Victoria (Aust) Introduces Voluntary Assisted Dying

Occams Barber

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Victoria Introduces Voluntary Assisted Dying

On 19 June 2019 the Australian State of Victoria will formally implement processes allowing for Voluntary Assisted Dying. This follows 18 months of preparation since the passage of enabling legislation in November 2017. The scheme defines strict qualifications for those seeking access along with a defined process. Doctors who conscientiously object to the scheme are under no obligation to participate or refer.

To access the scheme applicants must:
  • Be in the late stages of an advanced disease and expected to die within weeks or months, but not more than six months (or 12 months for a neurodegenerative disease, such as motor neurone disease).
  • Be experiencing suffering, which they consider unacceptable.
  • Have the ability to make and communicate an informed decision about voluntary assisted dying.
  • Make a voluntary, continuing and fully informed decision about voluntary assisted dying.
  • Be an adult, 18 years old or over.
  • Be an Australian citizen or permanent resident.
  • Be a current Victorian resident who has lived in the state for the last 12 months.

Qualified applicants will need to follow basic protocols:
  • Make two verbal requests
  • Sign a written request
  • Be assessed as eligible for voluntary assisted dying by two different doctors (one of the doctors must be a specialist in the field of the relevant disease).
There is no maximum time limit for completing the voluntary assisted dying process. However, the process cannot be completed in less than 10 days unless death is imminent

Health practitioners must have the appropriate skills and training as defined by the scheme and may choose their level of involvement. If a health practitioner conscientiously objects to voluntary assisted dying, they are under no obligation to participate. Health practitioners are under no obligation to refer the patient to someone who will assist them, but should not inhibit a person's access to treatment.


Assisted Dying and/or Voluntary Euthanasia is currently legally available in six countries (Netherlands, Belgium, Switzerland, Luxembourg, Colombia and Canada) and six U.S. States (Oregon, Washington State, Vermont, California, Colorado, and Montana)

Sources
voluntary-assisted-dying
Voluntary assisted dying will soon be legal in Victoria, and this is what you need to know
Assisted Dying in Other Countries - My Death, My Decision

OB
 
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Heavenhome

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Nup, call it what you want its murder.
just as abortion is no matter what nice term you use.
Suicide is self murder.
Please don't think I am saying this from a pedestal, before being Christian I attempts at suicide and it is only since then I realise the value of life and that our lives are not ours to take.
And I have had loved ones that have had their passing drawn out, so I know what it is like.
If you have proper medical care there is no reason whatever to be in pain and I firmly believe our life is not ours to make a decision on.
As a Victorian, I am devastated that this has happened.
Regardless of the law and the so called stringent criteria set out, do you really believe in the "goodness" of mankind that this won't be the beginning of much, much more?
 
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Ignatius the Kiwi

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These limits make no sense. Shouldn't a seventeen year old going through excessive depression be able to kill themselves? Also why limit it to Australian citizens? Isn't this discrimination uncalled for? especially when foreigners may feel the need to die more than any native citizen or resident? Life obviously isn;t worth living if we tolerate people suffering killing themselves and therefore we should open assisted suicide to everyone.

I'm not being serious by the way, but if we are going to tolerate people killing themselves, why such arbitrary restrictions?
 
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Occams Barber

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These limits make no sense. Shouldn't a seventeen year old going through excessive depression be able to kill themselves? Also why limit it to Australian citizens? Isn't this discrimination uncalled for? especially when foreigners may feel the need to die more than any native citizen or resident? Life obviously isn;t worth living if we tolerate people suffering killing themselves and therefore we should open assisted suicide to everyone.

I'm not being serious by the way, but if we are going to tolerate people killing themselves, why such arbitrary restrictions?
Limiting it to Australian citizens with 12 month residence in Victoria is intended to stop suicide tourism - people from other states or countries coming for the express purpose of assisted dying.
I'm concerned that 18 is a bit young but it seems to be the current definition of adult (can drink, drive a car, vote)

Personally I'd like to see the restrictions a little more relaxed but I'm happy for the process to go slowly.
OB
 
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Ignatius the Kiwi

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Limiting it to Australian citizens with 12 month residence in Victoria is intended to stop suicide tourism - people from other states or countries coming for the express purpose of assisted dying.
I'm concerned that 18 is a bit young but it seems to be the current definition of adult (can drink, drive a car, vote)

Personally I'd like to see the restrictions a little more relaxed but I'm happy for the process to go slowly.
OB
Why would suicide tourism be a bad thing? Wouldn't it be good for the Australian economy? Wouldn't it be a nice additional industry to add to Australia?

