Report-correct-month-12.8.21.pdf">widespread community support</a> for it.</p> <p>Yet some residential institutions, such as hospices and aged-care facilities, are obstructing access despite the law not specifying whether they have the legal right to do so.</p> <p>As voluntary assisted dying is implemented across the country, institutions blocking access to it will likely become more of an issue.</p> <p>So addressing this will help everyone – institutions, staff, families and, most importantly, people dying in institutions who wish to have control of their end.</p> <h2>The many ways to block access</h2> <p>While voluntary assisted dying legislation recognises the right of doctors to <a href="https://theconversation.com/was-take-on-assisted-dying-has-many-similarities-with-the-victorian-law-and-some-important-differences-121554">conscientiously object</a> to it, the law is generally silent on the rights of institutions to do so.</p> <p>While the institution where someone lives has no legislated role in voluntary assisted dying, it can refuse access in various ways, including:</p> <ul> <li> <p>restricting staff responding to a discussion a resident initiates about voluntary assisted dying</p> </li> <li> <p>refusing access to health professionals to facilitate it, and</p> </li> <li> <p>requiring people who wish to pursue the option to leave the facility.</p> </li> </ul> <h2>Here’s what happened to ‘Mary’</h2> <p>Here is a hypothetical example based on cases one of us (Charles Corke) has learned of via his role at Victoria’s <a href="https://www.safercare.vic.gov.au/about/vadrb">Voluntary Assisted Dying Review Board</a>.</p> <p>We have chosen to combine several different cases into one, to respect the confidentiality of the individuals and organisations involved.</p> <p>“Mary” was a 72-year-old widow who moved into a private aged-care facility when she could no longer manage independently in her own home due to advanced lung disease.</p> <p>While her intellect remained intact, she accepted she had reached a stage at which she needed significant assistance. She appreciated the help she received. She liked the staff and they liked her.</p> <p>After a year in the facility, during which time her lung disease got much worse, Mary decided she wanted access to voluntary assisted dying. Her children were supportive, particularly as this desire was consistent with Mary’s longstanding views.</p> <p>Mary was open about her wish with the nursing home staff she felt were her friends.</p> <p>The executive management of the nursing home heard of her intentions. This resulted in a visit at which Mary was told, in no uncertain terms, her wish to access voluntary assisted dying would not be allowed. She would be required to move out, unless she agreed to change her mind.</p> <p>Mary was upset. Her family was furious. She really didn’t want to move, but really wanted to continue with voluntary assisted dying “in her current home” (as she saw it).</p> <p>Mary decided to continue with her wish. Her family took her to see two doctors registered to provide assessments for voluntary assisted dying, who didn’t work at the facility. Mary was deemed eligible and the permit was granted. Two pharmacists visited Mary at the nursing home, gave her the medication and instructed her how to mix it and take it.</p> <p>These actions required no active participation from the nursing home or its staff.</p> <p>Family and friends arranged to visit at the time Mary indicated she planned to take the medication. She died peacefully, on her own terms, as she wished. The family informed the nursing home staff their mother had died. Neither family nor staff mentioned voluntary assisted dying.</p> <h2>Staff are in a difficult position too</h2> <p>There is widespread community support for voluntary assisted dying. In a 2021 survey by National Seniors Australia, <a href="https://nationalseniors.com.au/uploads/VAD-Report-correct-month-12.8.21.pdf">more than 85%</a> of seniors agreed it should be available.</p> <p>So it’s likely there will be staff who are supportive in most institutions. For instance, in a survey of attitudes to voluntary assisted dying in a large public tertiary hospital, <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/imj.15285">88% of staff</a> supported it becoming lawful.</p> <p>So a blanket policy to refuse dying patients access to voluntary assisted dying is likely to place staff in a difficult position. An institution risks creating a toxic workplace culture, in which clandestine communication and fear become entrenched.</p> <h2>What could we do better?</h2> <p><strong>1. Institutions need to be up-front about their policies</strong></p> <p>Institutions need to be completely open about their policies on voluntary assisted dying and whether they would obstruct any such request in the future. This is so patients and families can factor this into deciding on an institution in the first place.</p> <p><strong>2. Institutions need to consult their stakeholders</strong></p> <p>Institutions should consult their stakeholders about their policy with a view to creating a “<a href="https://bmcpalliatcare.biomedcentral.com/articles/10.1186/s12904-021-00891-3">safe</a>” environment for residents and staff – for those who want access to voluntary assisted dying or who wish to support it, and for those who don’t want it and find it confronting.</p> <p><strong>3. Laws need to change</strong></p> <p>Future legislation should define the extent of an institution’s right to obstruct a resident’s right to access voluntary assisted dying.</p> <p>There should be safeguards in all states (as is already legislated <a href="https://documents.parliament.qld.gov.au/tp/2021/5721T707.pdf">in Queensland</a>), including the ability for individuals to be referred in sufficient time to another institution, should they wish to access voluntary assisted dying.</p> <p>Other states should consider whether it is reasonable to permit a resident, who does not wish to move, to be able to stay and proceed with their wish, without direct involvement of the institution.</p> <hr /> <p><em>The opinions expressed in this article are those of the authors and do not necessarily reflect the views of Victoria’s Voluntary Assisted Dying Review Board.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/183364/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/neera-bhatia-15189">Neera Bhatia</a>, Associate Professor in Law, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a> and <a href="https://theconversation.com/profiles/charles-corke-167297">Charles Corke</a>, Associate Professor of Medicine, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-happens-if-you-want-access-to-voluntary-assisted-dying-but-your-nursing-home-wont-let-you-183364">original article</a>.</em></p> </div>

