Northern Territory (NT) Labor is surveying whether there is public support for allowing people to access euthanasia because they are suffering from a mental illness, prompting concerns the government was considering offering vulnerable patients “death instead of the support they need”. With the NT planning on being the final jurisdiction in Australia to legalise voluntary assisted dying, residents have been encouraged to answer a government survey on how they think the Territory’s scheme should be designed. It includes a question of whether people should be able to use the scheme “if they only have a mental health condition as the reason for their access”. The survey also asked whether dementia patients should be able to initiate a plan to euthanise themselves when their disease has progressed to the point they can no longer consent. The questionnaire – which the Territory government itself describes as containing “controversial” ideas – also asks if the scheme should be limited to terminally ill people or to patients with a predicted life expectancy of six months for most conditions.
It also asks if a person should be able to use the scheme if they are not an NT resident but have “cultural or family connections” to the Territory. The NT government, now led by Labor Chief Minister Eva Lawler, began the consultation to reintroduce VAD laws in November, with the survey closing at the end of the month. The NT will follow the ACT in establishing a euthanasia scheme after federal parliament in 2022 overturned a 27-year ban on territories legalising the practice. Voluntary assisted dying is not available on the basis of a mental illness or dementia alone in any Australian state, with patients required to have a physical condition expected to cause their death in six to 12 months, depending on the jurisdiction. The ACT’s proposed model is the most liberal in Australia, but it only includes access for people with a terminal illness, with the Barr government to consider access for dementia patients after the scheme is operational.
Palliative care clinician Maria Cigolini, the administrator of advocacy group Health Professionals Say No, said the questions asked in the survey were “biased and insensitive to many of the issues that are facing Territorians and First Nations people”. Associate Professor Cigolini said it was problematic to introduce VAD legislation in the NT because of the significant health and social issues facing its large Indigenous population, and poor access to health services, including palliative care. “We already see in the Territory higher mortality rates, lower life expectancy, higher death rates from chronic disease, higher prevalence of mental health problems, high rates of alcohol abuse and smoking,” she said. “There is a crisis at the moment with crime and incarceration, and also poor access to healthcare and social services in general. “For example, for every dollar that is spent in mental health services in major cities in Australia only 10 per cent per capita is spent in remote rural areas.
“If you look at the First Nations suicide rates, they are twice the rate of non-Indigenous Australians, and in general there is a higher mortality in this group at a younger age. “So, what we really need is not another way for these people to die, what we need is upstream strategies to promote resilience and healing and access to healthcare and social services.” Associate Professor Cigolini said the prospect of mental health patients accessing voluntary assisted dying when they did not have a physical condition was concerning, especially against the backdrop of the shortage of mental health services. “What you’re doing is you’re offering them death instead of the support that they need,” Associate Professor Cigolini said. “You’re offering them death when they are experiencing duress from their illness and for which symptoms of this likely include suicidal risk and poor judgment or capacity.”
The Netherlands allows dementia patients to leave advance directives that they wish to access euthanasia once their disease has started to develop and allows for patients suffering from severe psychiatric disorders to access physician-assisted suicide. Belgium and Luxembourg also allow mental health patients to access VAD, with Canada last month postponing its own plans to allow euthanasia for mental illness. Former NT chief minister Marshall Perron, who oversaw Australia’s first VAD scheme in 1996, pushed for the government to legislate a framework for patients with an “incurable but not terminal condition” to leave advance directives for when they lose their faculties. “I strongly believe that it is simply a matter of time before the community desire for these initiatives will be met,” Mr. Perron said in his submission to the NT government. “The question is, will the NT parliament advance the case?” Northern Territory Voluntary Euthanasia Society president Judy Dent, whose husband, Robert, was the first Australian to access the NT’s VAD scheme before it was outlawed, said she supported including dementia patients in the framework. “You can’t turn dementia around, you’re not going to be able to cure them, so please give them the peace of mind that they’re not going to go on forever and ever,” Ms. Dent said.
Source: Compiled by APN from media reports
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