Dr Neera Bhatia hopes the landmark legislation helps us to talk more about death.

Last week’s passing of historic voluntary euthanasia laws has taken Victoria to the threshold of being the first Australian state to legalise assisted dying for the terminally ill.

With the Voluntary Assisted Dying bill now returning to the Lower House for final ratification, Deakin Law School’s health expert Dr Neera Bhatia says that questions remain about both its passage through parliament and its future implementation.

‘By no means was this an easy feat. The marathon debate in the Upper House was strung out by opponents of the bill questioning, often repetitively, challenging and debating at length many of the 141 clauses of the bill to deliberately delay its passage through parliament.  Supporters of the bill accused those against assisted dying of filibustering, a classic political tactic where MPs ‘debate’ a proposed bill at length with the objective of delaying, or even preventing, it from going to the next stage of the process. The difference in this situation was that the Lower House had already debated the bill at length.’

Dr Bhatia says that considering the bill also carried broad, popular public support, the deliberate delay in the Upper House could be considered undemocratic.

‘Is dragging out the debate for 28 hours to yet again debate each of the clauses of the bill, a beneficial use of taxpayer’s money? Of course the assisted dying bill is one of the most important pieces of legislation that will be passed in Australia’s history, yet we must question the behaviour and the conduct of our elected representatives who play an integral role in whether laws are passed. In this case that will ultimately affect the manner in which we may choose to die.’

The Voluntary Assisted Dying bill passed Victoria’s Lower House last month with a 47-37 vote but legislation required amendments to also pass the 40-member Upper House.

‘One of the main amendments was that the in order for a person to be eligible to access the voluntary assisted dying scheme, the timeframe for the number of months left to live was reduced from no more than 12 months to no more than six months. There will be exceptions made to this timeframe for those suffering neurodegenerative conditions – such as motor neurone disease and multiple sclerosis – who will be able to access the assisted dying scheme up to 12 months before their expected death,’ says Dr Bhatia.

With a raft of precautions, the legislation also includes that a person be aged over 18, of sound mind, have lived in Victoria for at least 12 months and be enduring an incurable illness which causes intolerable suffering.

‘Two independent medical assessments are required, and the patient must administer the drug themselves. In exceptional cases, where a patient is unable to administer the drug, a medical practitioner can do so. The legislation also includes 68 ‘safeguards’ that include criminal offences that specifically protect the vulnerable from coercion, and all cases will be reviewed by a special board. Once the legislation is passed, individuals that meet the stringent criteria and wish to opt for voluntary assisted dying can do so from 2019,’ she adds.

A research expert in health law, and end-of-life decision making, Dr Bhatia says she’s cautiously optimistic about the bill finally making it through parliament but says it will continue to fuel contention.

‘Should we be pleased with the assisted dying legislation? Those against assisted dying will of course, not be. But, those in support may share my cautious sense of optimism. It has taken decades to get this far, but it feels like we have only taken a few steps forward and yet it has taken all of our emotional and political might.’

While the bill’s passing is an historic moment in Victoria’s legal and political history, she questions whether the safeguard provisions to get it through the Upper House could end up compromising its purpose.

‘Perhaps the biggest sacrifice is the six-month timeframe. The criteria to access assisted dying stipulate that a person must be suffering an incurable illness and intolerable suffering with no more than six months to live. With such a restrictive and limited timeframe – thus a relatively accurate prognosis of foreseeable death – can we say that a person will have a good death? We must question how accessible the legislation will be in reality. Will the assisted dying legislation end up being a piece of legislation in name only because it is so restrictive? Will it be so restrictive that desperate individuals continue to end their lives using unlawful and unsafe methods?’ she asks.

Dr Bhatia suggests that if the legislation were to become inaccessible to the broader community, public and political advocacy may continue in a quest to amend the legislation’s clauses.

‘This however, is conjecture and we will have to wait until 2019 onwards to see how many individuals can – and do – access the assisted dying legislation before knowing if changes are required,’ she says.

In the meantime, Dr Bhatia hopes that the debate around Victoria’s landmark legislation will encourage more dialogue around end-of-life issues.

‘This time last year we did not have assisted dying legislation in Victoria.  Very soon we will. As a society we have started to talk more about death. It is important to start normalising death as it is a part of life. The assisted dying debate has played a key role in doing that.’