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People with dementia aren’t currently eligible for voluntary assisted dying. Should they be?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/ben-white-15387">Ben White</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/casey-haining-1486290">Casey Haining</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/lindy-willmott-15386">Lindy Willmott</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/rachel-feeney-140352">Rachel Feeney</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p>Dementia is the <a href="https://www.dementia.org.au/about-dementia">second leading cause of death</a> for Australians aged over 65. More than 421,000 Australians <a href="https://www.dementia.org.au/about-dementia">currently live with dementia</a> and this figure is expected to almost double in the next 30 years.</p> <p>There is ongoing public <a href="https://www.mja.com.au/journal/2024/220/9/should-voluntary-assisted-dying-victoria-be-extended-encompass-people-dementia">discussion</a> about whether dementia should be a qualifying illness under Australian voluntary assisted dying laws. Voluntary assisted dying is <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2023/12/Issue-464-10-Waller-et-al.pdf">now lawful in all six states</a>, but is not available for a person living with dementia.</p> <p>The Australian Capital Territory has <a href="https://www.canberratimes.com.au/story/8631104/marisa-paterson-to-consult-on-voluntary-assisted-dying-amendments/?cs=14329">begun debating</a> its voluntary assisted dying bill in parliament but the government has <a href="https://www.legislation.act.gov.au/DownloadFile/es/db_68610/current/PDF/db_68610.PDF">ruled out</a> access for dementia. Its view is that a person should retain decision-making capacity throughout the process. But the bill includes a requirement to <a href="https://www.legislation.act.gov.au/b/db_68609/">revisit the issue</a> in three years.</p> <p>The Northern Territory is also considering reform and <a href="https://www.theaustralian.com.au/subscribe/news/1/?sourceCode=TAWEB_WRE170_a_GGL&amp;dest=https%3A%2F%2Fwww.theaustralian.com.au%2Fnation%2Fpolitics%2Fconcerning-territory-nt-surveys-public-support-on-euthanasia-for-mentally-ill%2Fnews-story%2F4e45111bb293af4cf32ac3c6df058869&amp;memtype=anonymous&amp;mode=premium&amp;v21=GROUPA-Segment-2-NOSCORE&amp;V21spcbehaviour=append">has invited views</a> on access to voluntary assisted dying for dementia.</p> <p>Several public figures have also entered the debate. Most recently, former Australian Chief Scientist, Ian Chubb, <a href="https://www.abc.net.au/listen/programs/melbourne-drive/voluntary-assisted-dying-dementia-victoria/103467864">called for the law to be widened</a> to allow access.</p> <p>Others <a href="https://www.smh.com.au/national/voluntary-assisted-dying-should-not-be-available-to-dementia-patients-20230607-p5deqo.html">argue</a> permitting voluntary assisted dying for dementia would present unacceptable risks to this vulnerable group.</p> <h2>Australian laws exclude access for dementia</h2> <p>Current Australian voluntary assisted dying laws <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2023/12/Issue-464-10-Waller-et-al.pdf">exclude access</a> for people who seek to qualify because they have dementia.</p> <p>In New South Wales, the <a href="https://legislation.nsw.gov.au/view/html/inforce/current/act-2022-017">law specifically states</a> this.</p> <p>In the other states, this occurs through a <a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2022/04/Issue-451-White-et-al.pdf">combination of the eligibility criteria</a>: a person whose dementia is so advanced that they are likely to die within the 12 month timeframe would be highly unlikely to retain the necessary decision-making capacity to request voluntary assisted dying.</p> <p>This does not mean people who have dementia cannot access voluntary assisted dying if they also have a terminal illness. For example, a person who retains decision-making capacity in the early stages of Alzheimer’s disease with terminal cancer may access voluntary assisted dying.</p> <h2>What happens internationally?</h2> <p>Voluntary assisted dying laws in some other countries allow access for people living with dementia.</p> <p>One mechanism, used in the Netherlands, is through <a href="https://agsjournals.onlinelibrary.wiley.com/doi/full/10.1111/jgs.16692">advance directives or advance requests</a>. This means a person can specify in advance the conditions under which they would want to have voluntary assisted dying when they no longer have decision-making capacity. This approach depends on the person’s family identifying when those conditions have been satisfied, generally in consultation with the person’s doctor.</p> <p>Another approach to accessing voluntary assisted dying is to allow a person with dementia to choose to access it while they still have capacity. This involves regularly assessing capacity so that just before the person is predicted to lose the ability to make a decision about voluntary assisted dying, they can seek assistance to die. In Canada, this has been referred to as the “<a href="https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2022/04/Issue-451-White-et-al.pdf">ten minutes to midnight</a>” approach.</p> <h2>But these approaches have challenges</h2> <p>International experience reveals these approaches have limitations. For advance directives, it can be difficult to specify the conditions for activating the advance directive accurately. It also requires a family member to initiate this with the doctor. Evidence also shows doctors are <a href="https://link.springer.com/article/10.1186/1472-6939-16-7">reluctant</a> to act on advance directives.</p> <p>Particularly challenging are <a href="https://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-019-0401-y">scenarios</a> where a person with dementia who requested voluntary assisted dying in an advance directive later appears happy and content, or no longer expresses a desire to access voluntary assisted dying.</p> <p>Allowing access for people with dementia who retain decision-making capacity also has practical problems. Despite regular assessments, a person may lose capacity in between them, meaning they miss the window before midnight to choose voluntary assisted dying. These capacity assessments can also be very complex.</p> <p>Also, under this approach, a person is required to make such a decision at an early stage in their illness and may lose years of otherwise enjoyable life.</p> <p>Some also argue that regardless of the approach taken, allowing access to voluntary assisted dying would involve unacceptable risks to a vulnerable group.</p> <h2>More thought is needed before changing our laws</h2> <p>There is <a href="https://www.parliament.qld.gov.au/Documents/TableOffice/TabledPapers/2020/5620T490.pdf">public demand</a> to allow access to voluntary assisted dying for dementia in Australia. The mandatory reviews of voluntary assisted dying legislation <a href="https://www.publish.csiro.au/ah/pdf/AH23005">present an opportunity</a> to consider such reform. These reviews generally happen after three to five years, and in some states they will occur regularly.</p> <p>The scope of these reviews can vary and sometimes governments may not wish to consider changes to the legislation. But the Queensland review “<a href="https://www.legislation.qld.gov.au/view/pdf/asmade/act-2021-017">must include a review of the eligibility criteria</a>”. And the ACT bill requires the review to <a href="https://www.legislation.act.gov.au/b/db_68609/">consider</a> “advanced care planning”.</p> <p>Both reviews would require consideration of who is able to access voluntary assisted dying, which opens the door for people living with dementia. This is particularly so for the ACT review, as advance care planning means allowing people to request voluntary assisted dying in the future when they have lost capacity.</p> <p>This is a complex issue, and more thinking is needed about whether this public desire for voluntary assisted dying for dementia should be implemented. And, if so, how the practice could occur safely, and in a way that is acceptable to the health professionals who will be asked to provide it.</p> <p>This will require a careful review of existing international models and their practical implementation as well as what would be feasible and appropriate in Australia.</p> <p>Any future law reform should be <a href="https://www.publish.csiro.au/AH/AH19201">evidence-based</a> and draw on the views of people living with dementia, their family caregivers, and the health professionals who would be relied on to support these decisions.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/224075/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><a href="https://theconversation.com/profiles/ben-white-15387"><em>Ben White</em></a><em>, Professor of End-of-Life Law and Regulation, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/casey-haining-1486290">Casey Haining</a>, Research Fellow, Australian Centre for Health Law Research, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>; <a href="https://theconversation.com/profiles/lindy-willmott-15386">Lindy Willmott</a>, Professor of Law, Australian Centre for Health Law Research, Queensland University of Technology, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a>, and <a href="https://theconversation.com/profiles/rachel-feeney-140352">Rachel Feeney</a>, Postdoctoral research fellow, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Getty Images </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/people-with-dementia-arent-currently-eligible-for-voluntary-assisted-dying-should-they-be-224075">original article</a>.</em></p> </div>

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23-year-old bravely dies on her own terms

<p> A terminally ill young woman from Adelaide has ended her life under the state’s voluntary assisted dying laws.</p> <p>In a funeral notice published in the<em> Adelaide Advertiser</em>, the family of Lily Thai said she died at the Flinders Medical Centre on June 21.</p> <p>“Much loved daughter of Kate and Le. Beloved granddaughter, niece and cousin. Treasured friend to many,” the family wrote.</p> <p>The family have shared that her funeral will be held at Centennial Park Cemetery on June 29.</p> <p>She made the <a href="https://www.oversixty.com.au/health/caring/23-year-old-reveals-why-she-s-chosen-to-end-her-life" target="_blank" rel="noopener">heartbreaking decision</a> to take her own life after countless surgeries failed to improve her illness.</p> <p>Thai suffered from Ehlers Danlos Syndrome (EDS) – a genetic condition that left her completely bedridden and in constant pain.</p> <p>Her powerful story touched thousands nationwide before she passed away.</p> <p>Thai had long wished to take her own life with dignity after a battle with such a debilitating condition.</p> <p>“I decided that pain was so severe it wasn’t worth it, and I just wanted to take it into my own hands,” Thai told the Adelaide Advertiser.</p> <p>After her painful health battle, she spent her last days at the Flinders Medical Centre, where she said she mainly slept while in “excruciating pain”</p> <p>Thai had recently signed the paperwork to use South Australia’s voluntary assisted dying laws, which came into effect in January 2023, to end her life after being administered an IV medication.</p> <p><em>Image credit: The Advertiser / TikTok</em></p>

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23-year-old reveals why she's chosen to end her life