Also why assume 18 is too young? Recently a 17 year old killed herself in the Netherlands because of her rape and inability to get over that. Surely her death was necessary in order to preserve societal happiness.
 
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Occams Barber

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Nup, call it what you want its murder.
just as abortion is no matter what nice term you use.
Suicide is self murder.
Please don't think I am saying this from a pedestal, before being Christian I attempts at suicide and it is only since then I realise the value of life and that our lives are not ours to take.
And I have had loved ones that have had their passing drawn out, so I know what it is like.
If you have proper medical care there is no reason whatever to be in pain and I firmly believe our life is not ours to make a decision on.
As a Victorian, I am devastated that this has happened.
Regardless of the law and the so called stringent criteria set out, do you really believe in the "goodness" of mankind that this won't be the beginning of much, much more?


I believe that my life is my own to do with as I wish.

In time I'd like to see the rules relaxed. Not 'much, much more', just a little more.
OB
 
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Occams Barber

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Why would suicide tourism be a bad thing? Wouldn't it be good for the Australian economy? Wouldn't it be a nice additional industry to add to Australia?
Some people would agree with you, however the framers of the law didn't like the prospect of Victoria's medical facilities being swamped by suicide tourists or, of Vic getting a reputation as the Death State.

Give it time and other states will follow with similar legislation. It seems to have significant public support.

OB
 
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A couple of points:

Ending the lives of sufferers of disease removes the incentive to develop treatments for said disease. The smaller the population suffering from something, the less burden it is on the health system or society, and therefore will have less investment in it. Further there is a smaller pool of subjects for studies on it, or treatments to be applied to it. So once we start killing patients as a 'treatment' of a condition, it becomes the standard treatment in advance stages by default, as new treatments otherwise become improbable - from both economic and research grounds. There will also be less incentive for end of life care facilities, so killing someone at that stage will be favoured, simply by the self-fulfilling lack of appropriate care.

Doctors should also not be involved in this at all. Doctors are supposed to man the line border of Life, not allow the slip across it. There is a difference between not treating further, such as withdrawing treatment or not escalating intervention, and actively allowing a patient to kill themselves. What it does is muddy the waters. Doctors are supposed to do their utmost, but once a problematic patient is allowed to kill himself, in future 'doing your utmost' is weakened once you think that a viable, or maybe even preferred, option.

Deciding of 'sound mind' also makes little sense. Psychiatry determines that based on the social mileau. For instance, a Pentacostal speaking in tongues is in sound mind, while I would not be. Once society shifts, that barrier weakens significantly. A good example here is the Netherlands, where they allowed a 17 year old girl to starve herself to death for Post Traumatic Stress Disorder - that is not 'of sound mind' in my book, or would be seen as anything other than pathological in the Medical establishment here, but she was considered 'sound' in the Netherlands.
Personally, I consider the wish to kill yourself the very definition of madness though, requiring admission or at least Psychistric evaluation and Psychological treatment. It is a symptom of disease, and never a product of a 'sound mind', be it a Psychiatric disease, or part of the disease process in severe debilitating illness. Killing yourself is not treating this disease or symptom, merely negating it.

The end result will be a slippery slope, unfortunately. The Dutch and Belgians started out with the terminally ill, with stringent criteria and multiple evaluations, before it chipped away piecemeal. Today, 20 year olds can kill themselvesfor psychiatric disease without even being seen by a Psychiatrist, without exhaustive treatment having been tried.

There is a reason why Medicine has stood steadfast against this in general. My own country and the AMA, both recently reiterated the unacceptability of assisted suicide and Euthanasia. On purely secular grounds, without resorting to religious or such arguments, this does not bode well at all.
 
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Ignatius the Kiwi

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Some people would agree with you, however the framers of the law didn't like the prospect of Victoria's medical facilities being swamped by suicide tourists or, of Vic getting a reputation as the Death State.

Give it time and other states will follow with similar legislation. It seems to have significant public support.

OB

Death state? Why would anyone consider a state that kills people a Death state?
 
