About 400 terminally ill adults are expected to use Queensland's voluntary assisted dying laws to legally end their lives during the first 12 months of the new laws coming into effect.
The modelling by Queensland Health, based on rates in Western Australia and Victoria, projects there could potentially be 380 to 430 deaths through the scheme in 2023.
Queensland's voluntary assisted dying (VAD) laws come into effect on January 1 — almost 15 months after the legislation passed state parliament.
Professor Keith McNeil, the chair of Queensland's VAD implementation taskforce, believes it is the "biggest piece of social legislation" the state has introduced in his lifetime.
"This is introducing a new service at a social scale. I can't think of anything bigger, really," he told the ABC.
With just over a month to go until VAD becomes available, Professor McNeil said the implementation process was "going to plan", but nominated training enough practitioners like doctors and registered nurses for the roles as a priority.
"The big-ticket item now is getting clinical practitioners … to put their hands forward, getting them trained and then approved to provide the service," he said.
"But all of the processes are coming into alignment. We fully expect we'll be ready to go on the first of January."
So far, more than 240 clinicians have expressed interest in the training.
Given Queensland's vast geography, Professor McNeil confirmed there were contingency plans in case a regional or remote community did not have a local approved VAD practitioner.
One option was sending a practitioner to the patient.
"We have a travel scheme which enables [the practitioner] to go to the patient or consumer, and that will allow us to get right out to the very reaches of remote Queensland," he said.
"We expect GPs will really put up their hands… and we're seeing that already, which is great.
"And as we gather momentum and as the process starts, we fully expect that more and more people will come on board."
Associate Professor Harry Jacobs, a retired GP and the Royal Australian College of General Practitioners' representative on the VAD implementation taskforce, said there has been "considerable interest" from Queensland GPs.
He acknowledged the VAD workload could be a worry "if you don't know the patient", but suspected most GPs would be dealing with their regular patients.
Having undergone the mandatory training himself, he encouraged his colleagues to think about it too.
"This is not teaching doctors how to talk to patients or to do palliative care, these are specific instructions about the legislation and how to comply with the legislation," he said.
"It is important to understand the law — whether you're going to say yes I'm going to help you, or no I'm not – you really need to comply with the law."
How to access voluntary assisted dying
A person must be:
- At least 18 years old;
- Have an eligible condition that is advanced and progressive, expected to cause death within 12 months, and causing intolerable suffering;
- Have decision-making capacity;
- Be acting voluntarily and without coercion; and
- Fulfil a residency requirement.
That person must be separately and independently assessed by two doctors and make three different requests at least nine days apart from the first and last.
Between 800 and 1,100 people are estimated to seek a "first assessment" — when a coordinating doctor assesses whether the personal is eligible under the laws – during the first year of the VAD scheme, according to Queensland Health's modelling.
Faith-based aged care facilities do not have to participate in VAD but under the laws must not create barriers for their residents who want to use it. This means they have to allow other medical practitioners "reasonable" access.
Professor McNeil said the conversations over the past 12 months with faith-based organisations have been "very good" and "collegial".
"Everybody has been understanding, they've been respectful. And I think we have a good way forward there," he said.
"Now, do I think it's going to be all worked out on day one? No. There'll no doubt be issues that come up. But we'll deal with those."
The review board — described as an independent oversight body — will track VAD cases and identify any issues, including any equity or access concerns.
"We're keen to make sure we get it right," Professor McNeil said.
In a statement, Catholic Health Australia's strategy and mission director Brigid Meney said Catholic hospitals, aged care and other care services will not be providing VAD services at any of its facilities.
But she said some residents may wish to explore the option while under their care and they are committed to receiving any enquiries about VAD "in a compassionate and respectful manner".
"Throughout [the] process of communication Catholic facilities have developed a pathway consistent with our ethics and the law as it currently stands," she said.
"We will continue to analyse and assess these laws in practice, to ensure this remains the case."
Ann's mum went through the process. She says it was calm and quick
Ann Bonner's family has been through the process interstate.
In 2020, doctors told her Melbourne-based mother Vera Hunt that her cancers had progressed and they estimated she had about six months to live.
"It was around that mark she really deteriorated; her quality of life was really poor," Ms Bonner said.
"She was saying in the middle of the night to me that she thought the time was now and she'd like to start the [voluntary assisted dying] process."
Victoria was the first state in Australia to legalise voluntary assisted dying and it came into effect there in 2019 with strict eligibility criteria.
"For Mum, voluntary assisted dying was about giving her a choice, a choice as to when or if she decided to end her life sooner," Ms Bonner said.
"It wasn't a sudden decision, she had the medication available for a good four months. It wasn't a set date or event, it was when she felt the time was right."
She chose to end her life using VAD in late March 2021.
"We were all there to support her, she also spoke with her sister in London, and also her other granddaughter in London and they were Facetiming each other," she said.
"It was peaceful, it was calm and it was quick. It was clear Mum was not suffering at all."
Ms Bonner acknowledged the VAD process can be a "hard thing for families" but urged others to listen to their relatives who might be considering accessing it.
"Listen to them … it's their decision and their choice and to me that's the best thing a loved one could do," she said.
