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First permit issued under Australian state's assisted suicide, euthanasia law

The Alfred Hospital in Melbourne, where pharmacists will prepared and mix the drugs for assisted suicides in Victoria. / Alfred Health via Wikimedia (CC BY-SA 4.0).

The first permit for medically assisted death in Victoria was issued in recent weeks, less than a month after the Australian state's legalization of voluntary assisted suicide and euthanasia took effect.

The Voluntary Assisted Dying Act 2017 allows adult Victoria residents who are terminally ill, expected to die within six months (or 12 if they have a neurodegenerative condition), and mentally competent, to ask their doctor to prescribe drugs that will end their lives. The law took effect June 19.

Two doctors must verify the requester's eligibility, and the person must make three requests for assisted suicide or euthanasia. Those seeking to end their lives must have lived in Victoria for at least a year, and be an Australian citizen or permanent resident.

Neither the identity nor the medical condition of the person granted a permit to commit suicide have been released.

A spokesperson for the Victorian health department told the ABC that the state's "model for the voluntary assisted dying system is working."

"We know that doctors are talking to patients about voluntary assisted dying and are carrying out assessments."

Under the law, pharmacists at The Alfred Hospital will prepare and supply the mixture of drugs. They will deliver to the terminally ill the dose of about 100mL of liquid in a locked box with a key.

The box will include instructions on how to mix and drink the drugs, "and there is no expiry date on when the drugs can be consumed," Melbourne daily The Age reported in June.

Physicians will be allowed to administer the drugs via an intravenous drip to those incapable of swallowing.

Health practicioners are granted conscientious objection rights against participation in euthanasia or assisted suicide under the law.

About 100 doctors across the nearly 92,000 square mile state "have began receiving the mandatory training required to be allowed to assist terminally ill patients who need medical help to die," according to The Age.

A review board of 13 medical and legal experts will review assisted suicide-euthanasia applications after the fact to ensure compliance with the law. The board will also be able to recommend improvements to the state government, and refer breaches to police, coronors, or the Australian Health Practicioner Regulation Agency.

The Victorian health minister, Jenny Mikakos, has said the state expects about a dozen people to utilize assisted suicide or euthanasia during the first year the law is in effect. She expects this number to top out at about 150 people each year. There are about 6.5 million Victorian residents.

Efforts to expand access to assisted suicide and euthanasia have grown in recent years. Presently, at least one of the practices is legal in nine US states and the District of Columbia, as well as in all Canada, Switzerland, the Netherlands, Belgium, Luxembourg, and Colombia.

Victoria is the only Australian jurisdiction where assisted suicide or euthanasia are legal.

Advocates for assisted suicide and euthanasia have said the eligibility requirements are too onerous, and intend to challenge them in court, but do hope other Australian states will follow Victoria's lead.

Queensland and Western Australia are considering similar bills.

New South Wales rejected such a bill in 2017, as did the national parliament in 2016, and that of Tasmania in 2013.

The Northern Territory legalized assisted suicide in 1995, but the Australian parliament overturned the law two years later.

The four Latin rite ordinaries in Victoria wrote a pastoral letter denouncing the state's "new, and deeply troubling chapter of health care" when the Voluntary Assisted Dying Act 2017 took effect.

In a June 14 letter, the bishops of Melbourne, Ballarat, Sale, and Sandhurst wrote that "We cannot cooperate with the facilitation of suicide, even when it seems motivated by empathy or kindness."

"What is being referred to as 'VAD' is a combination of what in plain- speaking is more commonly known as physician assisted suicide and euthanasia," they said.

"We feel a responsibility not just to say 'no' to VAD, but to give every encouragement to model a way of life that renders VAD unnecessary."

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