ADVERTISING FEATURE: The capacity to consent to voluntary assisted dying

THE capacity to consent to voluntary assisted dying (VAD) will come under the spotlight during a public forum at the Cavanbah Centre next month.

The meeting is organised by the local group of volunteers called ChiLL (Choices in Later Life).

“Fortunately, we have excellent palliative and geriatric care available in our region, using both funded and private services,” said Judy Jackson, team leader of ChiLL, which has provided information about end-of-life preparation and care to some 500 senior citizens in seminars over the past three years.

“Palliative care is an excellent option for the control of symptoms, as well as a source of holistic care, for anyone with a terminal illness.”

This has been recognised by the Federal Government who will provide up to $25,000 for the last three months of an older person’s life, as part of their reforms of aged health care that commences on 1 November this year.

VAD has been a choice in NSW for people with a terminal illness since November 2023, and it is now legal in all Australian states and the ACT.

Hundreds of Australian residents have chosen to “die with dignity” using VAD, including a number from the Coffs Coast.

The Cavanbah event will feature testimony that highlights the availability and quality of local VAD services.

VAD accounts for about one percent of all deaths in this country, but this is about five-fold less than in those countries, like Canada, Belgium and the Netherlands, where it has been available for much longer.

VAD is not available to anyone who has lost capacity, and dementia is specifically excluded under NSW law.

As a result, some people on the path to VAD cannot follow through with their wishes.

This can lead to difficult and distressing outcomes.

In some cases, people choose VAD earlier than they might prefer to avoid losing capacity, while others avoid pain-relieving medication that could affect their consciousness.

“I could see that this could be a potential problem when the legislation was introduced into the Parliament,” said Coffs Harbour MP Gurmesh Singh, who supported the new laws but believes that some ongoing refinements will be required.

Mr Singh will introduce the two visiting speakers, recruited by ChiLL for the public forum to address questions, ethics and practical difficulties that will need to be overcome before VAD can become a valid option in an advanced care plan.

“Loss of capacity and dementia are the most common questions we are asked during our public education about VAD,” said Dr Linda Swan, former GP and current CEO of Go Gentle Australia.

It was Andrew Denton’s Go Gentle organisation that, along with many others, campaigned fearlessly for decades for VAD to be an option for Australians.

Dr Swan will review the practice of VAD across Australia and the rest of the world at the Cavanbah event.

Go Gentle has a neutral stand on the issue of VAD for dementia.

Dr John Ward, the second speaker, is a geriatrician whose medical practice extends now to more than 55 years.  He has never shied away from the difficult questions, whether it be reform of prison medical services or during his assembly of the Hunter Ageing Alliance, where he is currently Vice-President.

Dr Ward, who was NSW 2024 Senior Australian of the Year, said, “VAD for dementia will come eventually when some legal details are clarified.”

He will address options that lead to optimal ageing, problems in the assessment and management of dementia and will explain the difficult question of “what is capacity”.

“We were discouraged from mounting this public discussion by those who referred to ‘the slippery slope to involuntary euthanasia’ and the risk that opening this can of worms would undo the years of campaigning required to introduce the VAD option,” said ChiLL team leader Dr Max Brinsmead.

However, Dr Brinsmead calls for a democratic debate on VAD after loss of capacity.

“With strong public support for VAD, it’s unlikely we’ll turn back the clock,” he said.

“Australia is the safest place in the world in its practice of VAD, but some of its rules here are causing more grief and suffering. Can we do better?”

The public forum, “Optimal Ageing and Dying – The Choice is Yours” will occur on Saturday morning, 6 September.

Registrations are limited by the capacity of the Cavanbah Centre and can be made on-line using https://events.humanitix.com/optimal-aging-and-dying-the-choice-is-yours.

The event is made possible through a grant from City of Coffs Harbour Council and support from aged care provider Linked to Life, Go Gentle, Dying to Know Day and Woolworths.