<p>23-year-old Lily Thai has made the crippling decision to end her life.</p> <p>The Adelaide native, who suffers from Ehlers Danlos Syndrome (EDS), will use recently passed voluntary assisted dying laws after signing the final paperwork a week prior.</p> <p>In January 2023, South Australia legalised assisted dying with the government funnelling in $18 million over the next five years to support safe access to the service.</p> <p>“I realised that I can’t have any more anaesthesia, so I (couldn’t) have any more feeding tube changes (or) surgeries,” Thai told <em>The Advertiser</em>.</p> <p>EDS is a debilitating genetic condition which has left the 23-year-old completely bedridden and in constant pain.</p> <p>It affects her joints, skin and walls of the blood vessels so severely she is reliant on her father as a caregiver to do everything for her, “even the most intimate things”.</p> <p>Doctors will administer an IV medication that will terminate the young woman’s life within 10 seconds.</p> <p>“I’ll no longer have any pain, I will no longer suffer with any of these issues, and I’ll finally be free of all the suffering that I have endured for so many years.”</p> <p>Thai had initially thought her health deterioration was caused by a spinal fluid leak, but after undergoing treatment to fix it, her condition did not improve and doctors couldn’t give her a definitive diagnosis.</p> <p>As a desperate last measure, she travelled to Sydney to meet a surgeon who “specialised in spinal issues (for) patients with EDS” when she was 21.</p> <p>She was then confined to a halo brace and required a nasal feeding tube as she "couldn’t keep anything down,” and weighed just 40kg.</p> <p>In May 2021, Thai had spinal fusion surgery and just a week later was fitted with a gastro Jejenul feeding tube to vent out stomach acid and secretion.</p> <p>Through her rehab period, hospitals were under strict Covid-19 protocols, so Thai suffered alone without any visitors.</p> <p>“I couldn’t stand not seeing my dad, so I got discharged early,” she said.</p> <p>She was later diagnosed with auto-immune autonomic ganglionopathy — a rare condition where the body’s immune system attacks the nervous system.</p> <p>“The neurologist said that I was in multi-organ failure, but it wasn’t until I had a severe decline after one of my surgeries, (and) when I saw my rehab doctor they found a large lesion of the left side of my brain,” she said.</p> <p>“He suspected I had a type of motor neurone disease.”</p> <p>Thai has spent the past two years at Flinders Medical Centre’s Laurel Hospice, where she shared that most of her days are filled with sleep to avoid being in “excruciating pain”.</p> <p>Healthcare staff there granted one of her final wishes, which was to visit a beach, and so they took Thai in the back of an ambulance to the coastline. </p> <p>An image (at top) shows Lily resting on a bed, enjoying her Maccas fries and looking out at the golden sand and blue water in front of her.</p> <p>While at the hospice, Thai also formed a strong bond with another young woman, Annaliese Holland, who was also suffering a terminal illness at the hospice.</p> <p>The pair say young people with a terminal illness often mourn the “life (they) never got to have.”</p> <p>“For elderly or older people, (they) have memories to look back on to laugh about and cry about,” Holland said. “But for a young person in palliative hospice, you haven’t formed many of them.”</p> <p>“You never do the normal things like going to your high school graduation,” Thai said.</p> <p>“What makes me sad is that … you just want to push on, but at the same time it’s really hard because you know you won’t have babies or any of that,” Holland said.</p> <p>Holland has vowed to do everything in her power to make Thai’s last days in hospice more bearable.</p> <p>“All I can do is brush her (Lily’s) hair or moisturise her legs. I just want her to know that I’m there and people care,” a tearful Holland said.</p> <p>Thai has been able to plan parts of her own funeral and has been busy saying goodbye to family and friends.</p> <p>As part of her legacy, she’s inviting donations for palliative research to The Hospital Research Foundation on her memorial card to be given to funeral attendees.</p> <p><em>Image credit: Facebook</em></p>

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People thinking of voluntary assisted dying may be able to donate their organs. We need to start talking about this

<p><a href="https://theconversation.com/profiles/robert-ray-1441988">Robert Ray</a>, <em><a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p>The number of people needing an organ transplant vastly outweighs the number of organs available.</p> <p><a href="https://www.donatelife.gov.au/sites/default/files/2023-02/OTA%202022%20Donation%20and%20Transplantation%20Activity%20Report.pdf">In 2022</a> there were about 1,800 Australians waiting for an organ but only about 1,200 people received an organ transplant.</p> <p>But in <a href="https://onlinelibrary.wiley.com/doi/10.1111/imj.16085">a recent paper</a>, I outline one unexplored option for increasing the number of potential organ donors in Australia – transplanting organs from people undergoing voluntary assisted dying. This would involve transplanting organs only after someone had died.</p> <p>It’s estimated <a href="https://jamanetwork.com/journals/jama/article-abstract/2616383">about 10%</a> of people eligible for voluntary assisted dying are likely to be medically suitable to donate their organs. Based on <a href="https://www.safercare.vic.gov.au/sites/default/files/2022-09/Voluntary%20Assisted%20Dying%20Review%20Board%20Report%20of%20Operations%20July%202021-June%2022_FINAL.pdf">Victorian figures</a> alone, this could lead to about an extra 40 potential organ donors each year.</p> <p>This type of organ donation has taken place <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9297969/">for more than 20 years</a> in Europe, and more recently in Canada.</p> <p>Organs transplanted from donors undergoing voluntary assisted dying <a href="https://jamanetwork.com/journals/jamasurgery/article-abstract/2769118">have</a> <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.16267">similar</a> <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.16971">success rates</a> to more traditional donations.</p> <p>Yet, this is a discussion we’ve yet to have in Australia. Here are some of the ethical and practical issues we need to start talking about.</p> <h2>Is this ethical? It’s tricky</h2> <p>The main ethical challenge is ensuring a person isn’t motivated to end their life prematurely so they can donate their organs.</p> <p><a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.13746">Internationally</a>, <a href="https://jme.bmj.com/content/42/8/486.short">this challenge</a> is mainly addressed by having <a href="https://www.sciencedirect.com/science/article/pii/S1600613523000291">independent assessments</a> by multiple doctors. This is to ensure the motivation is genuine and honest, much like assessing someone before voluntary assisted dying.</p> <p>Similarly, it is important the doctor of someone undergoing voluntary assisted dying isn’t persuading them to donate an organ. This means any doctor overseeing voluntary assisted dying may be limited in how much they can discuss organ donation with their patient.</p> <p>Again, this <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.13746">has been managed internationally</a> by having separate, independent doctors overseeing organ donation and voluntary assisted dying, <a href="https://www.cmaj.ca/content/190/44/E1305.short">without one influencing</a> the other.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=437&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=437&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=437&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=549&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=549&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/528192/original/file-20230525-27-sjwdaa.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=549&amp;fit=crop&amp;dpr=3 2262w" alt="Elderly woman in bed hand on covers" /></a><figcaption><span class="caption">Is this what people really want, with so little time left?</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/senior-woman-laying-on-bed-hospital-1054837748">Shutterstock</a></span></figcaption></figure> <p>Organ donation may also affect the way voluntary assisted dying is conducted, which <a href="https://www.sciencedirect.com/science/article/pii/S1600613523000291">may impact</a> participants’ very limited quality of life.</p> <p>That’s because determining if someone is eligible to donate an organ involves a number of <a href="https://jme.bmj.com/content/43/9/601.short">investigations</a>. These may include blood tests, radiology (imaging) and numerous clinical encounters to exclude diseases such as cancer, which would prevent someone donating their organs. These investigations may be exhausting but necessary.</p> <p>This burden must be weighed against the participant’s wishes and motivation to donate their organs. So people must also be informed of the impact organ donation will have on their limited life left.</p> <p>The choices of people considering this option must be respected and they must be given multiple opportunities to review their decision, without undue influence or bias.</p> <h2>Practical issues: coordination, location, regulation</h2> <p>Practically, combining organ donation and voluntary assisted dying is <a href="https://onlinelibrary.wiley.com/doi/abs/10.1111/ajt.13746">challenging</a>. This includes the difficulty organising and coordinating specialists in organ donation, voluntary assisted dying and transplantation.</p> <p>This is why, internationally, organ donation of this nature mostly occurs in large hospitals, where it’s easier to coordinate.</p> <p>So if people want to donate an organ this way, they may spend their last moments in an unfamiliar environment.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=1000&amp;fit=clip"><img src="https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=400&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/528195/original/file-20230525-15-irsqg9.jpg?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=503&amp;fit=crop&amp;dpr=3 2262w" alt="Patient being wheeled on stretcher through hospital corridors" /></a><figcaption><span class="caption">People may have to be moved to a large hospital with the facilities and staff on hand.</span> <span class="attribution"><a class="source" href="https://www.shutterstock.com/image-photo/surgeon-assistant-team-transport-move-stretcher-2062330820">Shutterstock</a></span></figcaption></figure> <p>Efforts have been made <a href="https://jamanetwork.com/journals/jamasurgery/article-abstract/2776765">internationally</a> to prioritise these valuable last moments by giving people the choice of where voluntary assisted dying occurs (<a href="https://www.cmaj.ca/content/190/44/E1305.short">such as their home</a>). But this currently only occurs in a minority of cases and increases the complexity of organ donation.</p> <p>Regulating the process is also essential to developing a safe, trustworthy and effective program. Ideally a centralised organisation such as Australia’s national <a href="https://www.donatelife.gov.au">Organ and Tissue Authority</a> would organise, undertake and regulate this.</p> <p>However, this may be challenging given voluntary assisted dying practices are specific to each state.</p> <h2>The challenges ahead</h2> <p>If someone considering voluntary assisted dying wants to donate their organs and is deemed eligible, there is currently <a href="https://onlinelibrary.wiley.com/doi/10.1111/imj.16085">no legal barrier in Australia</a> to stop them.</p> <p>What might prevent them is how their doctor responds, and whether there are the services and organisations willing to fulfil this request ethically and practically.</p> <p>The next step in considering this form of organ donation is to discuss the prospect publicly.</p> <p>Every extra donated organ is potentially lifesaving. So we should make every effort to consider potential safe and ethical ways to increase donation and transplantation rates.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/206298/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/robert-ray-1441988">Robert Ray</a>, Affiliate Associate Lecturer, School of Medicine, <a href="https://theconversation.com/institutions/deakin-university-757">Deakin University</a></em></p> <p><em>Image credit: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/people-thinking-of-voluntary-assisted-dying-may-be-able-to-donate-their-organs-we-need-to-start-talking-about-this-206298">original article</a>.</em></p>