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Occams Barber

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Ending the lives of sufferers of disease removes the incentive to develop treatments for said disease. The smaller the population suffering from something, the less burden it is on the health system or society, and therefore will have less investment in it. Further there is a smaller pool ofsubjects for studies on it, or treatments to be applied to it. So once we start killing patients as a 'treatment' of a condition, it becomes the standard treatment in advance stages by default, as new treatments otherwise become improbable - from both economic and research grounds.
In this case the deaths are going to happen within six month. Based on data from other places the proportion of deaths by assisted dying is less than 1%. Spread this across a number of diseases/conditions and the research impact is negligible. I think your overblowing the problem.
Doctors should also not be involved in this at all. Doctors are supposed to man the line border of Life, not allow the slip across it. There is a difference between not treating further, such as withdrawing treatment or not escalating intervention, and actively allowing a patient to kill themselves. What it does is muddy the waters. Doctors are supposed to do their utmost, but once a problematic patient is allowed to kill himself, in future 'doing your utmost' is weakened once you think that a viable, or maybe even preferred, option.
In this scheme doctors can opt in or opt out. Why not leave them to decide? I know you're opposed but I suspect there are a number of doctors who see this as a compassionate act.
Deciding of 'sound mind' also makes little sense. Psychiatry determines that based on the social mileau. For instance, a Pentacostal speaking in tongues is in sound mind, while I would not be. Once society shifts, that barrier weakens significantly. A good example here is the Netherlands, where they allowed a 17 year old girl to starve herself to death for Post Traumatic Stress Disorder - that is not 'of sound mind' in my book, or would be seen as anything other than pathological in the Medical establishment here, but she was considered 'sound' in the Netherlands.

I'm not so sure about the Pentecostal. :rolleyes:

I also have concerns that people with a psychiatric condition could be drawn in to this. That's why detailed stats and monitoring are essential.
Personally, I consider the wish to kill yourself the very definition of madness though, requiring admission or at least Psychistric evaluation and Psychological treatment. It is a symptom of disease, and never a product of a 'sound mind', be it a Psychiatric disease, or part of the disease process in severe debilitating illness. Killing yourself is not treating this disease or symptom, merely negating it.
You're a Christian so of course you believe that life is sacred etc. etc. Personally, I think accepting your own death and taking control of your dying circumstances is the epitome of rational sanity. I don't wish to die but knowing I may have the possibility of exiting on my own terms is reassuring.

The end result will be a slippery slope, unfortunately. The Dutch and Belgians started out with the terminally ill, with stringent criteria and multiple evaluations, before it chipped away piecemeal. Today, 20 year olds can kill themselvesfor psychiatric disease without even being seen by a Psychiatrist, without exhaustive treatment having been tried.
I'm hoping for a little slippage in the slope but perhaps not as far as it seems to have gone in Europe.

I suspect that the spread of assisted dying/euthanasia is inevitable. It has both good and bad points. The trick will be minimising the bad while retaining the good.
OB
 
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now faith

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We knew it was on the way, justifiable homicide.
First Aboritions
Now so called mercy killing.
Next it will be the elderly.
Somehow those who promote death always have a altruistic reason for doing it.
Better term would be pseudo altruism.
I would say it is a pre planned agenda for the purposes of those in power.
It makes me wonder what is the agenda for all of us?
It seems the commericals come out just before the o set of illnesses.
Remember shingles?
One ad after another for shingles, then I started noticing more and more people with shingles.
Are we cash cows for big Pharmaceutical companies?
The Greek translation of pharmacy is Witchcraft.
 
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Occams Barber

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We knew it was on the way, justifiable homicide.
First Aboritions
Now so called mercy killing.
Next it will be the elderly.
Somehow those who promote death always have a altruistic reason for doing it.
Better term would be pseudo altruism.
I would say it is a pre planned agenda for the purposes of those in power.
It makes me wonder what is the agenda for all of us?
It seems the commericals come out just before the o set of illnesses.
Remember shingles?
One ad after another for shingles, then I started noticing more and more people with shingles.
Are we cash cows for big Pharmaceutical companies?
The Greek translation of pharmacy is Witchcraft.


If I mention 'Soylent Green' does it ring any bells? :eek:
OB
 
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In this case the deaths are going to happen within six month. Based on data from other places the proportion of deaths by assisted dying is less than 1%. Spread this across a number of diseases/conditions and the research impact is negligible. I think your overblowing the problem.
That "across a number of diseases and conditions" just hides the problem. Would it be 1% of Strokes in general? What of middle cerebral artery strokes? So a significant percentage of Stroke units lose research subjects, even more of specific subtypes. What of care facilities aimed specifically at these? Look at something like Huntingdon's Chorea - if anything is a good candidate, this would have been, but we are very close to curing it. Yet, it is rare. If even a tiny proportion was lost to assisted suicide, that would not have been the case.

No, this is a real problem, as there are often insufficient research cases as is, especially for the lower prevalence conditions or subtype presentations, and the percentages in specialised care facilities will certainly not be neglible. This is merely a way of hiding this, by generalising and lumping very different conditions and presentations together, and thus lose perspective. It is akin to saying we have no need for specific laws on incest say, because it is a small percentage of case law in sexual matters in general.

