Episode 191 – Voluntary Assisted Dying in Qld
The Queensland Parliament is considering introducing Voluntary Assisted Dying (VAD) legislation and has set up an inquiry into End of Life choices.
Dying With Dignity Queensland Inc (DWDQ) wants you to understand the issues and hopefully make a submission requesting that VAD laws be introduced.
In this episode of the podcast we interview Phil Browne, who is a DWDQ committee member and Dr Craig Glasby, a retired GP and member of DWDQ.
Firstly – some info about Phil and the DWDQ committee
Phil is a registered nurse and has worked in a large hospice for 7 years.
DWDQ has an eight member committee. Five of these eight committee members are either currently practicing, or retired, doctors or registered nurses.
Between these five health professionals, they have:
- 218 years front-line patient care experience, consisting of …
- Palliative care (37 years total), oncology, general practice, intensive care, general and specialist hospital wards and aged care, as well as …
- Established a Palliative Care service at a major Brisbane hospital, plus …
- Trained junior doctors in managing End of Life situations for patients and family, plus they have …
- Provided End-of-Life care in the final stages leading to the deaths of approximately 7,600 patients with advanced and progressive terminal, chronic or neurodegenerative conditions
Australia-wide there have been over 30 bills introduced in different state/Territory parliaments to legalise VAD. With the exception of two of these bills, all the others have been defeated (many by a mere 1 or 2 votes).
1. The NT legalised VAD in the 1990s. Multiple people took advantage of the law before the federal govt overturned the NT law one year later.
2. The Victorian parliament passed their Voluntary Assisted Dying Act. 2017. There is an 18 month period prior to the law taking effect. From June 2019 eligible Victorian residents will be able to access VAD.
In recent years Parliamentary inquiries into End of Life issues have been/are being conducted in three states to specifically examine if VAD should be legalised and if so, to determine the characteristics of future legislation.
Victoria and WA have completed their inquiries, and the Qld inquiry has just commenced (AND WANTS TO HEAR OUR VIEWS!)
Other State Inquiries Have Exposed Problems With End Of Life Choices
Both Victoria and WA have held Parliamentary inquiries into End of Life Choices.
- Victorian Parliament, Legislative Council Legal and Social Issues Committee – Inquiry into end of life choices report, June 2016
- Western Australian Parliament Joint Select Committee on End of Life Choices – My Life, My Choice report, August 2018
Both the Victorian report and the WA report revealed some key findings:
- Confirmation from palliative care experts that palliative care cannot relieve suffering in all cases.
- Confirmation from state Coroners of approximately one suicide weekly (frequently by hanging/shooting) in each state, of a person with a terminal/irreversible health condition. A report from the WA Coroner’s Office noted that this accounted for 13.9% of suicides in Western Australia.
- Recommendations that voluntary assisted dying be legalised in both Victoria and Western Australia.
The WA government has committed to introducing a Voluntary Assisted Dying bill this year.
Voluntary Assisted Dying – Definition
It used to be called Voluntary Euthanasia
Voluntary Assisted Dying occurs when a person, who is experiencing grievous and irremediable suffering related to an advanced and progressive terminal, chronic or neurodegenerative condition, legally accesses medical assistance to end their life. This assistance can be in the form of a doctor prescribing a medication that the person self-administers, or if the person is incapable of self-administering, a doctor may administer the medication to the person.
DWDQ supports expanding palliative care services as well as legalising VAD.
Palliative Care Cannot Relieve All Suffering.
“Too many Western Australians experience profound suffering as they die, in part due to inequitable access to palliative care; however, in the committee’s view, even with access to the best quality palliative care, not all suffering can be palliated.” (WA report, Finding 23, page 107)
“The percentage of patients for who palliative care was ineffective in relieving their symptoms varied; however, somewhere in the range of 2-5 per cent is consistent with the evidence.” WA report page 92
Terminal sedation is often used when all other medical treatments, including palliative care, cannot control severe, intolerable and otherwise unrelievable symptoms.
Terminal sedation and VAD both have the same intention – to relieve intolerable suffering at the end of life.
“Terminal sedation is the palliative care practice of gradually increasing doses of analgesics and/or sedatives, usually without providing nutrition or hydration, until a coma state occurs prior to death.” WA report, page 123
Terminal Sedation is a legal and slow form of VAD and it has problems.
- Inadequate guidelines and legal documentation.
