Dr. Cameron McLaren:

I practice within Victoria which was the first jurisdiction with legislation. I think the six-month requirement was also one of the points. I wrote them down so I will do them in that order. With our six-month requirement, I always talk to patients and say that the thing with people talking about this issues is that the majority of patients do not know they have six months to live until they have had a scan but then they have six weeks to live. It could be a case of one CT scan, where someone had been responding prior to it but the disease has suddenly progressed and we do not have any treatment options and we have to accelerate the palliative care pathway and journey. That transition is not smooth. It is more of a step type process. I think the six-month requirement is the most restrictive that I would recommend because on average, in Victoria, it takes between 25 to 30 days to get through the process. Someone in their last six months of life really will not enjoy spending a month of that through this process when they should be focussing that time on their family.

Interestingly, the committee may be aware that in Queensland has made it 12 months for all diagnoses. We are eagerly awaiting some feedback about how that goes and differences in that legislation. It has not been active for long enough to have a feel for that yet, however.

On the overbearing nature of legislation, it goes hand-in-hand with the evolution of the Victorian legislation, at the moment we are in our fifth year of activity in assisted dying. We are undergoing operational review of the legislation this year but I am not a legislator. There are many operational issues that cannot be resolved by legislative reform. It is a bit debated in many other states, as I think Dr. Allcroft mentioned before. Initiating the conversation about voluntary assisted dying is not allowed in Victoria or in South Australia. In some other jurisdictions it is allowed specifically in the context of a broader discussion about all treatment options. Those jurisdictions specify that it is not a health practitioner. It is a medical practitioner who is allowed to initiate those discussions. We have seen that be very beneficial for patients to be informed and to be aware of legislation and the options available. Patients are usually getting informed and educated about their healthcare options. Without the ability of being able to raise this as an option, one of my colleagues has said it is like being able to tell a patient, “You have a blocked artery in your heart and you can have tablets but I am not allowed to discuss surgery with you.” It does not lend itself to a fully informed nature of the care we are meant to be providing.