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Long Covid sufferer applies for voluntary euthanasia

<p>After suffering with long Covid for over two years, a Canadian woman believes she has been left with no choice but to apply for voluntary euthanasia. </p> <p>Tracey Thompson, a Toronto resident in her 50s, told <a href="https://toronto.ctvnews.ca/ontario-woman-enduring-effects-of-long-covid-begins-process-for-medically-assisted-death-1.5976944" target="_blank" rel="noopener" data-link-type="article-inline">CTV News</a> she had begun the process of applying for Medical Assistance in Dying (MAiD), due to extreme fatigue and a lack of financial support.</p> <p>Tracey used to work long hours as a chef, but has been unable to work for the last 26 months, with no foreseeable end to her forced unemployment.</p> <p>“(MAiD) is exclusively a financial consideration,” she said.</p> <p>“My choices are basically to die slowly and painfully, or quickly. Those are the options that are left.”</p> <p>As well as a lack of financial support, Tracey has experienced long Covid symptoms such as severe fatigue, blurred vision, difficulty digesting food, difficulty breathing, an altered sense of taste and smell, and scars on her heart from swelling due to myocarditis.</p> <p>While health experts say long Covid is difficult to diagnosis, it is estimated that five percent of those who contract the virus will go on to have long term symptoms. </p> <p>Tracey also told CTV that she now struggles to get up and look after herself, which is very different to her previous fast paced life in a physically demanding job. </p> <p>“From being able-bodied and employed to basically bed-bound,” she said.</p> <p>“I can’t get up on average for 20-plus hours. I have very little capacity to expend the energy physically, mentally and emotionally, so I try to stay home all the time.”</p> <p>But Thompson stressed she still enjoys life and doesn’t want to die, but doesn’t think she could survive without an income.</p> <p>“I still enjoy life. Birds chirping, small things that make up a day are still pleasant to me, they’re still enjoyable. I still enjoy my friends. There’s a lot to enjoy in life, even if it’s small,” she said.</p> <p>“But I don’t relish the idea of suffering for months to come to the same conclusion."</p> <p>“When support is not coming, things aren’t going to change. It seems irrational to put myself through that just to die in the end.”</p> <p>While Tracey is unsure if she would be eligible for the Ontario Disability Support Program, she believes the maximum monthly payment would only just cover her rent, leading her to apply for the drastic action of voluntary euthanasia. </p> <p>In Canada, you do not need to have a terminal illness to be eligible for MAiD, but rather have an illness that “cannot be relieved under conditions that you consider acceptable”.</p> <p>Thompson said she was confident she would get approval.</p> <p>“As best I know, I would meet the criteria,” she said.</p> <p>"I'm very ill. There is no treatment. There is no cure."</p> <p><em>Image credits: CTV</em></p>

Caring

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Aussie with terminal cancer uses time left to make her mark

