Sandra Sarantou, an Adelaide woman preparing for voluntary assisted dying (VAD) tomorrow, is urging national leaders to change a federal law. She claims a provision in the Commonwealth Criminal Code effectively denies some Australians access to care based on their location. This federal dictate overrides state provisions, creating a two-tiered system for citizens.
The 58-year-old, diagnosed nine weeks ago with aggressive lung cancer, states medication no longer manages her nerve pain, nausea, and dizziness. She expressed gratitude for ending her life on her own terms, having witnessed her father's prolonged suffering before VAD became legal nationwide. Ms. Sarantou described the struggle for many to travel hours to see a doctor for VAD, often without success. "Their time is ticking and they have to suffer. It's cruel, it's not fair," she pleaded.
The Commonwealth Criminal Code provision, originally intended to outlaw the use of "carriage services" to "incite suicide," has been interpreted to apply to doctors advising patients on VAD. This interpretation blocks the use of phone, email, internet, or video for medical advice regarding VAD medication. This federal overreach directly impacts state laws that otherwise permit telehealth for VAD discussions, especially for patients too ill to travel or living remotely.
Centralized Authority vs. Local Needs
Workforce shortages in rural and remote areas mean dying people are forced into long-distance travel for appointments. For some, this journey proves impossible, leading them to miss out on VAD access. Families of those who died before completing the process assert that telehealth consultations could have spared their loved ones unnecessary suffering.
While VAD is legal in every Australian jurisdiction except the Northern Territory, where legislation is expected this month, the federal code imposes a significant barrier. Federal Independent Kate Chaney introduced a private members bill today to amend the Commonwealth Criminal Code. Greens Senator Sarah Hanson Young plans a similar bill in the Upper House this month. Both bills face uncertainty without government backing.
Elite Reservations and the Cost to the People
Within the Labor Party, delegates at last month's National Conference voted to amend the party's platform, supporting telehealth for end-of-life care. They also enshrined a commitment to a conscience vote for Labor MPs and senators on all VAD issues. However, Prime Minister Anthony Albanese remains personally opposed to allowing telehealth for VAD. Labor sources indicate his opposition could be crucial to the legislative changes. He supports VAD but argues face-to-face consultations are vital to protect vulnerable patients. Attorney-General Michelle Rowland also voiced reservations, citing concerns about elder abuse if telehealth were permitted.
General practitioner Scott Lewis, who travels 3,000 kilometers across South Australia in a fortnight to see VAD patients, highlights the systemic failures. He flies his own plane to reach rural patients, seeing about two new VAD patients weekly. Dr. Lewis noted that workforce shortages and a lack of Medicare funding deter more rural doctors from offering VAD care. "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, adding, "I don't make much money from it, to be blunt." He expressed "a sense of failure" over patients missing VAD due to isolation.
Advocacy group Go Gentle's latest "State of VAD report" suggests strong demand outside cities, with 39 percent of 2024-25 applicants residing in rural, regional, and remote areas. Sydney University Law Health expert Dr. Christopher Rudge believes telehealth could be allowed without weakening protections. He stated, "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." Dr. Rudge, while sympathetic to concerns about telehealth replacing in-person consults, did not think this would be a consequence of changes to the Commonwealth Criminal Code.
Ms. Sarantou, a paramedic for 13 years who treated rural patients, feels "guilty" about her own access to VAD while others cannot. She reiterated her plea: "Please change these laws, make it fair and available for everyone despite where they are living."