Euthanasia comes from the Greek word εὐθανασία – “good death” – and for Greek Australian Victorian Health Minister Jenny Mikakos it is a “fundamental human right”.
The definition of a ‘good death’ differs from person to person, but for MP Mikakos it is one “alleviated from unnecessary suffering”. And, for the first time in Victoria, terminally-ill patients have an additional choice as the Voluntary Assisted Dying Bill goes into effect today giving them the right to lawfully end their lives.
The historic law, passed in November 2017 after a state parliamentary inquiry, and a ministerial advisory panel on voluntary assisted dying, is a matter of free choice for the Greek Orthodox minister whose faith does not condone voluntary assisted dying.
“I am a practising Christian yet I support this legislation,” she told Neos Kosmos. “My view is, as it is with other issues of conscience, that it is not for us as legislators to impose our religious views on others.
“How you wish to see your last moments is a fundamental issue of your rights. For the first time in Australia we are giving people additional choices and rights in that regard.”
MP Mikakos points to 68 safeguards described by the minister as the “most conservative of its kind” in the world to date. “We believe that we have struck the right balance in providing these additional choices for patients who are dying and have ensured community safety as well,” she said.
Eligibility criteria are draconian, including the necessity for the patient to have lived in the state for the past 12 months, to ensure that Victoria does not become the ‘euthanasia state’ (though the term euthanasia is not actually mentioned anywhere in the bill).
Under the scheme, terminally-ill Victorians of sound mind who are over 18 years can apply. In cases of dementia, voluntary assisted dying cannot be pre-planned. And only those in intolerable pain with less than six months to live or 12 months for a neurodegenerative disease can request their GP’s help in dying in three clear requests before being assessed by two experienced doctors and a claim to a 12-member review board chaired by retired Supreme Court judge Betty King.
A matter of choice
“The patients themselves need to mix the medication and administer it themselves. We want people to not feel that there is an appointment or a time or a date where they need to take these steps,” MP Mikakos said.
“We want to give people the ability to have a good death, surrounded by their loved ones, in their own home, at a time of their choosing.
“There may well be people who take prescriptions and medications sitting on their bedside table who ultimately choose not to take it.”
Ultimately, it is about giving people an alternative option. “We have excellent palliative care in Victoria. In fact our government has provided a 72-million dollar boost in funding in the budget this year to give people the support and care they need,” she said, adding that funding has also been benchmarked for voluntary assisted dying in cases where palliative care is not enough to alleviate suffering.
The legislation, says MP Mikakos, is not about cutting costs but about respecting the wishes of patients and health care providers alike, who are not obliged to take part in the process should they object to it. A hundred doctors across Victoria – a third in regional areas – have undertaken the mandatory training for the implementation of the new Act.
“A lot of people who have worked in the health care system are strong supporters of this,” MP Mikakos said, pointing to an interview with cancer-sufferer Margaret, a former nurse in Sydney who will be one of the first to request it after seeing first-hand what other patients have gone through.
“I acknowledge that there will be some people in the community who will not support these changes and there will other people in the community who feel that we have not gone far enough,” she said.
“We think we are on the right side of history here. We know that overwhelmingly the vast majority of Victorians support this change, but I respect there will be religious groups including our own church that will take a different point of view. And that’s fine. For people who have strong views about this. They will not need to participate in this.
“The important thing to stress here is that this is all about people making decisions for themselves.”
The Greek dilemma
The state of Victoria estimates that 100 people per year would make use of the Voluntary Assisted Dying Act, however Fronditha Care’s Chief Executive Officer George Lekakis has not heard of one at the Greek Australian residential aged care facility he manages. “As yet we have had no serious requests for this type of service, now or in the past,” he said of the Greek Australian residents at the facilities, many of whom have “strong religious values”.
After attending forums prior to the implementation of the Bill, Fronditha Care created its own policy following extensive consultation with consumers, staff and the board of directors.
“Fronditha Care values the rights of residents and consumers to make choices and decisions about their end of life care. This value underlies the provision of high quality care for all residents and takes into consideration the regulated access to Voluntary Assisted Dying,” Mr Lekakis said.
“Fronditha Care’s Model of Care does not have the capacity to perform voluntary assisted dying at our aged care residential facilities. However, providing that a care recipient meets the necessary safeguards in accordance with the Voluntary Assisted Dying Act, Fronditha Care will make every effort to facilitate a care recipient’s request for voluntary assisted dying by supporting their access to other premises and service providers offering this model of care.”
He states that the decision for the policy took many factors into account. “A variety of reasons lead to our decision,” he said, without wishing to stipulate further.
Asked about the notion of a good death, Mr Lekakis states that “the ultimate contribution we can make is to maintain people’s dignity in the process of palliative care”, however he adds that “no death is a good death.”
“Nobody likes to see someone die.”
Neos Kosmos contacted the Greek Orthodox Archdiocese with questions about the Voluntary Assisted Dying Bill but has yet to receive a response.