ACT government voluntary assisted dying consultation to consider role of senior nurses

Consultation opened on laws for the scheme which will help in informing laws that are expected to be introduced to the Legislative Assembly later this year.

A key part of this consultation is the role health care providers will play in any scheme.

The territory's small health workforce will likely limit the number of health professionals who are able to assess a person's condition, a discussion paper has said.

Schemes in all Australian states require two health professionals to independently agree a person has a terminal condition or illness and is likely to die within a certain period.

However, both health professionals must be registered medical practitioners.

But through consultation the ACT government is considering whether nurse practitioners are able to be one of the health professionals to assess a person's eligibility.

A discussion paper on the territory's voluntary assisted dying scheme says nurse practitioners in Canada are able to assess a person's eligibility.

The government is asking whether the ACT should follow this course, citing the small workforce in Canberra's health system.

"In a small jurisdiction like the ACT, with limited health resources and a relatively small workforce, imposing a narrow or inflexible health professional qualification requirements is likely to restrict the pool of health professionals who are eligible to participate in voluntary assisted dying, which in turn may restrict a person's access to voluntary assisted dying," the discussion paper said.

Human Rights Minister Tara Cheyne said the government wanted to seek the views of the community and medical professionals about who should be involved at different stages of the voluntary assisted dying processes.

"In a small jurisdiction like the ACT with a limited health workforce we are asking the question of if it needs to be a specialist or a GP or is there a broader role for nurse practitioners who are highly trained professionals in this area," she said.

"We have seen through consultation in other jurisdictions that some members of the clinical community have strongly suggested that there is a role for nurse practitioners in being able to support a voluntary assisted dying process.

"We do not have a predetermined idea but it is incumbent on us to ask the question."

The ACT is also likely to allow a doctor to bring up voluntary assisted dying as one of many options for a person nearing the end of their life. In Victoria, a doctor can only discuss this if a patient brings it up first. The discussion paper said this had been identified as an "unnecessarily strict safeguard".

The government will consider whether to not include a requirement around death being expected in a certain time frame.

In most states a medical professional must expect a person to die from an illness within six months, or 12 months for neurodegenerative disorder, to be eligible for voluntary assisted dying.

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However, the discussion paper said this was restrictive and it is difficult to determine an exact time frame.

Australian Medical Association ACT president Professor Walter Abhayaratna said a considerable part of the discussion would be around how to access the required services to make these decisions.

"It is very important that the resources, and some of those resources include the medical decision makers in terms of assessing whether patients are eligible for any assisted dying program and if this program is similar to other states then it requires an independent doctor," he told ABC Radio.

"At the moment the models are based on medical decisions because that does require an assessment of a patient's chronic disease, which could be a disease that is potentially going to cause death in six months.

"These are all decisions that require medical knowledge so traditionally it would be a medical doctor who makes those decisions."

Opposition Leader Elizabeth Lee said she wanted to listen to as many views as possible about voluntary assisted dying. Ms Lee is supportive of laws but wants strong safeguards.

"We know this is a very, very important issue that affects many, many Canberrans and we want to make sure we are listening to the full gambit of views that are out there," she said.

"We want to make sure there are robust and necessary frameworks in place so that this type of very important decision isn't being taken advantage of or abused in any way."

Ms Lee said on Tuesday afternoon she hadn't had a chance to thoroughly examine the discussion paper but some concerns had been raised about whether people under-18 could access voluntary assisted dying.

"Some of the concerns that have already been raised with me are in relation to whether teens are going to be able to access the scheme and that on first blush is something that concerns me so I'll need to look at that very, very carefully," she said.

Across all Australian states people must be 18 years or older to access voluntary assisted dying but the ACT government is asking the public whether eligible people under 18 with the "maturity and capacity" to make decisions should also be able to access this.

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