Sandra Sarantou, an Adelaide woman facing death tomorrow, is urging the prime minister to amend the Commonwealth Criminal Code, a legal barrier that effectively denies regional Australians access to voluntary assisted dying (VAD). Diagnosed with aggressive lung cancer just nine weeks ago, the 58-year-old finds medication no longer effective for her severe nerve pain, nausea, and dizziness. She watched her father endure a protracted, agonizing death before VAD became legal across the country. Ms. Sarantou expressed gratitude for her own ability to choose her end, but shock at the systemic denial faced by others based solely on their location.
The Bureaucratic Wall
A provision within the Commonwealth Criminal Code, originally designed to outlaw the use of "carriage services" to "incite suicide," has been broadly interpreted to prevent doctors from advising patients about VAD via phone, email, internet, or video. This interpretation overrides state laws that otherwise permit telehealth for VAD discussions, especially for those too ill or remote to travel. The consequence is stark: dying Australians in regional and remote areas are forced into arduous journeys for appointments, or they simply miss out on care altogether.
Prime Minister Anthony Albanese remains personally opposed to allowing telehealth for VAD, a stance that could prove decisive for any legislative change. He supports VAD but argues face-to-face consultations are crucial to protect vulnerable patients. Attorney-General Michelle Rowland has also voiced reservations, raising concerns about potential elder abuse if telehealth provisions were expanded. Several Labor MPs, while confident the law will eventually change, concede it requires more time and conversations to sway the prime minister.
Workforce shortages in rural and remote areas exacerbate the problem. General practitioner Scott Lewis, who flies his own plane to reach isolated patients, travels 3,000 kilometres across South Australia in a fortnight to see VAD applicants. He sees about two new VAD patients weekly. Dr. Lewis states that rural doctors, already overwhelmed, lack the time or resources to extend their practice into VAD care, noting he makes little money from it. He described a "sense of failure" knowing patients have been denied VAD due to their isolation, witnessing the "hurt in family members who've had to see their loved ones suffer."
The People's Pushback
Despite the elite resistance, a push for change is gaining momentum. Federal Independent Kate Chaney today introduced a private members bill to amend the Commonwealth Criminal Code. Greens Senator Sarah Hanson Young will introduce a similar bill to the Upper House this month. Without government backing, however, both bills may languish. Last month, delegates to Labor's National Conference voted to amend the party's platform, supporting the use of telehealth for end-of-life care. They also enshrined a commitment to give Labor MPs and senators a conscience vote on all VAD issues.
Ms. Sarantou, who served as a paramedic for 13 years and treated rural patients, feels "guilty" that she can access VAD while others cannot. "Their time is ticking and they have to suffer. It's cruel, it's not fair," she stated, pleading for laws to be changed to make VAD "fair and available for everyone despite where they are living." Advocacy group Go Gentle's latest "State of VAD report" confirms strong demand outside cities, with 39 percent of applicants in 2024-25 residing in rural, regional, and remote areas.
Sydney University Law Health expert Dr. Christopher Rudge believes telehealth could be allowed without weakening overall protections. He noted that states maintain rigorous processes for VAD procedures, which would still apply. Dr. Rudge clarified that telehealth communications would occur at an early stage, with in-person witnessing and other processes likely still required. He expressed sympathy for concerns about telehealth replacing face-to-face consults, but does not anticipate this outcome from changes to the Commonwealth Criminal Code. For Sandra Sarantou, the hardest part is saying goodbye to her son, though they've found comfort in "black humour" about her ashes. "It is hard. It is emotional at times. But we just try to make the best out of it."