Sandra Sarantou, an Adelaide woman preparing for voluntary assisted dying tomorrow, is using her final hours to expose a federal law she calls "cruel." This provision in the Commonwealth Criminal Code effectively denies many Australians access to end-of-life care based solely on where they live. Ms. Sarantou, diagnosed nine weeks ago with aggressive lung cancer, demands Prime Minister Anthony Albanese change this structural barrier.
Medication no longer eases her nerve pain, nausea, or dizziness. She feels "grateful" to end her life on her terms, having witnessed her father's prolonged suffering before VAD was legal. Yet, her personal relief is overshadowed by the systemic injustice faced by others.
"It's even a struggle just to move from one end from the house to another," Ms. Sarantou explained. "For those people to travel hours to possibly see a doctor and not get the chance for VAD is just horrific." Their time is ticking. They have to suffer. "It's cruel, it's not fair," she pleaded, urging leaders to "make it fair and available for everyone despite where they are living."
The State's Hand in Suffering
VAD is legal across Australia, with the Northern Territory expected to pass legislation this month. State laws often allow telehealth for some VAD discussions, especially for those too ill to travel or living remotely. However, a provision in the Commonwealth Criminal Code, originally designed to outlaw using "carriage services" to "incite suicide," has been weaponized. It's now interpreted to prohibit doctors from using phone, email, internet, or video to advise patients on VAD medication, overriding state provisions.
This legal interpretation, enforced by the state, creates a stark class divide. Workforce shortages in rural and remote areas mean dying people must travel vast distances for appointments. Many cannot, missing out on VAD entirely. Families report unnecessary suffering for loved ones who died before completing the process, a suffering that telehealth consultations could have prevented.
Prime Minister Anthony Albanese remains personally opposed to allowing telehealth for VAD. His opposition may prove crucial to the fate of any legislative change. He argues face-to-face consultations are vital to protect vulnerable patients, a justification that maintains the existing structural barrier. Attorney-General Michelle Rowland echoes these reservations, citing concerns about elder abuse if telehealth were permitted.
Capital's Neglect and Labor's Burden
Federal Independent Kate Chaney introduced a private members bill today to amend the Commonwealth Criminal Code. Greens Senator Sarah Hanson Young will introduce a similar bill this month. Without government support, these reform efforts may languish, demonstrating the limits of legislative action against entrenched state opposition. Even within Labor, delegates at the National Conference voted last month to amend the party's platform, supporting telehealth for end-of-life care and enshrining a conscience vote for MPs. This internal party struggle highlights the disconnect between the party's base and its leadership.
Dr. Scott Lewis, a general practitioner, has flown 3,000 kilometers across South Australia in the past fortnight alone to see VAD patients. He sees about two new patients weekly. Dr. Lewis points to systematic workforce shortages and the lack of Medicare funding as primary obstacles preventing more rural doctors from offering VAD care. "[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," he stated. "I don't make much money from it, to be blunt." He expressed a "sense of failure" knowing patients miss out due to isolation, witnessing the "hurt in family members who've had to see their loved ones suffer."
Sydney University Law Health expert Dr. Christopher Rudge believes telehealth could be allowed without weakening protections. He notes states have "very rigorous and documented process" for VAD, which would still apply. Advocacy group Go Gentle's report confirms strong demand outside cities, with 39 percent of 2024-25 applicants living in rural, regional, and remote areas. Ms. Sarantou, a paramedic for 13 years who treated rural patients, feels "guilty" she can access VAD while others cannot. Her plea for change is a demand for justice against a system that prioritizes abstract legal interpretations over human dignity. "It is hard. It is emotional at times. But we just try to make the best out of it." she said.