“Given the evidence received by the committee that the practice is not regulated, nor specifically noted in patient medical records, …” WA report, page 129
- Uncertainty regarding the legality of terminal sedation could lead to withholding treatment.
“There remains some confusion among health professionals as to the legal status and reasonableness of the clinical practice of terminal sedation and this confusion is likely to result in the denial of adequate symptom relief to some patients at end of life.” WA report, page 130
- Uncertainty regarding if legal consent has been obtained.
There are serious concerns as to “whether the patient (or patient’s family) are involved in the decision-making process, particularly where consent is obtained before this kind of sedation is provided” WA report, page 129
There are valid ethical and legal concerns regarding the use of terminal sedation in the absence of thorough regulations or legislation.
Currently in Queensland
Currently, without the legal option of VAD, Queenslanders experiencing irremediable and grave suffering related to their terminal decline, have limited – and unsatisfactory – options if their intolerable symptoms cannot be palliated by palliative care:
- Refusal of medical treatment.
- Will not result in a guaranteed peaceful death.
- May even result in increased suffering and distress.
- A drawn-out cruel prolonged means of dying.
- Will not result in a guaranteed peaceful death.
- May even result in increased suffering and distress.
- Terminal Sedation. (as discussed)
- The person may suicide alone and afraid, fearful of involving their family due to the possibility of criminal charges for aiding and abetting a suicide.
- Many suicide attempts fail, potentially leaving the person in a worse state.
- Coroner reports from Victoria and Western Australia identified approximately one suicide/week, or 13.9% of the total state suicides, being committed by people with a terminal or debilitating progressive illness.
Let’s discuss suicide.
“Prohibition of assisted dying is causing some people great pain and suffering. It is also leading some to end their lives prematurely and in distressing ways” VIC report,
“People are choosing suicide over dying with irremediable pain” VIC report, page 197/198
Statistics provided by the Coroner’s Offices of both Victoria and WA, show the high rate of suicide by people suffering with a terminal or debilitating progressive illness – approximately 1 suicide per week, or 13.9% of the total state (WA) suicides, being committed by people with a terminal or debilitating incurable progressive illness.
“There were two-hundred and forty (240) deaths of relevance identified with the date of notification between 01/01/2012 and 05/11/2017 that were reported to a Western Australian Coroner where the deceased died as a result of an act of intentional self-harm and had been diagnosed with a terminal or debilitating physical condition prior to their death.
These two-hundred and forty (240) cases represented 13.9% of all intentional self-harm cases reported to a Western Australian Coroner between 01/01/2012 and 05/11/2017 (n = 1,720).”
REFERENCE: WA Coroner/NCIS report, Page 7
“The Coroners Court of Victoria presented particularly disturbing evidence that around 50 Victorians a year are taking their lives after experiencing an irreversible deterioration in physical health” VIC report, page 197/198
QLD statistics are likely to be just as high as Vic & WA.
People are suiciding earlier than if they could use VAD:
“It is not surprising that many of those who choose to take their lives as a result of a terminal or chronic illness are doing so earlier than they otherwise would want to on the basis that they fear some future loss of physical capacity.” WA report page 144
People are suiciding more violently than if they could use VAD:
“As Coroner Caitlin English described in evidence to the Committee:
These are people who are suffering from irreversible physical terminal decline or disease, and they are taking their lives in desperate, determined and violent ways” VIC report, page 197/198
Friends and relatives are torn between acting out of love to help their loved one to suicide, or to obey the law.
Queenslanders are illegally importing the suicide drug Nembutal in order to end their lives. Some have been charged by Police https://www.news.com.au/national/breaking-news/two-charged-with-importing-euthanasia-drug/news-story/970cdb8ecffec96860a2a384c84d66ec
(DWDQ does not condone illegal activity)
DWDQ respects the right of people to practice their deeply held faith, but not to force their values on others who do not share their beliefs.
People of Faith Overwhelmingly Support VAD
Many people of faith believe their god is a god of love and compassion who would not want us to live our final days in intolerable suffering.
- 2007 Newspoll survey of 2423 respondents found 74% of Catholic respondents and 81% of Anglican respondents surveyed thought doctors should be allowed to provide “a lethal dose to a patient experiencing unrelievable suffering and with no hope of recovery.” https://cdn.theconversation.com/static_files/files/4/76079-2017-04-24-polling-Dying_With_Dignity_Summary_Report_V2.pdf?1518043685
- A 2012 Newspoll survey of 2521 respondents found that 77% of Catholic respondents and 88% of Anglican respondents said Yes to the following question- “Thinking now about voluntary euthanasia. If a hopelessly ill patient, experiencing unrelievable suffering, with absolutely no chance of recovering asks for a lethal dose, should a doctor be allowed to provide a lethal dose, or not?”
