Bottom-Up Approach

'Bottom-up' approach led to Victorian assisted dying laws; other States will follow, say researchers.

Two research papers released this week show how a citizen-driven 'bottom-up' approach led to the passing of Victoria's new voluntary assisted dying laws, Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven said today.

Victoria's Voluntary Assisted Dying Act was passed by the state parliament in December 2017 and will come into effect in June 2019 after an 18-month period of implementation work.

'On the basis of what occurred in Victoria, plus international trends, scientific evidence and changes to the local political environment, it is likely that similar reforms will become law in the other Australian states and territories', Ms Verhoeven said.

The two papers, published in the AHHA's Australian Health Review journal, are Documenting the process of developing the Victorian assisted dying legislation (author team led by Professor Margaret O'Connor, Monash University), and the Future of assisted dying reform in Australia (by Professors Ben White and Lindy Willmott, Queensland University of Technology).

Despite sustained law reform efforts in parliaments across the country over many years, Victoria is the first Australian jurisdiction to successfully legislate for voluntary assisted dying.

The lack of lasting legislative reform in other jurisdictions is surprising when public support for change has been very strong"estimated at 75% in an ABC survey in 2016.

'The authors say that the rise of individualism and personal autonomy in society has been a key factor in changing social attitudes to issues such as assisted dying', Ms Verhoeven said.

'They argue that "restlessness" in democratic societies can be attributed to individuals seeking to maximise their places in society through expressing their individuality and autonomy in various ways.

'This includes the rise of the consumer voice in healthcare, resulting in an increasing focus on consumer or patient decision-making, and a cultural shift away from traditional "top down" communication patterns to a more equal relationship between consumers, the professions and governments.

'The key to the legislative outcome in Victoria was that an inclusive public health approach was adopted, combining evidence, science and social action.

'The process began with a government request to the Parliamentary Legal and Social Issues Committee (Victoria) to inquire into the need for Victorians to make informed decisions regarding the end of their lives. Significantly, the Committee always comprises membership from all political parties and cross benches"and Parliaments across Australia are increasingly taking this kind of approach to complex social issues.

'The Committee sought input from all sectors of the community and received over 1,000 submissions before recommending legislating for voluntary assisted dying (VAD), using a cautious approach that was most likely to be passed in the Parliament"where VAD would only apply to people in the end stages of terminal illness, and with numerous safeguards and respect for conscientious objections.

'The government then formed an innovative seven-person Multidisciplinary Advisory Panel to progress the work, supported by Department of Health and Human Services staff. The legislation was never in question, only the shape of it with regard to eligibility, the request and assessment process, and oversight and governance. Again, consultation and listening to concerns were key, as well as catering for every detail.

'Ultimately the process achieved its aims and will serve as a model for other jurisdictions as they develop their own voluntary assisted dying legislation"I understand the Western Australian Parliament is currently considering this issue', Ms Verhoeven said.

The Australian Healthcare and Hospitals Association is the national peak body for public and not-for-profit hospitals, and community and primary healthcare services.