Loved-ones of Victorian euthanasia patients have decried barriers to accessing the assisted dying scheme, but the state government has ruled out radical reforms.
A peer-reviewed study from the Queensland University of Technology found Victoria's voluntary assisted dying scheme caused considerable distress.
Thirty-two family caregivers and one patient were interviewed in 2021 for the research, which was led by end-of-life law and regulation professor Ben White and is part of a broader study into euthanasia regulations in Australia, Canada and Belgium.
A Victorian ban on health practitioners initiating discussion on voluntary assisted dying was among several cited barriers for terminally ill patients.
While study participants understood its intent to ensure free choice, most were concerned that doctors were "muzzled" or "silenced".
"Some people found it difficult to raise the subject with their doctors and others described conversations that were 'awkward and a bit contorted' as they tried to find 'the right words'," the study found.
"Concerns were repeatedly expressed about the prohibition particularly reducing access for people from culturally and linguistically diverse backgrounds, and people with lower levels of education or poorer technology and information literacy."
It was ridiculous and borderline negligent, one interviewee said, that doctors could not proactively mention voluntary assisted dying.
"Not on their fault, but it's the equivalent of you're withholding an important medical and lifestyle option from a patient when they're facing into this difficult scenario," they said.
The rigidity of the Victorian legislation meant it required a determined person to raise it with their health team, another caregiver said.
Other access barriers included federal laws outlawing discussing assisted dying over telehealth, difficulty finding doctors, the length of the application process and institutional objections.
A woman said an aged-care home's objection resulted in her mother being wheeled out without being able to say goodbye to people.
"It will always be a great sadness for me that the last few precious hours on mum's last day were mostly filled with stress and distress, having to scurry around moving her out of her so-called 'home'," she said.
The researchers recommended increasing the pool of doctors willing and qualified to be involved in Victoria's scheme, and requiring objecting doctors to refer patients to a participating practitioner.
Premier Daniel Andrews defended Victoria's model, saying his government and the parliament set it up to be conservative.
"I don't think this system is going to change radically in any way," he told reporters on Wednesday.
"But we do want those to make that conscious decision ... to have access to this because that's the dignified thing for everyone to have that option, to have that choice."
Victoria became the first state to legalise euthanasia in 2019.
Western Australia, Queensland, NSW, Tasmania and South Australia have since passed legislation to allow the practice.
As of June 30, 2022, 1035 permits had been issued and 604 holders died under Victoria's laws.