<p dir="ltr">An Australian researcher who has been diagnosed with terminal ovarian cancer is busy making plans for when she’s gone - including a contribution she hopes will help advance research in animal studies.</p> <p dir="ltr">Siobhan O’Sullivan was diagnosed with stage 3 ovarian cancer in July 2020, finding out within a year that the cancer had spread and that her illness was terminal.</p> <p dir="ltr">“In the week prior to my diagnosis, I was starting to say to people, ‘I’m not feeling right - I think it’s stress because Dad’s going to die soon’,” she told <em><a href="https://7news.com.au/lifestyle/health-wellbeing/a-silent-killer-has-left-her-terminally-ill-now-this-aussie-woman-has-a-simple-message-c-6854866" target="_blank" rel="noopener">7News</a></em>.</p> <p dir="ltr">“The week before dad died, I went to the doctor and said, ‘Something’s not right’.”</p> <p dir="ltr">During her treatments Siobhan suffered multiple strokes - an unexpected side effect - but even extensive treatment couldn’t stop the cancer from spreading.</p> <p dir="ltr">“That was a huge blow for me because a lot of women at that point do get some remission time,” she said.</p> <p dir="ltr">“I’m now at 19 months, which means I’m on borrowed time.”</p> <p dir="ltr">Though she’s living with death, Siobhan has maintained her humour and optimism, as well as her advocacy for ovarian cancer and the legalisation of voluntary assisted dying.</p> <p dir="ltr">She also began making plans, divesting her property and funds to her niece, nephew, godson and his sister, and ensuring her podcast is in good hands once she’s gone.</p> <p dir="ltr">Siobhan has also bequeathed $50,000 to the Australisian Animal Studies Association (AASA), which she is a founder of, and is helpling to establish two awards for future researchers.</p> <p dir="ltr">She is an associate professor of politics at Sydney’s University of New South Wales and was extremely involved in research around animal studies and her other passion, the alleviation of social issues related to poverty.</p> <p dir="ltr">Thanks to her donation, the AASA is offering two new prizes: one for early-career researchers, and the other for animal studies scholars, artists or advocates who have worked to promote their insights and findings with their peers and the public.</p> <p dir="ltr">“This is an exciting way to help the field of animal studies,” she said in a <a href="https://www.inside.unsw.edu.au/awards/new-awards-scheme-advances-the-emerging-sub-discipline-animal-studies#:~:text=As%20a%20founder%20of%20the,be%20established%20in%20coming%20years." target="_blank" rel="noopener">statement</a>. “My own research … suggests that many animal studies scholars feel isolated and their research is not acknowledged by their own institutions. </p> <p dir="ltr">“These awards are a way of strengthening the animal studies community and giving scholars a sense of achievement and recognition.”</p> <p><span id="docs-internal-guid-797bc252-7fff-26df-4e48-a4265576659f"></span></p> <p dir="ltr">As she nears the end of her life, Siobhan has said she would feel immensely comforted by the thought that she could legally end her life before her cancer brings her even more suffering.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">I was so honoured to speak on behalf of people facing horrible deaths in NSW. Today I'll be watching <a href="https://twitter.com/nsw_upperhouse?ref_src=twsrc%5Etfw">@nsw_upperhouse</a> &amp; <a href="https://twitter.com/NSWParlLA?ref_src=twsrc%5Etfw">@NSWParlLA</a> closely. I hope our political leaders use their power to ease the load of the terminally ill &amp; their friends &amp; family. <a href="https://twitter.com/hashtag/AssistedDying?src=hash&amp;ref_src=twsrc%5Etfw">#AssistedDying</a> <a href="https://twitter.com/hashtag/VAD?src=hash&amp;ref_src=twsrc%5Etfw">#VAD</a> <a href="https://twitter.com/hashtag/nswpol?src=hash&amp;ref_src=twsrc%5Etfw">#nswpol</a> <a href="https://t.co/hecIbBdBAl">pic.twitter.com/hecIbBdBAl</a></p> <p>— Siobhan O'Sullivan 🥦😸♋ (@so_s) <a href="https://twitter.com/so_s/status/1527089433501405184?ref_src=twsrc%5Etfw">May 19, 2022</a></p></blockquote> <p dir="ltr">“My view is that there is no benefit that’s going to come to me, or my family, or this world, for me to suffer the last couple of weeks of a death by ovarian cancer,” she said.</p> <p dir="ltr">But the very recent <a href="https://www.oversixty.com.au/health/caring/emotional-scenes-as-nsw-passes-law-on-voluntary-assisted-dying" target="_blank" rel="noopener">passing of the Voluntary Assisted Dying Bill</a> in NSW Parliament might still come too late for Siobhan, since it could take up to 18 months for the law to come into effect.</p> <p dir="ltr">Despite it not necessarily being an option she could take up, Siobhan says her advocacy will help others in the future.</p> <p dir="ltr">“This is for the other people, for the next people - the people in one, two, three years time,” she said.</p> <p dir="ltr"><span id="docs-internal-guid-62a0997d-7fff-4443-1f85-8266d60241af"></span></p> <p dir="ltr"><em>Image: Siobhan O’Sullivan (Facebook)</em></p>

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Emotional scenes as NSW passes law on Voluntary Assisted Dying

<p dir="ltr">The NSW parliament has legalised voluntary assisted dying (VAD), with Thursday's historic vote meaning terminally ill people can now choose the timing of their death.</p> <p dir="ltr">NSW joins the rest of Australia’s states in making VAD legal with a final vote of 23 MPs in favour and 15 opposing.</p> <p><span id="docs-internal-guid-57b1d52d-7fff-87bc-6fab-77fde5fd183a">Independent Sydney MP Alex Greenwich, who introduced the bill to parliament late last year, told members that the “entire diversity” of parliament were involved in passing the bill, with 28 co-sponsors from all parties - the highest number in Australian parliamentary history per <em><a href="https://www.smh.com.au/politics/nsw/voluntary-assisted-dying-legalised-in-nsw-20220519-p5amo0.html" target="_blank" rel="noopener">The Sydney Mkorning Herald</a></em>.</span></p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">"We are celebrating this historic day"<br />"Compassion has won"<br />says Independent MP <a href="https://twitter.com/AlexGreenwich?ref_src=twsrc%5Etfw">@AlexGreenwich</a>, flanked by the Voluntary Assisted Dying Bill's co-sponsors and advocates.<br />It's been 20 years since the first attempt to pass a law like this in NSW. <a href="https://twitter.com/hashtag/nswpol?src=hash&amp;ref_src=twsrc%5Etfw">#nswpol</a> <a href="https://t.co/8wNpjSEZP3">pic.twitter.com/8wNpjSEZP3</a></p> <p>— Sarah Navin (@SarahNavin) <a href="https://twitter.com/SarahNavin/status/1527131431163797505?ref_src=twsrc%5Etfw">May 19, 2022</a></p></blockquote> <p dir="ltr">“For those wondering what happened with the Voluntary Assisted Dying Bill last night; the bill was debated till midnight and almost all amendments were dealt with,” Mr Greenwich explained on social media at 6am on Thursday morning.</p> <p dir="ltr">“There is one more amendment this morning to vote on and then a final vote in both the Upper and Lower House.”</p> <p dir="ltr">MPs debated nearly 100 amendments on Wednesday, with the sitting ending at midnight.</p> <p dir="ltr">The majority of amendments, including the push to allow aged care and residential homes to block VAD from occurring in their facilities, were voted down during the debate according to the <em><a href="https://www.abc.net.au/news/2022-05-19/voluntary-assisted-dying-laws-pass/101079940" target="_blank" rel="noopener">ABC</a></em>.</p> <p dir="ltr">At midday, it was announced that the bill had passed the upper house.</p> <p><span id="docs-internal-guid-e5a4c3c0-7fff-a6a1-f7fe-4002e71c7631"></span></p> <p dir="ltr">The lower house then approved the bill approximately an hour later.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Proud to be sitting in the NSW parliament to watch the Voluntary Assisted Dying Bill finally pass into law. This will make such a difference to the lives of so many, allowing people to choose to live the end of their lives as well as possible and to die with dignity. ✨❤️</p> <p>— Abigail Boyd (@AbigailBoydMLC) <a href="https://twitter.com/AbigailBoydMLC/status/1527120671498588161?ref_src=twsrc%5Etfw">May 19, 2022</a></p></blockquote> <p dir="ltr">Finance Minister Damien Tudehope, an opponent of the bill, told the upper house that it was a “dark day” for the state.</p> <p dir="ltr">“It was a sad day because it was an opportunity for NSW to say ‘we can be better than this’,” Mr Tudehope said.</p> <p dir="ltr">He added that it would be judged by history as a “dreadful mistake”.</p> <p dir="ltr"><span id="docs-internal-guid-7061fe4b-7fff-c2d4-1a70-0c7be574e249"></span></p> <p dir="ltr">However, advocate groups such as Go Gentle Australia and Dying with Dignity, as well as individual supporters of VAD, have welcomed the decision.</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">Voluntary assisted dying set to become law in NSW. Congratulations and thank you to all the advocates, especially those who fought for their right to die with dignity, and died waiting and the 28 MPs who co-signed the Bill, tabled by my MP, <a href="https://twitter.com/AlexGreenwich?ref_src=twsrc%5Etfw">@AlexGreenwich</a> <a href="https://twitter.com/hashtag/voluntaryassisteddying?src=hash&amp;ref_src=twsrc%5Etfw">#voluntaryassisteddying</a></p> <p>— Kimberley Ramplin (@Kimbo_Ramplin) <a href="https://twitter.com/Kimbo_Ramplin/status/1527130066349481985?ref_src=twsrc%5Etfw">May 19, 2022</a></p></blockquote> <p dir="ltr">“VAD is now legal in NSW, the culmination of 50 years of advocacy. Congratulations to all involved,” Go Gentle Australia tweeted.</p> <p dir="ltr">“Congratulations to everyone involved in this campaign!” Greens Senator Mehreen Faruqi wrote.</p> <p dir="ltr">“I was part of the Working Group on Assisted Dying in NSW Parliament, which introduced the first bill. I’m proud to have played a role so that people can die with dignity.”</p> <p dir="ltr">“Genuinely stoked,” Scott Phillips, the director of City Recital Hall, said.</p> <p dir="ltr">“I have no idea if my old man would have taken the option, in his final days as he battled cancer.</p> <p dir="ltr"><span id="docs-internal-guid-33a92312-7fff-da90-5db0-3ce7e371afd6"></span></p> <p dir="ltr">“But I am so pleased that the choice will be available to others in NSW as a result of this bill.”</p> <blockquote class="twitter-tweet"> <p dir="ltr" lang="en">At long last. Choice &amp; dignity for terminally ill patients in NSW. Congrats to all who fought so courageously for this change. Now legalised in every State, the Federal Government need to stop blocking the NT &amp; ACT from debating this reform. <a href="https://twitter.com/hashtag/ausvotes?src=hash&amp;ref_src=twsrc%5Etfw">#ausvotes</a> <a href="https://twitter.com/hashtag/auspol?src=hash&amp;ref_src=twsrc%5Etfw">#auspol</a> <a href="https://twitter.com/hashtag/nswpol?src=hash&amp;ref_src=twsrc%5Etfw">#nswpol</a> <a href="https://twitter.com/hashtag/vad?src=hash&amp;ref_src=twsrc%5Etfw">#vad</a> <a href="https://t.co/UAwfar1O4X">https://t.co/UAwfar1O4X</a></p> <p>— JillHennessyMP (@JillHennessyMP) <a href="https://twitter.com/JillHennessyMP/status/1527130639816093696?ref_src=twsrc%5Etfw">May 19, 2022</a></p></blockquote> <p dir="ltr">According to <em><a href="https://twitter.com/10NewsFirstSyd/status/1527133466181005312" target="_blank" rel="noopener">10 News First Sydney</a></em>, the bill allows for people to choose to end their life if they have suffering that can’t be relieved and are likely to die of a disease within six months, or within a year in the case of neurodegenerative disease. </p> <p dir="ltr">The news comes just days after Sara Wright, a nurse who has long advocated for VAD to be legalised, <a href="https://www.oversixty.com.au/health/caring/terminally-ill-nurse-caught-in-desperate-waiting-game" target="_blank" rel="noopener">spoke out</a> about waiting for the decision to be made while being “virtually paralysed” as a result of motor neuron disease - estimating she has months left to live.</p> <p dir="ltr">“I don’t think that I will live for more than another six to eight months, as my breathing capacity is reducing very fast and I do not wish to have a tracheostomy (an operation where a breathing hole is cut into the front of the neck and windpipe),” she told 7News.</p> <p dir="ltr">“I know that all my family, my parents, my brothers, my ex-husband are all in support of voluntary assisted dying and helping me relieve my suffering.</p> <p dir="ltr">“But none of us want to break the law or risk anyone being imprisoned if they helped me.”</p> <p dir="ltr"><span id="docs-internal-guid-4f1cf650-7fff-f54a-3901-698f66650fb4"></span></p> <p dir="ltr"><em>Image: @DWDnsw (Twitter)</em></p>

