Professor Nancy Preston:

I absolutely agree with the points the Senator made on families. Our recommendation is that when a patient has a consultation about an assisted death, they are informed about the potential impact for their immediate family who know what is happening and also the wider family, and that they start to consider how they would have those conversations. Even if that might be exhausting for a patient, other family members who are aware of the situation could have those conversations.

Bereavement support often comes through hospices.

Hospices often have, perhaps, a religious title but may not be a religious hospice but they are still called saint something. People feel unable to access them because they are concerned that they have committed an act they should not have and can sometimes feel excluded from bereavement services. Again, we should ensure that we are offering bereavement services to support people after an assisted death.

In navigating the system, I would say that that is as much for the patients and their families as it is for healthcare assistants. An example in Victoria when it first came in and was legislated for was that one had to have two specialists to complete the forms and to do the assessments. It becomes very difficult to find those people. In Switzerland, people get lost within the healthcare system asking palliative care doctors about an assisted death but they do not to help them. Only two of the people we ever interviewed said that they had even mentioned right-to-die associations. Patients are having to find out other ways to navigate that system. These are people who are ultimately dying and are quite unwell, so it is very hard for them to try to work out what the system they should be navigating is.

The other thing I would say about conscientious objection is that it is not an either-or decision, or it is not binary. A doctor or a nurse may decide that they would not actually help in physically administering a drug or prescribe one, but they might or might not be willing to do an assessment. They might be willing to say that there are right-to-die associations and they might not. They might make a bed for a patient who is receiving an assisted death and they might not. We found a real continuum on conscientious objections on certain levels as to what a doctor or nurse would be involved with and it was not always binary.