Andrew Denton, a longtime advocate for choice at the end of life and founding director of Go Gentle Australia, warns that a federal law prohibiting telehealth for voluntary assisted dying (VAD) is causing tragic consequences. Speaking in an opinion piece, Denton highlights cases where patients died in agony because they could not access timely VAD care due to the ban.
Federal law clashes with state VAD laws
At the ALP national conference last week, delegates voted to support removing federal barriers to VAD, including telehealth. They also guaranteed Labor parliamentarians a conscience vote on the issue. However, Prime Minister Anthony Albanese stated he remains unconvinced about telehealth for VAD, citing concerns about misuse and undermining confidence in the system. Cabinet will decide whether the issue reaches parliament. Denton argues that a conscience vote that never reaches parliament is no conscience vote at all, urging the PM to bring on the debate.
The core issue is a commonwealth criminal law enacted in 2005 that makes it an offence to use a carriage service—phone, email, or video conferencing—to send 'suicide-related material.' The law targeted harmful online content and people encouraging suicide, not VAD. In 2023, Melbourne GP Nick Carr sought a federal court ruling on whether 'suicide' in the law includes lawful VAD. Despite state laws explicitly stating VAD is not suicide, the commonwealth argued it did, and the court agreed. As a result, doctors risk prosecution and fines of up to $300,000 if they use telehealth for any part of the VAD process.
Tragic cases illustrate the harm
Denton cites several cases. Patrick Hammer, 38, of regional Queensland, died of liver disease. He was eligible for VAD, but his prescription had to be posted instead of sent electronically, arriving too late. His wife Helena described his death as 'torture' with no peace. Tom, a 79-year-old with end-stage lung disease in far north Queensland, was too unwell to travel. Two doctors made three trips totalling 8,500 km to assess him, but he died before medication could be dispensed. In Melbourne, Terry Hargreaves, managing end-stage prostate cancer, could not even reach the bathroom in his final weeks. His daughter Emma watched him suffer excruciating pain because he could not travel for a VAD consultation, even for five minutes. 'He deserved a better death,' she said.
Safety concerns addressed
Attorney General Michelle Rowland has expressed concern about denying the dignity of a face-to-face consultation. Denton responds that allowing telehealth does not require its use; in-person consultations remain the gold standard. Telehealth would simply provide an additional clinical tool when distance or pain makes in-person visits unreasonable. Regarding coercion, Denton notes that VAD laws are built on two core requirements: mental competency and voluntary choice. The process is deliberately careful: two doctors trained to detect coercion independently assess eligibility, review medical records, and consult the healthcare team. Either doctor can stop the process. Two witnesses who are not family members or beneficiaries must attest to the written statement. Crucially, patients can change their mind at any time; one-third of those who receive VAD medication do not use it. Video consultations would remove none of these safeguards.
Broad support for change
Denton points out that telehealth is already accepted in palliative care, where it provides flexibility for supportive care in the last weeks of life. The commonwealth funds such care. The solution is simple: independent MP Kate Chaney introduced a private member's bill in 2024 to create an exception for telehealth under state and territory VAD laws, which is before parliament again. The Australian Medical Association, Law Council, VAD regulatory bodies, some 20 health organisations, and state and territory attorneys general and health ministers support the change. Denton concludes that the Labor government should honour its conference commitments and allow a conscience vote in practice, not just in theory.
