Sandra Sarantou is preparing to die tomorrow using voluntary assisted dying, and she says a Commonwealth Criminal Code provision is blocking some Australians from accessing the care because of where they live. The Adelaide woman, diagnosed nine weeks ago with the same aggressive lung cancer her father died from, is using her final days to push Prime Minister Anthony Albanese to change the law she calls cruel.
Who Pays for the Rules
Ms Sarantou said medication is no longer effective for her nerve pain, nausea and dizziness. She said she is "grateful" to be ending her life on her terms after watching her father endure a long and painful death before VAD was legal around the country. That gratitude sits beside the uglier reality she described: a system where geography decides who gets access and who gets left to suffer.
"It was even a struggle just to move from one end from the house to another … for those people to travel hours to possibly see a doctor and not get the chance for VAD is just horrific," she said. She added, "Their time is ticking and they have to suffer. It's cruel, it's not fair," and pleaded, "Please change these laws, make it fair and available for everyone despite where they are living."
The law she wants changed sits in the Commonwealth Criminal Code. It was intended to outlaw the use of "carriage services" to "incite suicide," but it has been interpreted to apply to doctors advising patients about VAD. That interpretation has overridden state provisions that allow telehealth for some discussions about VAD, particularly where patients are too ill to travel or live remotely. The result is blunt. Doctors cannot use phone, email, internet or video to advise patients about accessing VAD medication.
What the System Calls Protection
VAD is legal in every Australian jurisdiction except the Northern Territory, which is expected to pass legislation allowing it this month. Even so, the Commonwealth restriction still reaches across state lines and narrows what doctors can do. Workforce shortages in rural and remote areas have made the problem worse, forcing some dying people to travel long distances for appointments. For others, that trip has simply not been possible, and they have missed out.
Families of people who wanted to access VAD but died before completing the process say telehealth consultations could have spared them unnecessary suffering. That’s the human cost of a legal setup that treats access like a privilege to be managed, not a need to be met.
Federal Independent Kate Chaney today introduced a private members bill to have the Commonwealth Criminal Code amended. Greens Senator Sarah Hanson Young will introduce a similar bill to the Upper House this month. Without government support, both bills may languish. The machinery of reform is there, but it still depends on the same institutions that created the blockage in the first place.
Who Gets Heard, Who Gets Ignored
There is also a push within Labor's rank and file for change. 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. Delegates also enshrined a commitment to give Labor MPs and senators a conscience vote on all VAD issues. But the party's internal vote doesn't settle the matter. Prime Minister Anthony Albanese is personally opposed to allowing telehealth for VAD, and Labor sources have said his opposition may prove crucial to the fate of any legislative change.
He supports voluntary assisted dying but has argued face-to-face consultations are an important way to ensure vulnerable patients are not taken advantage of. Attorney-General Michelle Rowland has also expressed reservations and raised concerns about the risk of elder abuse if telehealth was allowed. That’s the familiar script: a narrow gate, guarded from above, with the people who are dying expected to wait politely while the apparatus debates their suffering.
Ms Sarantou, who worked as a paramedic for 13 years and treated patients in rural areas, said she felt "guilty" she could access VAD while others could not. She said, "Please change these laws, make it fair and available for everyone despite where they are living." She also said, "We had the idea to put my ashes into a big party cracker … and then everybody has got a bit of my ashes," and added, "But it is hard. It is emotional at times. But we just try to make the best out of it."
Advocacy group Go Gentle's latest "State of VAD report" suggested there was strong demand for the care outside cities, with 39 per cent of applicants in 2024-25 living in rural, regional and remote areas. General practitioner Scott Lewis has travelled 3,000 kilometres across South Australia in the past fortnight alone to see people seeking voluntary assisted dying. Dr Lewis, who flies his own plane to reach rural patients, said he saw about two new VAD patients a week. He said workforce shortages and the lack of Medicare funding were preventing more rural doctors from offering VAD care.
He said, "[Rural and remote] doctors are so busy as it is, that they simply haven't had the time or thought to extend their practice into voluntary assisted dying," and, "I don't make much money from it, to be blunt." He told ABC News he had experienced "a sense of failure" knowing patients have missed out on VAD due to their isolation. He said, "To see the hurt in family members who've had to see their loved ones suffer and … come so close to being approved for voluntary assisted dying but not quite get there … it's hard at times."
Sydney University Law Health expert Dr Christopher Rudge said he believed telehealth could be allowed without weakening overall protections. He said, "Across the country the states have very rigorous and documented process for permitting someone to undergo a VAD procedure, and all of those would apply whether it's by telehealth or any other circumstance." He also said, "My understanding is that the telehealth communications would occur at an early stage of the process but that at some stage, the witnessing and some other processes, would presumably need to occur in an environment where doctors are present."
Dr Rudge said he was "sympathetic" with concerns that telehealth could replace face-to-face consults, but did not think that would be a consequence of changes to the Commonwealth Criminal Code. He said, "In circumstances where informed consent is not clear, the in-person consultation is the best place for those questions to be answered. And so, I can understand why people could be concerned."