Euthanasia and assistance to suicide became legal in South Australia from 1 January 2023 under the Voluntary Assisted Dying Act 2021.
In the first three months of legalization (31 January – 30 April 2023), 8 people died by suicide following prescription of a lethal substance and a further 3 people died by euthanasia following administration of a lethal substance by a medical practitioner. This represents about 0.3% of all deaths in that period.
In the next two months (1 May 2023-30 June 2023) a further 19 people died by suicide following prescription of a lethal substance and a further 8 people died by euthanasia following administration of a lethal substance by a medical practitioner. This represents about 1% of all deaths in that period.
Eligibility criteria include a prognosis that death is expected within 6 months (or 12 months in the case of a neurodegenerative condition) from an incurable disease, illness or medical condition.
One of the two assessing medical practitioners “must have relevant expertise and experience in the disease, illness or medical condition expected to cause the death of the person being assessed”.
The law generally requires a nine-day period between a first and final request but this can be waived if two medical practitioners agree the person may die within that period.
Euthanasia (practitioner administration of a lethal poison) may only be applied for if a medical practitioner professes to be satisfied that the person “is physically incapable of the self-administration or digestion of an appropriate [lethal] poison”.
Government facilitation of suicide and euthanasia
Under the Act no person may commit suicide with a prescribed lethal poison or be administered a lethal poison by a medical practitioner without a permit issued by the Chief Executive of the Department for Health and Wellbeing! This power to issue suicide/euthanasia permits can be delegated to any person or body.
The South Australian Government has established the South Australian Voluntary Assisted Dying Care Navigator Service which will directly link a person seeking to end their life with a medical practitioner willing to help them do so.
The South Australian voluntary assisted dying pharmacy service is funded to supply the lethal poisons for suicide to individuals and for euthanasia to administering medical practitioners.
The only data required to be collected and made public in an annual report is on the number of permits issued, the number of people who die after self-administration or practitioner administration of a prescribed lethal poison, their age at time of death and the underlying condition for which they were assessed as eligible.
No data on referrals for additional assessments of eligibility or decision-making capacity is to be collected. Nor is there any provision for reporting on complications, the time between administration of the poison and loss of consciousness, or the time between administration of the poison and death.
Given the general complication rate of 7% or higher reported from other jurisdictions this is a concerning lack of transparency that undermines any future claim that there are no problems with the practice of assistance to suicide and euthanasia in South Australia. We will never know.
No safe space
The Act imposes on all residential aged care facilities in South Australia the obligation to allow suicide and euthanasia by lethal poison on their premises for any permanent resident of the facility and for any other resident where a “deciding medical practitioner” determines transferring the person for this purpose is not “reasonable”.
This is a violation of the human rights of freedom of association, freedom of religion and freedom of conscience. The elderly should be able to choose to live in a place where no-one is intentionally killed or helped to commit suicide.