Caring

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Terminally ill nurse caught in desperate waiting game

<p dir="ltr">A nurse who has months to live as a result of her diagnosis of motor neuron disease (MND) is “virtually paralysed” and waiting for the NSW government to decide how she will die.</p> <p dir="ltr">Sara Wright had been a nurse for 33 years before she was diagnosed with amyotrophic lateral sclerosis (ALS) - a subtype of MND - two years ago, and is now dependent on a carer 24 hours a day.</p> <p dir="ltr">“The disease started as a weakness in my right foot, travelled up my right leg, then my left foot and leg,” the 54-year-old told <em><a href="https://7news.com.au/news/public-health/virtually-paralysed-nurse-waits-for-nsw-parliament-to-decide-how-she-will-die-c-6699939">7NEWS.com.au</a></em>.</p> <p dir="ltr">“Then it travelled up my torso affecting my upper body, firstly my abdominal muscles, and now it affects both of my arms and hands, my lungs and my swallowing and speaking muscles.”</p> <p dir="ltr">Ms Wright, who shared her story via dictation since speaking is difficult and painful, is waiting to see whether voluntary assisted dying laws (VAD) will be passed in the NSW Upper House next week.</p> <p dir="ltr">If they don’t pass, she says she will likely “have to deal with suffocating or choking to death”.</p> <p dir="ltr">“It’s a terminal illness and the average life expectancy is three to five years,” she explained.</p> <p dir="ltr">“Given I have already been living with the disease for three years, and the progression has been faster than I ever could have expected, I don’t know how long I will live.</p> <p dir="ltr">“I don’t think that I will live for more than another six to eight months, as my breathing capacity is reducing very fast and I do not wish to have a tracheostomy (an operation where a breathing hole is cut into the front of the neck and windpipe).”</p> <p dir="ltr">ALS/MND is more common among adults aged between 40 and 70 years, with 384 people diagnosed each day according to the <a href="https://www.als-mnd.org/what-is-alsmnd/" target="_blank" rel="noopener">International Alliance of ALS/MND Associations</a>.</p> <p dir="ltr">Ms Wright’s career as a nurse made her all too aware of the “limitations of palliative care in the final stages of terminal illness”, so she initially planned to book into Dignitas, a non-profit organisation in Switzerland that offers a range of end-of-life services.</p> <p dir="ltr">But, the COVID-19 pandemic derailed her plan with the closure of international borders.</p> <p dir="ltr">She then considered moving interstate, where VAD is legal, but she worried about uprooting her 15-year-old daughter, Ester, from her home and friends, especially since most of their family is UK-based.</p> <p dir="ltr">“(Ester) is now 15 and she needs to have her community around her for support when I die,” she said.</p> <p dir="ltr">“Obviously this is an incredibly difficult conversation to have with your own child.</p> <p dir="ltr">“We have not specifically spoken about what could happen to me if the laws aren’t passed … but I have tried to assure her that family in the UK will fly out to be with her as soon as they can if I die unexpectedly.”</p> <p dir="ltr">Ms Wright’s fate is tied to the voluntary assisted dying bill, which passed through the NSW Parliament’s lower house last year and is legal or will soon be legal in <a href="https://end-of-life.qut.edu.au/assisteddying" target="_blank" rel="noopener">every other state</a> except NSW.</p> <p dir="ltr">“I know that all my family, my parents, my brothers, my ex-husband are all in support of voluntary assisted dying and helping me relieve my suffering,” she said.</p> <p dir="ltr">“But none of us want to break the law or risk anyone being imprisoned if they helped me.”</p> <p dir="ltr">Since the bill entered the upper house last March, it has been debated passionately and passed through a second reading stage last week.</p> <p dir="ltr">It has even divided the state’s core leadership, with Premier Dominic Perrottet opposing the bill in favour of improving palliative care and Health Minister Brad Hazzard supporting it - despite opposing euthanisia for 29 years.</p> <p dir="ltr">Ms Wright, a strong supporter of VAD laws, has been brought close to the death of others during her nursing career and said she was “pretty certain” that if members debating the bill had seen people die uncomfortable, drawn-out deaths like she had, they would support the bill.</p> <p dir="ltr">“I have seen far too many people, elderly people, in the middle of the night in a ward without anyone there to hold their hand because nobody knew that was going to be their time to die,” she said.</p> <p dir="ltr">“I think that most people don’t think enough about death because we are all frightened of it.</p> <p dir="ltr">“And this could be the reason that some people are refusing to consider VAD laws, because it’s a topic that is deeply uncomfortable and taboo.</p> <p dir="ltr">“If we as a society were more mindfully aware and thoughtful about death, as it is the only certain outcome of life, then perhaps people would develop more compassion.”</p> <p dir="ltr">Though the laws could still be passed at some point if it fails to pass in next week’s final vote, Ms Wright said it would affect her whole family if it was too late for her to take advantage of it.</p> <p dir="ltr">“This will not only cause suffering to me but also to all of my family,” she said.</p> <p dir="ltr">“I wonder how many people have really stopped to think about what they would like, if they were in a position where they were going to die of (an) unpleasant and drawn-out death.”</p> <p><span id="docs-internal-guid-efb8451b-7fff-fb48-8f9b-0af951ee000d"></span></p> <p dir="ltr"><em>Image: 7News</em></p>

