To qualify for assisted suicide or euthanasia the person’s medical condition needs to be an advanced illness that is irreversible and incurable and for their death to be expected within 6 months or 12 months for a neurodegenerative condition. The person can also qualify even if they refuse, or request the withdraw of, treatment that can prolong their life possibly for many years. For instance a type I diabetic could qualify if they refuse to have insulin injections.

A patient is defined to be suffering intolerably if they are experiencing “persistent suffering [due to physical or mental pain] that is, in the opinion of the person, intolerable,” and is being caused by their relevant medical condition, their treatment or any complications. The person is not obliged to take any treatment that might potentially improve their health or alleviate their suffering. This criteria is very broad and subjective and it is hard to see how anyone with a relevant medical condition would not meet it as they can also include any persistent mental pain that arises from the anticipation of future suffering.

This aspect of the Bill’s eligibility criteria concerns a patient’s ability to give informed consent to receive the lethal poison that will enable their assisted suicide. There is a large body of evidence that shows that GPs can drastically overestimate the decision making capacity of a patient to make such a serious life-ending decision especially those who are elderly and have advanced medical conditions. Furthermore decision making capacity assessments will be less accurate when conducted over audio-visual links (e.g. Zoom) as allowed by the Bill. Patients who lack decision making capacity for such a serious decision are vulnerable and need to be protected.

Elder abuse is a growing phenomenon in our community. It is difficult to detect especially if consultations are being held over video conferencing platforms as allowed in the Bill. A major element of elder abuse that has emerged is elder self-neglect.

Doctors shift from being healers and end-of-life supporters to being eligibility assessors for death. Doctors are allowed to promote assisted suicide to their patients under this Bill. This is not the case in Victoria. All these changes will impact medical ethics and reduce the confidence of patients in the health system.

The Bill is significantly more risky that the Victorian laws allowing assisted suicide as it removes the requirement for specialist doctors who are more likely to identify a misdiagnosis that can occur in up to 15% of cases. The Bill also reduces the cooling off period between the first request and the last request from 9 days (as applies in Victoria and Western Australia) to 4 days. This reduction reduces the ability of a vulnerable patient from having time to make a very serious and irrevocable decision.