industry & reform
Voluntary assisted dying was in legalised in NSW after years of debate . Picture : Jeremy Piper / NewsCorp
“ There ’ s a clash between the conscientious objection rights of organisations and the rights of patients .
A matter of choice
Experts forecast disputes in aged care as voluntary assisted dying is legalised in NSW .
By Elise Hartevelt
Experts have said aged care providers will face considerable challenges when voluntary assisted dying ( VAD ) laws come into force in NSW in 2023 .
The bill was recently passed in the NSW parliament after decades of debate and will allow those who are terminally ill to access euthanasia .
While polls indicated that over 85 per cent of older people supported access to VAD , experts expect not everyone will be willing to follow the legislation .
Penny Hackett , president of advocacy organisation Dying with Dignity has been pushing for the legalisation of VAD since the ‘ 70s .
“ There have been stories in other jurisdictions like Canada and Victoria of aged care providers refusing to allow people to access it on their premises ,” she says .
“ Healthcare is a person ’ s right – they ’ re entitled to have the medical care of their choice without being impeded by the operator .
“ Unfortunately , there ’ s a clash between the conscientious objection rights of organisations and the rights of patients in aged care .
“ They may require that their staff don ’ t be involved and that ’ s understood , but they can ’ t prevent doctors from coming to consult with patients and administering the VAD substance ,” Hackett says .
Victoria spearheaded the legalisation of VAD and has since reported that 836 people had sought a permit , of which 331 people had passed away from the prescribed medications .
Though the state has overcome its initial teething problems , it still grapples with a lack of access to telehealth and trained practitioners .
Hackett anticipates similar roadblocks in NSW , and says that “ it has proven quite difficult for people to access VAD because the medical profession is not prepared for it ”.
“ Certainly , in the early stages , it will be hard to find enough doctors willing to sign up to do the training and be prepared to participate in the VAD process ,” Hackett says .
Opposed aged care facilities have said the bill forces them to comply with VAD and disregards their principles and beliefs .
“ We acknowledge that some people have a religious objection to this , but denying those who don ’ t have access to available medical treatment is akin to abandoning their duty of care to the patients ,” Hackett says .
State director of the conservative Christian organisation FamilyVoice Australia , Greg Bondar , has also been campaigning during talks about the VAD bill .
“ It ’ s a very dark day for NSW because it has removed the levity of conscientious objection from people who do not want to submit or be part of VAD ,” Bondar said .
Bondar is backed by the Anglican Church and Catholic Church , who echo that “ from a Christian point of view , life can only be given and taken away by the creator ”.
Homes such as Catholic Health Australia and HammondCare have voiced strong objections , while Uniting Care has agreed to VAD in their facilities .
Aged Care Insite asked the general manager of Health and Palliative Care at HammondCare , Andrew Montague , how they expect to implement VAD in their facilities .
“ HammondCare will be working with the relevant departments to ensure we follow the legislation .
“ As an organisation , we have to be very conscious of how we will participate and that will become much clearer once we ’ ve had these discussions with NSW health ,” Montague says .
“ We ’ ll also make it really clear to staff on the ground if they ’ re asked about VAD , what information they can actually provide .
During the bill ’ s passage , HammondCare endorsed palliative care as the best approach for those who are terminally ill .
Yet , Montague says that “ access to palliative care for aged care residents is quite a small percentage of people who actually get and are able to receive formal palliative care ”.
In 2021 , just under 2 per cent of older people in aged care received palliative care .
“ What really concerned us was that the whole palliative discussion was lost in the VAD debate ,” Montague said .
COTA NSW CEO Meagan Lawson says palliative care will continue to play a significant role in end-of-life support , alongside VAD .
“ I hope politicians keep talking about palliative care and provide additional funding to ensure that every person who needs palliative care gets access to it ,” she says .
“ It ’ s about a level of respect for the people who are paying you for the services they are using , and respecting their rights and agency to make decisions about their own bodies .” ■ nursingreview . com . au | 9