Despite no bill currently before the Legislative Assembly, the ACT government is insisting that Canberrans will have access to voluntary assisted dying in future, with laws that could differ significantly from those in other jurisdictions.
The ability to debate voluntary assisted dying was only recently returned to the territories after the Territory Rights Bill passed federal parliament late last year, overturning a 25-year ban.
Anticipating that outcome, ACT lawmakers, including Human Rights Minister Tara Cheyne, have been taking a closer look at laws already passed in all of Australia's six states.
In conducting the research, she said one complication that was found to be occurring interstate was a reluctance from some doctors to offer a timeline as part of their prognosis.
In most states, two doctors must decide that a patient has an incurable, advanced and progressive condition that is expected to cause death within six months.
But Ms Cheyne said that requirement was "fraught" because "terminal illnesses do not have a straightforward timeline".
She said she was aware of some interstate patients who were unable to get an expected timeline for their death "until it was just mere weeks that they had left to live".
Opportunity to craft laws that reflect 'unique characteristics' of Canberra community
Ms Cheyne said rather than requiring a timeline, potential legislation in the ACT could stipulate that a person was eligible for the process if they had a prognosis that indicated there was suffering and that death was "reasonable and predicted".
The ACT government has opened public consultation on how the law might look before it takes the legislation to the assembly for debate.
"We will have voluntary assisted dying laws, the question is, what will they look like," Ms Cheyne said.
"We're our own jurisdiction and while all of the states have broadly similar legislation, none of the states have identical legislation.
"So, there is an opportunity for us here to craft legislation that is broadly consistent but also reflects our own unique characteristics of the Canberra community."
Will nurse practitioners play a role?
Ms Cheyne said one of the questions being asked as part of consultations was whether there was a role for nurse practitioners.
"We're wondering quite openly: is there also a role for our nurse practitioners who are quite specialised and trained?"
She said nurse practitioners "could potentially be one of the [medical practitioners who assess patients], or, as is the case in some jurisdictions, be part of administering medications."
The Australian Medical Association's ACT branch president Dr Walter Abhayaratna did not disagree with the suggestion that nurse practitioners could play a key role, but said if the ACT's program was similar to other states, "it would require … two doctors making the decisions".
"And at the moment, those decisions are based on medical decisions because [voluntary assisted dying] does require an assessment of a patient's chronic disease, which could be a disease that's potentially going to cause death in six months," he said.
"There are also neurodegenerative diseases that have an expected 12-month timeline and these are all decisions that require medical knowledge, so traditionally it would be a medical doctor who would make those decisions."
He added that the ACT government should look closely at the resources needed for implementing voluntary assisted dying in Canberra, including the availability of doctors.
"Because certainly our palliative care services could be improved," Dr Abhayaratna said.
Will younger Canberrans have access?
Ms Cheyne said she expected the debate about age eligibility to form a key part of consultations.
She said young people had an "evolving capacity to make decisions about their best interests" and that extended to their medical needs.
"This is not about the capacity of five-year-olds to make decisions in their best interests … but, the law does recognise that as children age, and particularly in their later teen years, they develop maturity."
She said she did not have a "predetermined view" about an age limit for accessing voluntary assisted dying in the ACT, and said the autonomy of children as decision makers in medical decisions was generally a "case-by-case basis."
The ACT government said it expected to put a voluntary assisted dying bill before the assembly in the second half of this year.
