Dr. Peter Allcroft:

With reference to six months, you cannot be initially diagnosed with an illness. You need to be within that six month period but you may not appreciate you are in a six month period until you are asked the question. We have had a number of patients who ask for assessment for voluntary assisted dying. They get that assessment but they are found not to be eligible because the likelihood of dying within that timeframe of six months is quite remote. That does not mean they are abandoned. There might be a referral back to their general practitioner or active ongoing engagement with the palliative care team. The patient can reapply at a later date, so it is not an abandonment just because they may not have that six months.

On why people do not take the medications, they just choose to change their mind. They may feel very comfortable that they have it as their trump card and they are comfortable with the care they are receiving and do not need the medication. That could be comfortable physically but also existentially and psychologically. They may die as a result of the disease. Things change so we may use alternative medications for sedation at that time. They may lose capacity, that is, if they have a delirium as part of their illness which we see a lot in end-of-life care. If they lose capacity, they cannot make that choice themselves and their family cannot administer.

It is important to know that if you look at the figures around the world with regard to the slippery slope, particularly with legislation that is tight, it is around 1% to 2% of all anticipated deaths. That has not grown exponentially across time. In Australia, it is roughly working out to be around 1% to 1.5% of all anticipated deaths, so we have not seen that as a slippery slope.

I do not think I, as an individual, can say that someone's dignity is better or worse than others. It is a personal choice as to how that person deals with what is important to them and what their goals are. I do not think it is our right to be able to imply someone's dignity is less important because it is their meaningfulness in life.

Those are important aspects for people. It is the individual's understanding and the importance of their dignity, their contribution to society and their losses. With medical illnesses, the losses are cumulative.