Some Church Leaders Support VAD
Archbishop Emeritus and Nobel peace laureate, Desmond Tutu:
“People who are terminally ill should have the option of dignified and compassionate assisted dying alongside the wonderful palliative care that already exists. I pray that politicians, lawmakers and religious leaders have the courage to support the choices terminally ill citizens make in departing Mother Earth with dignity and love.”
The former worldwide head of the Anglican Church and Archbishop of Canterbury, Lord Carey, wrote an article saying that VAD is“profoundly Christian and moral”.
“For the sake of those suffering at the point of death, we must not waste this opportunity to change the current law that has let so many people down so badly.”
Christians Supporting Choice for Voluntary Euthanasia is group of practising Australian Christians who support legalising VAD.
“We are Christians who believe that, as a demonstration of love and compassion, those with a terminal or hopeless illness should have the option of a pain-free, peaceful and dignified death with legal voluntary assisted dying or legal voluntary euthanasia.”
The group says an argument often used against VAD is that “God has allocated each of us a time span for life on earth” and to interfere is criticised as “playing God”.
“But to be consistent we should also refuse antibiotics, refuse surgical operations, refuse insulin, refuse dialysis, refuse blood transfusions, and so on,” the group counters. The list is almost endless: each of these are human interventions deliberately designed to alter our life span.” Source: https://christiansforve.org.au/
Historic rise in support since 1962.
Overwhelming Majority Support.
Polls by the Newspoll organisation during the last 12 years, suggest there is 80 – 85% support for VAD.
These are credible randomised polls by professional polling companies. The below polls were of 2423, 1201 and 2521 respondents respectively.
- Newspoll 2007 https://cdn.theconversation.com/static_files/files/4/76079-2017-04-24-polling-Dying_With_Dignity_Summary_Report_V2.pdf?1518043685
- Newspoll 2009 https://cdn.theconversation.com/static_files/files/5/76079-2017-04-24-polling-091005_Euthanasia_Study.pdf?1518043791
- Newspoll 2012 https://cdn.theconversation.com/static_files/files/6/76079-2017-04-24-polling-121104_Dying_with_Dignity_Report_Revised.pdf?1518043821
2018 Queensland poll.
There has only been one credible randomised Queensland-specific poll on Voluntary Assisted Dying, by a professional polling organisation.
The ReachTEL poll of 834 respondents was conducted on 28 August 2018, and showed overwhelming Queensland support for Voluntary Assisted Dying, including:
- 1% support for law reform.
- Overwhelming support across all ages and genders.
- Overwhelming support across all voting intentions.
Question: Thinking about voluntary assisted dying, sometimes known as voluntary euthanasia, where terminally ill people with no hope of recovery are given the choice of legally terminating their life with the assistance of medical professionals. Do you support or oppose voluntary assisted dying for people in those circumstances?
DWDQ’s Position Statement on VAD
Here is the Dying With Dignity Position Statement
DWDQ aims to have laws introduced in Queensland allowing an adult who is experiencing grievous and irremediable suffering related to an advanced and progressive terminal, chronic or neurodegenerative condition, to legally access medical assistance to end their life should the person choose to do so.
The assistance can be in the form of the doctor prescribing a medication that the person self-administers, or if the person is incapable of self-administering, the doctor may administer the medication to the person.
This policy is consistent with the longstanding, ovenrhelming majority support for Voluntary Assisted Dying that is held by Queensland residents.
To protect vulnerable citizens, the below mandatory eligibility criteria and safeguards apply.
- must be aged at least 18 years.
- must be a resident of Queensland.
- must have been assessed by two doctors.
- must be mentally competent. If there is any question as to competency, the person must be assessed by a psychiatrist before the request can proceed.
- must be experiencing grievous and irremediable suffering related to an advanced and progressive terminal, chronic or neurodegenerative condition that cannot be alleviated in a manner acceptable to the person.
- is encouraged to discuss their decision with their family members, but there is no obligation to do so.
- must have been informed of and have explored all other treatment options reasonably available.
- must make two requests, either oral or written to their doctor. At least one of the requests should be with no other person present.
- must re-confirm their request once all conditions have been met.
