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Removing the Prohibition to Telehealth Consultations for VAD

Updated: Sep 8


FORE Australia Reporter: Christopher Noonan

Publish Date: 07/9/2024







Problem Identification: 

Telehealth consultations for Voluntary Assisted Dying (VAD) are illegal in Australia. 


Section 474.29A of the Commonwealth Criminal Code 1995 prohibits the use of a ‘carriage service’ to counsel or incite suicide, or to provide instructions on particular methods for committing suicide.


This means that patients in regional areas, or those who are immobile, face significant barriers to accessing VAD services. This could delay or prevent access to the necessary consultations and support, especially for those patients living in regional areas. 

Context: 

Solution Identification: 

Advice: 


Download the 1-page policy brief PDF here:



 

Endorsed by: 


Public Support: 

Katherine Waller:

Ben White:

Lindy Willmott:

Casey Haining: 

Eliana Close:

Dying with Dignity Victoria: 

Go Gentle Australia: 

Voluntary Assisted Dying Australia and New Zealand: 




Where to go to learn more: 

  1. White, B., Willmott, L., Haining, C., Del Villar, K., & Close, E. (2023). Commonwealth telehealth ban is an unfair barrier to seeking voluntary assisted dying.https://eprints.qut.edu.au/244543/1/Commonwealth_telehealth_ban_is_unfair_barrier_to_VAD_Research_briefing.pdf 

  2. Go Gentle Australia, Joint Statement: Electronic communications must be available for voluntary assisted dying (Aug 2024). https://assets.nationbuilder.com/gogentleaustralia/pages/3036/attachments/original/1722389765/Joint_statement_Electronic_communications_and_VAD.pdf?1722389765 

  3. Davey, M., Kolovos, B., & editor, M. D. M. (2023, November 30). Telehealth consultations for voluntary assisted dying are illegal under Australian law, court finds. The Guardian. https://www.theguardian.com/australia-news/2023/nov/30/voluntary-assisted-dying-bill-australia-telehealth-illegal 


Lived Experience: 

Tom’s Story: Tom was a 79 year old with lung cancer in far-north Queensland who requested access to Voluntary Assisted Dying. This involved being assessed by two separate doctors to determine Tom’s eligibility. Tom was too ill to travel, and telehealth consultations were prohibited. The first doctor therefore had to travel 3000km to assess Tom, followed by a second doctor a week later who traveled 2,500km. The first doctor then made the 3000km journey once more to witness Tom’s final request for VAD. The teleleath ban means that prescriptions for the life-ending medication have to be hand-delivered, and so the pharmacy only received Tom’s prescription after his final request was witnessed. Tom died before his prescription could be delivered. Instead of the autonomy and dignity that Tom could have been afforded through VAD, Tom spent his final days uncertain and in pain. This could have been avoided if telehealth was available to expedite his application. 



Reference list (name, date): 

  1. Assisted dying assessment processes – Health New Zealand | Te Whatu Ora. (2018). Govt.nz. https://www.tewhatuora.govt.nz/health-services-and-programmes/assisted-dying-service/assisted-dying-information-for-the-public/assisted-dying-assessment-processes/

  2. Australia’s Suice Prevention Leaders. (Nov 2023). Voluntary Assisted Dying Should Not Be Described as Suicice. In www.assets.nationbuilder.com. Go Gentle Australia. https://assets.nationbuilder.com/gogentleaustralia/pages/2982/attachments/original/1702513241/Joint_statement.pdf?1702513241  https://assets.nationbuilder.com/gogentleaustralia/pages/2982/attachments/original/1702513241/Joint_statement.pdf?1702513241.

