This is the fourth time Tasmania has considered legalising voluntary assisted dying (VAD), with the most recent attempt being outvoted in 2017.

VAD includes both “physician-assisted suicide”, where a lethal drug is supplied to the patient to self-administer, and “voluntary euthanasia”, in which a lethal drug is administered to a patient at their request.

“This is a bill that allows for safe sanction suicide for people who are not terminally ill.” – Dr Megan Best

The current VAD bill before Tasmania’s upper house – introduced by Independent member for Mersey Mike Gaffney – is a hefty 122 pages long, in contrast to the 19-page Dying with Dignity bill first considered by that parliament in 2009.

However, despite appearances, Christian ethicist and palliative care doctor Megan Best says the content of the bill is being described by many experts as “dreadful”.

“Length is no indication of quality and whoever thinks it’s a stringent bill, hasn’t read it,” says Best, a research associate with the Institute for Ethics and Society and senior lecturer at the University of Notre Dame Australia.

She gives two main reasons for this assessment: “This is a bill that allows for safe sanction suicide for people who are not terminally ill and it contains a clause that it should be reviewed in two years’ time after passing to see if it should be extended to include children …

“There are people saying that it’s such a dreadful bill it shouldn’t even be debated, and that it doesn’t deserve to be treated as a reasonable bill.”

The bill stipulates that those eligible for VAD must be over 18, have “decision-making capacity” and have a “relevant medical condition” – that is “a disease, illness, or injury” which is “serious, incurable and irreversible” – which fails to restrict VAD to those with terminal conditions.

However, government departments tasked with analysing the bill also share some of Best’s concerns. A letter from Tasmanian Premier Peter Gutwein to Gaffney presenting an analysis of the bill said it “potentially poses significant risks to patients”, as medical conditions could be incorrectly diagnosed. The Australian Medical Association is also opposed to the bill, however this is primarily because it involves doctors in physician-assisted suicide.

More than two Victorians each week are using the voluntary assisted dying laws.

Over the past few decades, there have been around 30 VAD bills knocked back by parliaments in different states and territories around Australia, according to Best. While the Northern Territory legalised VAD in 1995, it was overturned two years later when the federal government passed a bill that banned legally assisted suicide in the NT and in the ACT.

Alongside Tasmania, inquiries into the legalisation of VAD are now also underway in Queensland and South Australia. Currently, Western Australia and Victoria are the only two places in the country where VAD is legal. In Western Australia, where a bill passed in December 2019, VAD will not be made available until mid-2021.

Meanwhile in Victoria, where VAD was introduced in June 2019 after legislation was passed in 2017, Best says the number of people opting to use VAD is “much higher than the proponents of the bill said they would be.”

In fact, more than two Victorians each week are using the VAD laws, with a total of 124 Victorians dying as a result since June last year, according to a report in the Herald Sun.

Similarly, in other countries where VAD has been legalised – including Poland, Belgium and Canada – Best says the number of people using these laws has also been higher than anticipated.

“As far as we know, in places with accurate statistics, it’s been used more than expected and more frequently over time …

“I certainly think it’s premature to even consider [VAD] in other places [in Australia] before we see how it plays out in Victoria. But I think [Victoria’s one-year VAD review] shows that there is a great risk in introducing euthanasia legislation in that it normalises suicide as a way to deal with suffering,” she warns.

“And I think that it distracts people from doing what we can to improve the suffering of people without killing them.”

“Vulnerable people are at risk just by the mere presence of euthanasia legislation.” – Dr Megan Best

Best expands on her concerns about eligibility for VAD and the potential for safeguards around this criteria to be abused.

“Any so-called safeguards tend to be seen by the people trying to access to legislation as barriers to be overcome,” she says.

“We have seen from when Northern Territory had legislation allowing euthanasia for a brief time that patients would lie to try to get past some of the safeguards. It’s not just what’s in the bill, it’s also how it is implemented.”

According to Best, no safeguards – no matter how stringent or well executed – would ever be adequate.

“I think vulnerable people are at risk just by the mere presence of euthanasia legislation. There’s no way you can protect against coercion. A lot of coercion can occur within families behind closed doors. There’s just no way of policing the things that put people at risk.”

She adds: “I don’t think it’s possible to write a safe euthanasia bill. Because behind every euthanasia or physician-assisted suicide bill is the assumption that some lives are not worth living.”

“As Christians, we need to think, well, if these people’s lives are so bad that they think life is not worth living, what can we do to improve their lives?’ – Dr Megan Best

And this is where Best says the church has an important role to play.

“It is not good for our society to start thinking that there are some lives not worth living because it devalues human life. We know in countries where euthanasia has been legalised that the unassisted suicide rate also goes up. So it presents this idea that if you’re suffering and life’s not good, the best thing is to die.

“As Christians, we need to think, well, if these people’s lives are so bad that they think life is not worth living, what can we do to improve their lives?

“And we know from the places where euthanasia is legal that things like pain are a very rare reason for people to request euthanasia. It’s much more likely to be psychosocial reasons, such as loneliness, a fear of becoming a burden, a fear of loss of control, fear of dying alone.

“A lot of those things we could do something about. So I think the church would have a huge role in changing the face of the dying experience if we got organised.”

“We need to let the parliamentarians know there are a lot of people who don’t want euthanasia.” – Dr Megan Best

“Getting organised” also means Christians should speak up about current and future VAD legislation in Australia, says Best.

“We need to let the Tasmanian parliamentarians know that there are a lot of people who don’t want euthanasia …

“We actually need people to make the effort to say, ‘I’m happy that we don’t have any euthanasia legislation and I don’t want any to be introduced.’ For the people who don’t live in Tasmania, we need to write to our politicians as well and say that this is not a good thing for our society.”

When asked if it’s just a matter of time before VAD is legalised across Australia, Best says, “By no means! It’s actually a fairly small number of people who are pushing hard for it …

“A lot of people misunderstand what a voluntary euthanasia law involves. Some people think that to get adequate pain control at the end of life, for example, it requires a euthanasia bill, which is not the case. So there’s a lot of confusion.

“I think if people knew the Tasmanian bill doesn’t require someone to be terminally ill and they’re considering extending it to children, I think a lot of people would say, ‘No, that’s not a good thing for Australians, that’s not the kind of society we want to have.'”