In this scheme doctors can opt in or opt out. Why not leave them to decide? I know you're opposed but I suspect there are a number of doctors who see this as a compassionate act
Because it poisons the well regardless. Again, the examples of the Low Countries are instructive. You don't ask wolves to defend sheepfolds, unless you make them into dogs.

You're a Christian so of course you believe that life is sacred etc. etc. Personally, I think accepting your own death and taking control of your dying circumstances is the epitome of rational sanity. I don't wish to die but knowing I may have the possibility of exiting on my own terms is reassuring.
Regardless of my faith, I disagree. I do not see how non-existence can ever be valued more than existence. How can we determine the proportion? How does a certain experience become a negative point trumping the other aspects of life? Who determined the relative values? This is hopelessly subjective. Something trumps Nothing always, in my opinion. Without bringing faith into it, I see literally no way to rationally argue for Euthanasia at all. You simply have no objective measures of varying levels of experience, and such subjectivity is why Euthanasia measures inevitably result in 'mental anguish' of stupid teenagers becoming seen as the equivalent of a terminal cancer patient's.
 
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Ignatius the Kiwi

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Awww. Now you're being sarcastic Iggy. ;)
OB
Yes I am, though I consider it a serious question. Why shouldn't we consider such an entity a death state? Why should Victoria limit the age? Do young people not experience trauma? Maybe someone's just tired of living. Who are we to stop them? Why not have a national industry of doctors killing people?
 
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Occams Barber

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That "across a number of diseases and conditions" just hides the problem. Would it be 1% of Strokes in general? What of middle cerebral artery strokes? So a significant percentage of Stroke units lose research subjects, even more of specific subtypes. What of care facilities aimed specifically at these? Look at something like Huntingdon's Chorea - if anything is a good candidate, this would have been, but we are very close to curing it. Yet, it is rare. If even a tiny proportion was lost to assisted suicide, that would not have been the case.
No, this is a real problem, as there are often insufficient research cases as is, especially for the lower prevalence conditions or subtype presentations, and the percentages in specialised care facilities will certainly not be neglible. This is merely a way of hiding this, by generalising and lumping very different conditions and presentations together, and thus lose perspective. It is akin to saying we have no need for specific laws on incest say, because it is a small percentage of case law in sexual matters in general.
You have this uncanny ability of making a short story long and wandering off piste.
1. These people will die within 6 months
2. Their (assisted) death represents a tiny proportion of the total deaths
3. Their conditions will be spread across a range of possible severe conditions
If you look at the probable research potential of no assisted death vs assisted death it's patently obvious that their (un)availability makes little difference.
In any case -do we have the right to keep them ticking over as oversized lab rats instead of allowing them a dignified release?
Because it poisons the well regardless. Again, the examples of the Low Countries are instructive. You don't ask wolves to defend sheepfolds, unless you make them into dogs.
Sorry. I got entirely lost in the metaphorical thicket and its relevance

Regardless of my faith, I disagree. I do not see how non-existence can ever be valued more than existence. How can we determine the proportion? How does a certain experience become a negative point trumping the other aspects of life? Who determined the relative values? This is hopelessly subjective. Something trumps Nothing always, in my opinion. Without bringing faith into it, I see literally no way to rationally argue for Euthanasia at all. You simply have no objective measures of varying levels of experience, and such subjectivity is why Euthanasia measures inevitably result in 'mental anguish' of stupid teenagers becoming seen as the equivalent of a terminal cancer patient's.
It's not up to you to determine anything. If things get too painful, or too undignified or too boring I will decide when its time to go. It's subjective, but if were talking about my life, it's my subjectivity that counts - not yours.
OB
 
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You have this uncanny ability of making a short story long and wandering off piste.
1. These people will die within 6 months
2. Their (assisted) death represents a tiny proportion of the total deaths
3. Their conditions will be spread across a range of possible severe conditions
If you look at the probable research potential of no assisted death vs assisted death it's patently obvious that their (un)availability makes little difference.
In any case -do we have the right to keep them ticking over as oversized lab rats instead of allowing them a dignified release?
As the record shows, it doesn't remain there. Nor is it us keeping them as labrats, but if they don't exist, there is no incentive to research that condition or develop ways to alleviate dysfunction - so it forces the question.
Sorry. I got entirely lost in the metaphorical thicket and its relevance
Pity. Doctors should be keepers of life, not arbitrers of death, or you compromise the former.

It's not up to you to determine anything. If things get too painful, or too undignified or too boring I will decide when its time to go. It's subjective, but if were talking about my life, it's my subjectivity that counts - not yours.
OB
So don't pretend it is rational then. It isn't. It is a purely emotional decision to choose a certain experience, pain say, as trumping all other experiences or potentiality of experiences or potentiality of treating or alleviating it
 
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