- can withdraw their request at any time.
Participation by doctors and nurses would be voluntary.
Disclaimer: These conditions outline DWDQ’s current position. Conditions may alter in the future, but act as a guideline to future legislation. DWDQ President – Jos Hall Date: January 2A19
Some General Principles and Arguments
Voluntary Assisted Dying will:
- Not mean more people die. It will mean fewer people suffer.
- Protect vulnerable members of society (e.g. disabled people or the elderly), as rigid safeguards must be first met to be eligible to use Voluntary Assisted Dying.
- Not be used by a large proportion of the population. Many people eligible to use Voluntary Assisted Dying, will choose not to do so.
- Provide great comfort to people suffering in their terminal decline, knowing that Voluntary Assisted Dying is available to them, even if they never use it.
- Provide safeguarded choice and control to terminally ill adults and prevent prolonged suffering among these dying adults who want to have choice over how and when they die.
- Ensure that adults suffering in their terminal decline who have assistance to die, do so having met clear pre-determined criteria and have considered all treatment options.
Voluntary Assisted Dying will not:
- Be compulsory. It will only ever be an option, for those who are eligible, if they wish to access it – therefore the use of the word “Voluntary”.
- lead to legalised suicide for those who are not dying.
- Legalise a system where the person being directly helped to die is no longer able to make that choice for themselves. Voluntary Assisted Dying Bill would only apply to adults with mental capacity, both at the time of their request and at the time of their death.
- Legislation to allow VAD must not compel health professionals with conscientious or religious objection to provide assistance to people seeking VAD.
- Health professionals are entitled to their beliefs on VAD, but they must not force their beliefs on their patients or other people.
“Personal objections must not present an impediment to those lawfully seeking assistance to die.” WA Report, Page 221
If a doctor has a conscientious objection to VAD, they must be required under legislation, to:
- Refer any patient seeking VAD to another doctor or health service who will assist them, and …
- That this referral must occur within 24 hours of the patient’s request.
“A referral system that is easily accessible must be available to individuals who are eligible for voluntary assisted dying. In addition, health service providers who hold an objection to assisted dying must be required to facilitate timely transfer of patients in their care to a suitable health provider when a patient requests assisted dying.” WA Report, Page 221
CURRENT UNLAWFUL USE OF VAD.
“Academic evidence supports the position put by witnesses to the Committee that doctors practice unlawful assisted dying despite its prohibition and despite prospective liability for serious crimes.” Vic report, Page 181
“Despite facing potential criminal convictions, medical practitioners are openly performing unlawful assisted dying. This is occurring in an unregulated environment, and sometimes in circumstances that compromise patient care.
The Committee heard evidence that some doctors act in ways which may be unlawful, but that this is driven by a sense of obligation to alleviate pain.” Vic report, Page 183
“We currently allow voluntary euthanasia, but we have it hidden. It happens all the time, in fact, that people are assisted to die.” Vic report, Page 184
In 2016, Australian Doctor conducted a survey based on a Voluntary Assisted Dying model put forward by the Victorian parliamentary report, Inquiry into End-of-Life Choices.
“The survey of 366 doctors and 26 nurses found that 65% supported legal reforms allowing patients to end their own lives and 49% would be willing to assist patients to take their own lives.” Source https://www.australiandoctor.com.au/news/half-doctors-back-assisted-suicide
The Queensland Parliamentary Inquiry
View the inquiry media release here
A media report on the current inquiry
View the inquiry here
Qld Parliament commences inquiry into Voluntary Assisted Dying, aged care & palliative care.
- The inquiry is being conducted by the Health, Communities, Disability Services and Domestic and Family Violence Prevention Committee of the Qld Parliament (which is comprised of six cross-party MPs).
- The inquiry will investigate Aged Care, Palliative Care and VAD.
- The Qld inquiry has called for “Public Submissions” (i.e. an e-mail or letter) allowing ordinary citizens to tell our law-makers if we want VAD legalised.
- (many individuals and organisations will write in telling our lawmakers NOT to legalise VAD – so it’s very important that we all speak up, as well as encouraging our friends and family to also speak up)
- Public submissions ARE NOW OPEN & WILL CLOSE ON 15 APRIL – you won’t be able to have your say after 15 April (so start drafting your letter now!).
- The inquiry will conclude & provide a written report back to Parliament by 30 November 2019.
- This Qld report may follow WA & Vic in calling for VAD to be legalised.