  3. Close, E., Del Villar, K., Willmott, L., & White, B. P. (2021). Voluntary assisted dying and telehealth: Commonwealth carriage service laws are putting clinicians at risk. Medical Journal of Australia. https://doi.org/10.5694/mja2.51287

  4. Commonwealth Criminal Code, 1995. 

  5. Davey, M., Kolovos, B., & editor, M. D. M. (2023, November 30). Telehealth consultations for voluntary assisted dying are illegal under Australian law, court finds. The Guardian. https://www.theguardian.com/australia-news/2023/nov/30/voluntary-assisted-dying-bill-australia-telehealth-illegal

  6. Del Villar, K., White, B. P., Close, E., & Willmott, L. (2022). Voluntary Assisted Dying by Practitioner Administration Is Not Suicide: A Way Past the Commonwealth Criminal Code? Journal of Law and Medicine, 29(1), 129–141. https://eprints.qut.edu.au/229735/

  7. Dion, S., Wiebe, E., & Kelly, M. (2019). Quality of care with telemedicine for medical assistance in dying eligibility assessments: a mixed-methods study. CMAJ Open, 7(4), E721–E729. https://doi.org/10.9778/cmajo.20190111

  8. Directorate, J. and C. S. (2023, February 7). Voluntary assisted dying laws in the ACT. Www.justice.act.gov.au. https://www.justice.act.gov.au/justice-programs-and-initiatives/voluntary-assisted-dying-laws-in-the-act

  9. HealthLeaders. (2022). Vermont Amends Assisted Suicide Law to Include Telemedicine. Healthleadersmedia.com. https://www.healthleadersmedia.com/telehealth/vermont-amends-assisted-suicide-law-include-telemedicine

  10. K, W., K, D. V., L, W., & BP, W. (2023). Voluntary assisted dying in Australia: a comparative and critical analysis of state laws. UNSW Law Journal , 46(4).

  11. May, N., & Luca Ittimani. (2024, August 11). Too complex, too late: the guardrails acting as roadblocks to voluntary assisted dying across Australia. The Guardian; The Guardian. https://www.theguardian.com/australia-news/article/2024/aug/12/too-complex-too-late-the-guardrails-acting-as-roadblocks-to-voluntary-assisted-dying-across-australia

  12. Payne, H. (2024, February 13). New bill to legalise telehealth VAD - Medical Republic. Medical Republic. https://www.medicalrepublic.com.au/new-bill-to-legalise-telehealth-vad/105082

  13. Submission to the Centre for Evaluation and Research Evidence at the Victorian Department of Health. (2024). Dying with Dignity Victoria . https://www.dwdv.org.au/wp-content/uploads/2024/02/DWDV-submission-to-Victorian-VAD-5-Year-Review.pdf 

  14. Telehealth continues to be illegal for terminally ill people seeking Voluntary Assisted Dying – Dying With Dignity Victoria. (2023, November 30). Dwdv.org.au. https://www.dwdv.org.au/telehealth-continues-to-be-illegal-for-terminally-ill-people-seeking-voluntary-assisted-dying/

  15. Vermont Ethics Network (n. d.). Medical Aid in Dying, Act 39: Patient Choice and Control at the End of Life. www.vtethicsnetwork.org https://vtethicsnetwork.org/palliative-and-end-of-life-care/medical-aid-in-dying-act-39#:~:text=In%20May%20of%202023%2C%20Vermont,in%20which%20they%20legally%20reside.  

  16. Voluntary Assisted Dying Australia and New Zealand. (2024). Submission to Review of the operation of the Voluntary Assisted Dying Act 2017 (Victoria). https://www.vadanz.com.au/content/uploads/VIC-VAD-Review-VADANZ-submission.pdf

  17. Voluntary assisted dying (VAD) in the Northern Territory | Have Your Say Northern Territory. (n.d.). Haveyoursay.nt.gov.au. https://haveyoursay.nt.gov.au/vad 

  18. Voluntary Assisted Dying Review Board. (2023). Annual Report July 2022 to June 2023. In www.safercare.voc.gov.au. Safer Care Victoria. https://www.safercare.vic.gov.au/sites/default/files/2023-08/VADRB%20Annual%20Report%202022-23.pdf 

  19. White, B., Willmott, L., Haining, C., Del Villar, K., & Close, E. (2023). Commonwealth telehealth ban is an unfair barrier to seeking voluntary assisted dying. https://eprints.qut.edu.au/244543/1/Commonwealth_telehealth_ban_is_unfair_barrier_to_VAD_Research_briefing.pdf 



Conflict of interest / acknowledgment statement: 

N/A.




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