Dr. Greg Mewett:

In regard to the first question, there is some variability in the laws of the six states of Australia. The capital territory, which is Canberra, and the Northern Territory have now been given permission to debate the legislation and they will inevitably do that. Generally, in Australia, the criteria are that you must have an illness that is expected to cause your death within six months, or in less than 12 months in the case of a neurodegenerative disorder, which is classically something like motor neuron disease. After an extensive consultation and a law reform commission review, Queensland came to a conclusion, which I think this is correct, that there is no logical reason you should have a different six-month prognosis, for example, for cancer, and then have a 12-month prognosis for neurodegenerative disorders. There is no logical reason for that. In Queensland, they have said that you have to have an illness that is expected to cause your death within 12 months, regardless of the type of general illness. That is a major improvement and I hope that in other territories, when other states review their legislation, they will say that there is no reason for that.

There are a number of other criteria, for example, residential criteria. I will not go into great detail on that, because we have six states. That is quite different from what happens in Ireland, of course. You have to be a resident of that particular state. However, Queensland has made exceptions for that, which is useful, because a patient may travel from one state to another to be cared for by a relative at the end stage of their life. They should have access if they are living in that state. There have been some residential criteria which have been loosened up a little bit in Queensland.

The other point I made about the patients is that there is often the assumption that if you want to end your life, you must be suicidal. This is a huge issue that we do not have time to discuss today. I will say briefly that the American Association of Suicidology, AAS, which has been in existence since the mid-1960s, brought out a discussion paper on this a few years ago. It concluded that so-called physician-assisted suicide, as it is often called in the US, is not the same as voluntary assisted dying. In fact, voluntary assisted dying should not be called “assisted suicide”. Those patients are not suicidal and this conflates two very important societal issues. That is often done to try to blur the issues for people.

The patients I have looked after, without exception, are not depressed. They are not depressed to the point that it affects their decision-making capacity. Just because someone is a bit depressed, it does not mean it affects their decision-making capacity. Depression is a very broad term even in medicine. These patients would therefore be offended if someone said to them that they must be mentally ill because they want to kill themselves. No, they want to die a little earlier than they otherwise would.