Caring

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TGA warns Aussies against using Ivermectin for COVID-19

<div class="body_text redactor-styles redactor-in"> <p>The Therapeutic Goods Administration (TGA) has detected an increase in the amount of a drug called Ivermectin being imported and it warns against the use of this drug for the treatment of COVID-19 as it is untested for this condition.</p> <p>Ivermectin is an anti-parasitic drug which has been shown to be effective in vitro against a broad range of viruses including HIV, dengue, influenza and zika.</p> <p>However, it is not approved for the treatment of COVID-19. In a statement, the TGA said: ‘The Therapeutic Goods Administration (TGA), part of the Department of Health, has detected increased importation and prescribing of Ivermectin for the treatment of COVID-19.’</p> <p>‘The TGA strongly discourages self-medication and self-dosing with Ivermectin for COVID-19 as it may be dangerous to your health.’</p> <p><strong>Even the drug’s manufacturer warns against using it this way</strong></p> <p>Even the drug's manufacturer, Merck Sharp &amp; Dohme (MSD), has urged people not to use the medication to treat COVID-19, warning in a statement saying:</p> <p>"No scientific basis for a potential therapeutic effect against COVID-19 from pre-clinical studies; No meaningful evidence for clinical activity or clinical efficacy in patients with COVID-19 disease, and a concerning lack of safety data in the majority of studies."</p> <p>Despite those urgings, Ivermectin's popularity amongst fringe medical and anti-vaccination groups - and its promotion via the Internet - has seen demand for it increase here in Australia.</p> <p><strong>Ivermectin is often promoted by anti-COVID figures</strong></p> <p>The cheap and common drug is often promoted by anti-COVID vaccination or anti-lockdown figures, such as former Liberal backbencher Craig Kelly and a number of US conservative, fringe campaigners.</p> <p>Ivermectin has been used around the world for years as a treatment for a range of conditions including head lice, parasites, worms and scabies. It is available as a pill, lotion and shampoo.</p> <p>The drug's advocates have pointed to several studies which allegedly show its effectiveness against COVID-19.</p> <p><a rel="noopener" href="https://pubmed.ncbi.nlm.nih.gov/32251768/" target="_blank">Some Australian research</a> indicated Ivermectin could inhibit the virus from replicating within a cell and reported the drug warrants further investigation into the possible benefits for humans. However, this trial was only carried out in a laboratory.</p> <p>Other research found the amounts needed of Ivermectin would not be possible for human and other research said there was <a rel="noopener" href="mailto:https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015017.pub2/full" target="_blank">‘conflicting’ evidence</a> as to its benefits.</p> <p>The Cochrane alliance, a global collaboration between scientists to assess clinical research, said the completed studies were "small and few are considered high quality".</p> <p>"We are uncertain about the efficacy and safety of Ivermectin used to treat or prevent COVID‐19," the alliance reported.</p> <p>The TGA has not approved the drug for COVID-19 treatment, saying more investigation was needed.</p> <strong>What’s happening overseas?</strong> <p>In the United States, health authorities have warned people against using doses of Ivermectin.</p> <p>The problem has become noticeable in some states where local health authorities have noticed dramatic increases in poisoning.</p> <p>The Health Department of the US State of Mississippi said 70 per cent of the calls it received recently about poisoning have been related to people taking Ivermectin.</p> <p><em>Photo: Getty Images </em></p> </div>

Caring

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Another Aussie fashion label goes bust

<p>Yet another Australian fashion retailer has bitten the dust, joining the likes of Diana Ferrari, Maggie T, Oroton, and David Lawrence.</p> <p>After 76 years, men’s fashion chain Roger David has gone into administration, its collapse because of competition from online and international retailers, reports<span> </span><em><a rel="noopener" href="https://www.news.com.au/finance/business/retail/rogers-david-goes-into-administration/news-story/e8f278b7030938c6e2b039cf63e99f97" target="_blank">news.com.au</a></em>.</p> <p>It is now in the hands of administrators KordaMentha.</p> <p>“Despite the directors’ best efforts with the business, it simply could not compete with the influx of multinational retailers and the rapid, global evolution of online shopping,” Roger David directors said in a statement yesterday.</p> <p>“Thank you also to Roger David’s loyal customers who have been on a journey with Roger David since we opened our doors,” said the directors.</p> <p>“Like you, we are heartbroken but forever grateful to have served generations of your family since 1942.”</p> <p>KordaMentha administrator Craig Shepard said that, "Roger David, like many other fashion retailers, has been buffeted by global competition, stagnant sales and rising fixed costs," according to<span> </span><em><a rel="noopener" href="https://www.smh.com.au/business/companies/heartbroken-roger-david-collapses-into-administration-20181018-p50adk.html" target="_blank">The Sydney Morning Herald</a></em>. "The company has been exploring all options, including a sale of the business, but has been unable to find an alternative to administration."</p> <p>“The competition in the market, the internationals and in general online, it has just got tougher and tougher."</p> <p>Roger David had already closed over half of its stores, downsizing from 135 to 57 locations, and the administrators announced that a closing down sale would begin immediately. Shepard said gift cards for the brand would be honoured for a month.</p> <p>The chain, which employs over 300 staff, is due to operate throughout the Christmas shopping season.</p>

Beauty & Style

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Jamie Durie's legal battle with former right-hand man

