“When you’re faced with a terminal diagnosis, there are so many things to be afraid of and to worry about. What’s going to happen to your family? And then at some point, your mind turns to what will my death be like?” explains Scott Riddle, a man who, statistically speaking, shouldn’t be alive.
When Sydney-based Riddle was diagnosed with stage-four bowel cancer in 2017, he was told there was a 15% chance he’d still be alive in five years’ time. By then, the eldest of his three children would have been only 10 years old.
That’s when the now 42-year-old tech worker started on his “dual-track” strategy of unrelenting optimism and brutal pragmatism about his likely imminent death.
“I wrote handover documents for my wife with all our passwords and did videos for my kids,” he says.
“You have to keep in your head at the same time a level of optimism, but then a worst-case scenario.”
Over the proceeding years of treatment and time off work, Riddle – a self-described planner – learned about voluntary assisted dying. It wasn’t legal in his home state of New South Wales, so he lent his voice and time to the cause.
Riddle’s advocacy, alongside that of many others, saw voluntary assisted dying passed into law in May 2022 after independent Sydney MP Alex Greenwich introduced a bill into parliament the year before.
It was not supported by the premier or the opposition leader.
“That was particularly hard,” Greenwich recalls. “That said, both Dominic Perrottet and Chris Minns, who were genuinely opposed to the reform, also approached it with a great deal of leadership.
“They made it very clear to their parliamentary colleagues that this was a conscience vote and they should vote as their conscience directed them.”
Since the laws were passed, NSW Health has been working with medical practitioners and campaigners, and learning from experiences in other states, to give people access to voluntary assisted dying in time for the law coming into effect on Tuesday 28 November.
More than 100 doctors and nurses have completed their training and are now authorised to provide voluntary assisted dying services. Another 250 have started the accreditation process.
“All NSW residents have the right to access high-quality healthcare, including end-of-life care,” a health department spokesperson says.
NSW was the last state to legalise voluntary assisted dying and there are stringent eligibility guidelines.
Only adults will be able to apply and they need to have at least one advanced medical condition that will, on the balance of probabilities, cause a person’s death within six to 12 months, depending on their illness.
The person must be suffering in a way that cannot be relieved in a way they consider tolerable, and they must have decision-making capacity.
They also need to have voluntarily asked to access the process and have been asking for a prolonged period of time.
Go Gentle Australia’s chief executive, Dr Linda Swan, describes voluntary assisted dying as one of the biggest social reforms in NSW in decades. She says it hands power back to the individual after it was withheld by institutions for so long.
“Wondering and worrying about what your last week’s going look like can destroy your ability to live the life that you have left,” she says.
“In some strange way, voluntary assisted dying actually gives life back to dying people.”
She expects many people will ask about accessing the law quickly, acknowledging the pain of those who have died waiting.
“I’m sure the first couple of months will be quite busy because there are people who’ve been waiting for years and who probably can’t wait much longer,” she says.
“There are people who died waiting for this law to come into effect in NSW. There will be some families that are frustrated they still had to watch their loved one suffer unnecessarily.”
Voluntary assisted dying has been available in Victoria since 2019, in Western Australia since 2021, Tasmania since last year and Queensland and South Australia since January of this year.
For many, including Shayne Higson, the campaign was as personal as it was harrowing. The Dying with Dignity NSW chief executive has been pursuing the reform after watching her mother die from an aggressive brain cancer almost 11 years ago.
“She was only 77 and she had a lot to live for, wonderful grandchildren, but in the last few weeks she was so disabled … She was basically pleading for somebody to end the [pain] ,” Higson recalls.
“She wasn’t able to achieve a peaceful death and after witnessing that traumatic death, I made myself a promise that I would do everything I could to change the law.”
NSW health minister, Ryan Park, was in opposition when the law was passed but is now in charge of overseeing the implementation of the reforms. He thanks advocates such as Higson for their work.
“I know many people have worked incredibly hard to realise this scheme – both advocates and clinicians alike – and their efforts should be recognised,” he says.
For now, Sydney father Riddle considers himself one of the lucky ones. He is “cancer free” and hopes he never has to use the rights he fought for.
“No one wants to take their own life in that situation. You’re really worried about staying alive,” he says. “But knowing there is the option when you need it gives you immense peace of mind.
“It seems like a weird thing to get excited about. But if worst comes to worst, you have this choice. It’s great.”