- Once released, this report will be studied by all 93 Qld state MPs prior to them (hopefully) voting on a future Qld Voluntary Assisted Dying Bill.
IMPORTANT! Issues Paper released on 14/2/19
An “Issues Paper” has been released to help provide the information the Health committee is seeking, to help them determine if Voluntary Assisted Dying should be legalised in Qld.
In your submission, please answer these questions from the Issues Paper
Issues for consideration
25. Should voluntary assisted dying (VAD) be allowed in Queensland? Why/why not?
26. How should VAD be defined in Queensland? What should the definition include or exclude?
27. If you are a health practitioner, what are your views on having a scheme in Queensland to allow VAD?
28. If there is to be a VAD scheme, what features should it have?
29. Are there aspects of VAD schemes in other jurisdictions that should, or should not, form part of any potential VAD scheme for Queensland, and why?
30. Who should be eligible to access VAD and who should be excluded?
31. Should the scheme be limited to those aged 18 and over? If so, why? If not, why not?
32. Under what circumstances should a person be eligible to access VAD? Could it be for example, but not limited to, the diagnosis of a terminal illness, pain and suffering that a person considers unbearable or another reason?
33. What features should be included in a process to allow a person to legally access VAD?
34. What safeguards would be required to protect vulnerable people from being coerced into accessing such a scheme, and why?
35. Should people be provided access to counselling services if they are considering VAD? If so, should such counselling be compulsory? Why?
36. How could a VAD scheme be designed to minimise the suffering and distress of a person and their loved ones?
37. Should medical practitioners be allowed to hold a conscientious objection against VAD? If so, why? If not, why not?
38. If practitioners hold a conscientious objection to VAD, should they be legally required to refer a patient to a practitioner that they know does not hold a conscientious objection or to a service provider that offer such a service? If so, why? If not, why not?
Advice about submissions
Everyone can send in a “submission” stating your views on any, or all, of the issues being investigated – i.e.
You can address only Voluntary Assisted Dying if you wish, or if you also have opinions on aged care and palliative care, you can address all three issues (however,
clearly state which issue/s you are writing about in your submission).
It’s not compulsory to address all three issues in your submission. (note – a “submission” is merely an e-mail or a letter written by you)
Begin drafting our submission to the inquiry. (very important!)
The inquiry is Now accepting submissions on VAD (plus aged care & palliative care), but ONLY UNTIL 15 APRIL. Take advantage of this rare opportunity to speak directly to our lawmakers.
Remember our opponents will be speaking up.
Write down dot-points of key things you want to mention in your submission (write things down as you think of them).
Include your PERSONAL STORY. Some MPs say they have changed their opinions – and their votes – after hearing powerful personal stories.
A former politician made this comment about writing VAD submissions:
“Submissions need to be brief. Trust me nobody reads long winded anything these days. But the opening paragraph should grab and hold attention. (Very important!!) Can’t wait to write mine.”
The Iron Fist opening paragraph will be:
Unfortunately one of my lasting memories of my father is an image of him lying in a bed in John Flynn Hospital. He was gaunt and in a nappy. He had been in and out of consciousness for 3 days as he was slowly dehydrating to death. Occasionally a nurse would wipe his mouth with a mouthwash swap and he would groan. I couldn’t tell if it was pain or pleasure. During one of his conscious moments I lent over and told him he had been holding on for 3 days. He could not speak but his eyes were wide in shock. Dad was a POW in Changi prison and on the Burma railroad. It was a defining part of his life and it strikes me that in his last moments he was effectively transported back to the railroad. It is shameful that our society could not offer a veteran a better alternative.
Some helpful tips for submission writing:
Submissions must include your name and address (and signature if posted) – if these details are missing, your submission will be rejected.
You don’t need to be a Qld resident to lodge a submission – so encourage your friends & family to lodge submissions, regardless of whether or not they live in Qld.
Couples – Please write two individual submissions, not one joint submission.
The Quality of submissions is what counts – keep it concise and on-topic. There is no need to write a book.
Submissions can be in the form of an e-mail, posted letter, or even a video (if incapable of writing due to illness/incapacity).
Photos can be included to personalise and empower your submission (a picture tells a thousand words). Photos make it real and can convey great love and emotion. DWDQ encourage you to include photos – maybe your wedding photo, family birthday/Xmas photos, holiday photos, photos from retirement etc (show the MPs the people who legalising VAD could assist).