<p>Jamie Durie founded his design practice in 1998 and then soon after, became a household name after appearing on home improvement shows, such as Backyard Blitz and The Block.</p> <p>He then received international acclaim after making regular appearances on The Oprah Winfrey Show for over four years and has now hosted more than 50 design shows around the globe.</p> <p>However, the 48-year-old’s multimillion-dollar design company has been quietly crumbling.</p> <p>On May 3, Durie’s company JPD Media and Design Pty Ltd went into voluntary administration, with Simon Cathro from Worrels Solvency and Forensic Accountants appointed to look into the company’s financial affairs.</p> <p>The news followed a long legal battle between Durie and his former employee Mike Curnow, who had worked as the company’s global head of licensing.</p> <p>Curnow was hired by the company in 2004 and let go in 2013.</p> <p>Curnow then launched legal action against his former employer for unpaid commissions.</p> <p>In March, the Supreme Court ruled Mr Curnow was owed $563,049, which does not include the judgement on interest and costs which is yet to be made. Solicitors estimate the interest and costs could push the total amount owed to more than $1 million.</p> <p>Mr Curnow was not paid the initial sum by April, and so his legal team filed a creditor’s statutory demand for the payment, which was due by May 4, reported the <a href="https://www.smh.com.au/entertainment/celebrity/private-sydney-dirt-flies-over-fall-of-gardening-empire-20180531-p4zims.html" target="_blank"><em><strong><span style="text-decoration: underline;">Sydney Morning Herald.</span></strong></em></a></p> <p>However, just one day before the payment was due, Durie placed his company into voluntary administration, with just $1 in the bank.</p> <p>Curnow, who is still waiting for his payout, said he was “absolutely disgusted” over the situation.</p> <p>“This has cost me my marriage, my home and my career,” Mr Curnow said of the legal fight with Durie.</p> <p>“If he thinks I’m going to give up now, he’s mistaken. I’m not going anywhere.”</p> <p>According to the <em>Sydney Morning Herald</em>, the company also owes cash to other creditors including the Australian Taxation Office, with more than $215,000 in unpaid taxes for the 2016/17 financial year.</p> <p>The legal battle also revealed that Durie had taken a $500,000 loan from ex-Macquarie group boss Bill Moss in 2010 to keep his business running.</p> <p>Durie had been forced to ask for an extension on the loan, admitting to Moss that he had “made some bad decisions”.</p> <p>Durie previously told Fairfax reporters that Curnow had “made millions out of me over the years”.</p>

Legal

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Toys 'R' Us goes into voluntarily administration in Australia

<p>Toys 'R' Us Australia has gone into voluntary administration months after the US and UK stores collapsed.</p> <p>Directors of the company appointed voluntary administrators McGrathNicol after the withdrawal of the final bidder for the sale of the Australian business, a McGrathNicol spokesman said in a statement on Monday.</p> <p>All Toys 'R' Us and Babies 'R' Us stores will remain open and continue to trade while the administrators look at their options – either to sell the stand-alone Australian business or a recapitalisation through the voluntary administration process.</p> <p>There are 44 retail stores across Australia which employs about 700 permanent staff.<br /> No employee positions are affected by the appointment, the spokesman said.</p> <p>However, Toys ‘R’ Us Australia will no longer offer refunds, and gift cards and vouchers will only be honoured if customers spent an additional equivalent amount.</p> <p>Online orders and lay-bys will be delivered or honoured where goods have been paid for in full and the stock is available.</p> <p>“The administrators will continue to pay employees and expect that employee entitlements will be met either through a sale of the business, recoveries from the sale of stock, or through the Commonwealth Government's Fair Entitlements Guarantee (FEG) Scheme,” the statement said.</p> <p>Toys 'R' Us Australia posted a $7.7 million loss in the financial year to January 2017 and a $9 million loss the previous year.</p> <p>It follows the announcement in March earlier this year that Toys 'R' Us in the US was preparing to sell or close all its 885 stores.</p> <p>Administrators closed a quarter of the company's 100 UK stores by mid-March with plans to close the remaining stores by the end of April.</p> <p> </p> <p> </p>

Money & Banking

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Bad news for Jamie Oliver’s Aussie fans

<p>Jamie Oliver’s Australian restaurant group has gone into voluntary administration forcing the immediate closure of the Canberra-based restaurant.</p> <p>Two years ago, the celebrity chef bought back the Jamie’s Italian chain from failed hospitality group the Keystone Group in March 2017.</p> <p><em>The Canberra Times</em> revealed that staff at the Canberra restaurant were given no warning of the sudden closure of the eatery.</p> <p>Jamie Oliver’s other Italian restaurants in Perth, Brisbane, Sydney and Adelaide will be taken over by Brisbane-based Hallmark Group.</p> <p>Yesterday, chief operating officer of the Australian Jamie’s Italian chain, Ben Shaughnessy, called in the voluntary administrators after consecutive meetings with Hallmark to discuss the sale and creditor HSBC.</p> <p>On Monday evening, the PR business representing Jamie’s Italian in Australia issued a statement, announcing “a new operating partner for its Australian business”.</p> <p>A spokesperson for the Jamie Oliver Restaurant Group Australia said, “Australia has and continues to be one of our best performing international markets and, after a short period of in-house management we are pleased to be partnering with Hallmark.</p> <p>"The team brings a huge amount of experience and passion for our brand, from collaborating with the key suppliers to our food philosophy, and we look forward to working with them as they develop the Jamie’s Italian restaurant offering across Australia."</p> <p>On social media the Canberra restaurant said, “This is pretty sad news for the staff but Jamie's Italian has closed suddenly this morning and it looks like it won't be reopening anytime soon.”</p> <p>“The remaining restaurants in Sydney, Brisbane, Perth, Parramatta and Adelaide are to remain open.</p> <p>The announcement follows a recent scandal where a chef at one of the Italian restaurants was caught using packet gnocchi – despite claims the restaurant makes produce fresh daily.</p> <p>An observant customer dining at the restaurant on Pitt Street, Sydney, took a photo of a chef preparing to use a packet of ready-made gnocchi.</p> <p style="text-align: center;"><img width="499" height="645" src="https://oversixtydev.blob.core.windows.net/media/7817516/1_499x645.jpg" alt="1 (118)"/></p> <p>On the menus of the popular restaurants, it says that they "make fresh pasta, right here every day”.</p> <p style="text-align: center;"><img width="498" height="355" src="https://oversixtydev.blob.core.windows.net/media/7817517/2_498x355.jpg" alt="2 (69)"/></p> <p>It has been revealed that Jamie Oliver’s international restaurant chains had a pre-tax loss of $17.5 million. The UK business entered into a Company Voluntary Arrangement believing it can trade out of its trouble.</p> <p>On Friday, his chain announced that twelve of his restaurants will close as part of a company restructure.</p> <p>The firm said, “We are pleased to have received the overwhelming support from our creditors for our proposal to reshape Jamie's Italian restaurants.”</p> <p>“We have a strong brand and are focused on continuing to deliver the levels of service, taste and the experience our loyal customers deserve.”    </p> <p>The UK chef has 25 restaurants in the UK and 28 overseas. There are six Jamie’s Italian restaurants across Australia.</p>

Money & Banking

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Bad news for shoppers: Handbag brand Oroton goes bust

<p>Luxury handbag maker Oroton has gone into voluntary administration, with shoppers swarming the retailer to snap up bargains as it attempts to clear stock.</p> <p>Oroton, whose most public face is Australian actor Rose Byrne, made the announcement this morning prompting shoppers to head on line and snap up the heavily-discounted stock ahead of the busy Christmas shopping season.</p> <p>And there are plenty of bargains to be had. For example, the large Melanie tote bag that was retailing for $595 is now going for a paltry $116. And the Signature O Baby Bag which originally cost $495 is now just $148.50. </p> <p>Interim chief executive Ross Lane claimed the 79-year-old Australian retailer had no choice but to go bust, after efforts to recapitalise or sell the business failed miserably.</p> <p>“The board is disappointed that it has had to take this step after running such a comprehensive process,” he said in a statement lodged with the Australian Securities Exchange.</p> <p>“However, having carefully considered the options available to the company at the conclusion of its strategic review, it is apparent that voluntary administration is necessary to protect the Oroton business and the future of this iconic Australian brand.”</p> <p><iframe src="https://www.facebook.com/plugins/post.php?href=https%3A%2F%2Fwww.facebook.com%2Forotonstudio%2Fposts%2F10155176172128927&amp;width=500" width="500" height="736" style="border: none; overflow: hidden;" scrolling="no" frameborder="0" allowtransparency="true"></iframe></p> <p>Oroton is the latest company to go bust as retailers continue to struggle with pressures from online shopping, high overheads and an uncertain consumer market.</p> <p>What are your thoughts? </p>

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