Allowing doctors to start conversations with terminally ill patients about voluntary assisted dying will not be considered under a review of Victoria’s euthanasia laws – sparking criticism from advocates who say it is a missed opportunity for reform.
A five-year review of the dying laws is open for public submissions and will consider issues including access to the scheme and safeguards. Advocates say Victoria – which in 2017 became the first Australian jurisdiction to legalise VAD – is now lagging behind other jurisdictions.
Advocates have pushed for key changes including allowing scrapping the gag clause that prevents doctors from starting conversations with patients and expanding the scheme to people with dementia.
But the review will not consider changes to the legal framework – rather it will focus on how the laws operate.
Jane Morris, the president of Dying with Dignity, said the review would not address the main concerns people had raised with her organisation.
They included the gag clause and a requirement for patients to have a prognosis of death within six months or one year for neurodegenerative diseases.
“A lot of people were hoping this review would bring about change [but] we’re not very hopeful at all that we’re going to achieve much at all,” Morrison told Guardian Australia.
Under the laws, it is illegal for a doctor to start a conversation about voluntary assisted dying with a terminally ill patient. The safeguard – one of 68 in the legislation – is designed to prevent coercion.
In Western Australia, Tasmania, Queensland and New South Wales, medical practitioners can bring up VAD but must also discuss treatment and palliative care options at the same time.
Morris said some of the safeguards had become barriers for people to access VAD. She said expanding the scheme to people with dementia should also be investigated.
“We know it’s something that’s not going to happen overnight,” she said. “It’s going to be a very long, complex and contentious path to go down. But we do think we need to start a discussion about it.”
Nick Carr, a Melbourne doctor who has assisted 60 people legally end their lives, hoped the mandated review would be an opportunity to examine the operation of the laws and “the substance of the act itself”.
He argued that the gag clause prevented people from marginalised backgrounds from gaining access to VAD. “It’s not actually a safeguard, it’s a restriction that is preventing us telling people what is a medically available option,” he said.
“It’s impossible, from our view, for people to make a proper and informed choice about their end-of-life care if we can’t tell them about one of the options.”
In November Carr lost a legal challenge in the federal court against the commonwealth over its law banning discussions about suicide over phone or email, or in a telehealth appointment.
Carr had launched the legal action to clarify the definition of suicide in the commonwealth criminal code and whether it applied to state legislation.
The court ruled that telehealth consultations about VAD were illegal, in a judgment on an aspect of the law that had long been considered a grey area.
Victoria’s VAD legislation requires the government to undertake a review of how the laws have operated over their first four years. It does not rule out legislative changes.
A Victorian government spokesperson said it was complying with the requirement of the review outlined in the legislation.
“Our first-in-the-nation voluntary assisted dying laws are giving Victorians with an incurable illness at the end of their lives a compassionate choice,” the spokesperson said on Sunday.
“The review is not an assessment of the voluntary assisted dying legislation itself, but rather will consider how the laws have been implemented in Victoria and whether improvements can be made to how this is done in future.”
The review is due to be tabled in parliament later this year.