Your submission may be very personal and you may wish to keep it private (other than the committee MPs & staff). You can request in your submission for it to remain confidential (and not published on the Qld Parliament website).
Remember to include your Personal Story:
- Perhaps you have seen a loved one suffer greatly prior to their death.
- Perhaps you have a terminal illness and you can speak of how just having the option of VAD, if ever you need to access it, can reassure you.
- Perhaps you are a health professional and can speak of how VAD could have greatly assisted your patients who suffered unacceptably prior to death.
- Even if you have not had this “lived experience”, please still share your views and opinions, which are very important for the committee to hear.
Please tell these stories in your submissions. Our personal stories show the devastating impact that unnecessary suffering can have on our loved ones and their friends and families.
Please consider including a photo in your submission of yourself and your loved one/s that will/would have benefited from VAD being legalised (attach a photo/s to your email).
You may want to provide your MP and newspaper with a copy of your submission.
An example of a high quality submission:
(insert your name, address and your e-mail address or signature)
(In the next paragraph – briefly describe yourself and your loved ones/family. Clearly state that you support legalising VAD, plus a brief summary of your reasons – expand on your reasons in the rest of your submission)
(describe the devastating human toll if you have seen a loved one suffer intolerably, possibly in contrast to their wishes, prior to their death – if you have
not experienced this, then imagine how this might feel)
(describe if the days/weeks prior to death were in total contrast to the life lived & values held by your loved one during the rest of their life)
(how did this impact on your loved one, yourself and your family/friends?)
(why was this unacceptable to your loved one/yourself/family/friends?)
(did your loved one and/or yourself, ever contemplate suicide as an option in the absence of VAD?)
(how would legal access to VAD have assisted your loved one/yourself?)
(include one or more photos of yourself and your loved ones at key moments in your/their life)
Where to post or e-mail your submission to:
“The committee invites submissions on the issues identified for consideration in this issues paper, and any other issues relevant to the terms of reference. General guidelines on making submissions are available from the committee’s webpage here.
Written submissions can be posted to:
Committee Secretary Health Committee PARLIAMENT HOUSE QLD 4000
or faxed to:
07 3553 6699
or emailed to:
If you have difficulties sending your submission, please call the secretariat staff ph (07) 3553 6626 or 1800 504 022.”
Everyone is welcome to join DWDQ via the website (all membership fees help fund the campaign to legalise VAD)
Follow DWDQ on social media.
Dr Alex Deagon thinks it is a bad idea. Here are his reasons.
Australian firefighter Troy Thornton dies after lethal injection in Swiss clinic
From the SMH: Relatives and former colleagues of veteran Victorian firefighter Troy Thornton have paid tribute to the 54-year-old, who has died in a Swiss euthanasia clinic.
Mr Thornton died by lethal injection late on Friday, Australian time.
His disease – multiple system atrophy – is a progressive neurodegenerative disorder. There are no treatments and there is no prospect of recovery but death can take years.
His wife Christine was there to hold his hand, but he died without his two teenage children – Jack, 17, and daughter Laura, 14 – by his side. He farewelled them in Australia on Sunday.
Mr Thornton desperately wished he have could legally end his life at home in Australia, with all those he loved around him.
Despite Victoria becoming the first state to legalise voluntary assisted dying, he didn’t qualify.
That’s where the Victorian laws fall down, Mr Thornton said.
It left him with Switzerland as a solution to end his suffering, albeit without his children, his extended family and his loyal circle of friends.
The Victorian Act says:
VOLUNTARY ASSISTED DYING ACT 2017 (NO. 61 OF 2017) – SECT 9
Eligibility criteria for access to voluntary assisted dying
(1) For a person to be eligible for access to voluntary assisted dying—
(a) the person must be aged 18 years or more; and
(b) the person must—
(i) be an Australian citizen or permanent resident; and
(ii) be ordinarily resident in Victoria; and
(iii) at the time of making a first request, have been ordinarily resident in Victoria for at least 12 months; and
(d) the person must be diagnosed with a disease, illness or medical condition that—
(i) is incurable; and
(ii) is advanced, progressive and will cause death; and
(iii) is expected to cause death within weeks or months, not exceeding 6 months; and
(iv) is causing suffering to the person that cannot be relieved in a manner that the person considers tolerable.
(4) Despite subsection (1)(d)(iii), if the person is diagnosed with a disease, illness or medical condition that is neurodegenerative, that disease, illness or medical condition must be expected to cause death within weeks or months, not exceeding 12 months.