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Concerns for impact of assisted dying law in aged care


Palliative Care Victoria has raised concerns for the aged care sector over the passing of voluntary euthanasia legislation in Victoria, the first state in Australia to do so, as sector peaks and providers prepare their responses.

The Voluntary Assisted Dying (VAD) Bill, which was passed by the Victorian Parliament on Wednesday evening, is due to come into operation in mid-2019.

The bill provides for and regulates access to voluntary assisted dying and establishes the Voluntary Assisted Dying Review Board.

Palliative Care Victoria CEO Odette Waanders said there appeared to have been no consultation regarding this bill with the Commonwealth, which has responsibility for most residential aged care services in Victoria, or with the special context of residential aged care facilities.

Around 50 per cent of residents do not have dementia so may meet the decision-making requirement under the bill and Victorians in residential aged care don’t have good access to palliative care now, which could influence decision making, she said.

“The priority need is for urgent action to improve access to high-quality palliative care and end-of-life care for Victorians, including those living in residential aged care facilities,” Ms Waanders said.

She has also raised concerns for aged staff, particularly personal care workers who make up most of a facility’s care team.

“The mandatory reporting provisions of the Voluntary Assisted Dying Bill 2017 only apply to health practitioners and would cover only 20 per cent of the staff involved in providing residential aged care services,” Ms Waanders said.

“The right of conscientious objection provided by the [bill] is currently limited to health practitioners, but it needs to apply to all staff working in residential aged care services or other aged, disability and community services that may be affected, as well as the organisations providing these services,” she said.

“There are likely to be other issues and concerns in addition to these, such as the use of voluntary assisted dying drugs that would need to be addressed in relation to the residential aged care setting.”

A spokesperson for Victorian Minister for Health Jill Hennessy said a Victorian with a terminal illness residing in an aged care home would need to satisfy all eligibility criteria to access voluntary assisted dying.

“The oversight provisions through the Voluntary Assisted Dying Review Board will operate regardless of the clinical or residential environment of the person making the request,” the spokesperson said.

The Commonwealth is monitoring the progress of the new Victorian law, Minister for Aged Care Ken Wyatt said.

“This is a significant issue that I am monitoring closely, to ensure our aged care system has adequate safeguards in place to protect the rights of senior Australians,” Mr Wyatt told AAA.

(L to R:) Ken Wyatt, Suzanne Greenwood, Sean Rooney and Sandra Hills

Industry response

Industry peak bodies, Catholic Health Australia, Leading Age Services Australia and Aged & Community Services Australia, said they are watching and planning how to provide guidance to members on these complex issues.

Suzanne Greenwood, CEO of CHA, which strongly opposes the law, told AAA that: “Voluntary assisted dying is not a part of our practice and is not something that we can assist any person with in their home, in our residential aged care facilities, or in our hospitals.”

LASA CEO Sean Rooney said LASA would also assist its members with practical information for those that decide not to participate in the assisted dying provisions.

“We will advocate to the Victorian state government that all aged care providers are adequately resourced for and informed on the practical issues arising from the voluntary assisted dying,” Mr Rooney told AAA.

Victorian provider Benetas has already started preparing for the bill’s implementation, according to CEO Sandra Hills.

“We are currently developing an implementation plan that among other things identifies emotional, regulatory, compliance and operational issues associated with the changes, and develops procedures, a communication strategy and training and development,” Ms Hills told AAA.

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