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(TAS) End State Residency Requirements for Voluntary Assisted Dying
- Christopher Noonan
- Apr 7
- 5 min read
Updated: 4 days ago
Author: Christopher Noonan | Publish date: 04/07/2024
Problem Identification:
In TAS, to be eligible to receive Voluntary Assisted Dying (VAD), one must have been a resident in the state for at least 12 months.
Tasmania’s End-of-Life Choices (Voluntary Assisted Dying) Act 2021 states that a patient is eligible for VAD only if, ‘the person has been ordinarily resident in Tasmania for at least 12 continuous months immediately before the person makes the relevant first request.’
This means that patients who have been ordinarily resident in TAS for less than 12 months, and who are unable to return to their home-state, cannot receive VAD. It also places an additional administrative burden on patients in TAS to prove their residency.
Context:
VAD allows terminally ill patients to have a medical professional assist them in ending their life. VAD was legalized in TAS in 2021 by the End-of-Life Choices (Voluntary Assisted Dying) Act (ELCA). VAD is currently legal in all other states, and will likely be available in both territories soon.
The mandatory 12 month residency requirement was initially introduced to stop residents of other countries, or states, traveling specifically to receive VAD, a phenomenon known as death tourism.
These requirements have faced criticism. There are reports of patients who visit one state, are diagnosed with a terminal illness, and become too ill to travel back to their home state. The residency requirement then stops these patients from receiving VAD. This requirement also constitutes an administrative burden for patients hoping to receive VAD, which has already been criticized as being insufficiently accessible to patients.
Experts including Waller, Del Villar, White and Willmott, as well as organizations such as Dying with Dignity Victoria, Go Gentle Australia, and Voluntary Assisted Dying Australia and New Zealand, have argued that these requirements are unnecessary and should be removed. They have argued that Australia already requires eligible patients to be Australian citizens/permanent residents, preventing international death tourism. They also claim the legality of VAD in all Australian states removes the potential for domestic death-tourism.
There is precedent for removing state residency requirements. The American states of Vermont and Oregon have repealed their state-residency requirements for VAD, and the Ministers for Health in Western Australia and Queensland have both shared that they are open to reviewing these requirements in their state.
Solution Identification:
Amend the Tasmanian End-of-Life Choices (Voluntary Assisted Dying) Act 2021 to remove section 11(1)b, which states that patients be residents of TAS for 12 months before being eligible for VAD.
This could allow patients who have been in TAS for under 12 months, and who are unable to return to their home-state, to receive VAD. It could also remove unnecessary administrative hurdles for patients in TAS to receive VAD.
Advice:
The TAS Minister for Health, Mental Health and Wellbeing should seek to amend the Tasmanian End-of-Life Choices (Voluntary Assisted Dying) Act 2021 to remove s 11(1)b at the next opportunity.
Public Support:
Dr Katrine Del Villar
Katherine Waller
Dr Aidan Ricciardo
Dying with Dignity Victoria
Go Gentle Australia
Voluntary Assisted Dying Australia and New Zealand
Where to go to learn more:
Waller, K., Del Villar, K., Willmott, L. and White, B.P., 2023. Voluntary assisted dying in Australia: a comparative and critical analysis of state laws. https://www.unswlawjournal.unsw.edu.au/wp-content/uploads/2023/12/Issue-464-10-Waller-et-al.pdf
Go Gentle Australia, Submission to the Centre For Evaluation and Research Evidence at the Victorian Department of Health (Feb 2024). https://assets.nationbuilder.com/gogentleaustralia/pages/3000/attachments/original/1708908681/Final_-_GGA_submission_to_Vic_Review_-_Feb23.pdf?1708908681
Keane Bourke, “Voluntary assisted dying almost universally available in Australia, but residency requirements block some from accessing it” (Jul 2024). https://www.abc.net.au/news/2024-07-12/residency-requirements-blocking-access-to-vad/104050352
Human Perspective:
Marion’s Story: Marion lived in Western Australia for most of her life and then retired to Tasmania. While visiting WA, she was diagnosed with incurable lung cancer. She became too ill to travel back to Tasmania and wanted to spend her final days with her family. Because she had not been living in Western Australia for 12 months, she was not eligible for VAD (even though she likely would have been if she could get back to Tasmania). This meant that she did not have autonomy during her final days alive, which led to devastating mental health issues. ‘It was extremely harrowing, emotionally distressing and left me feeling very angry which has resulted in me suffering anxiety attacks for which I am now under medication’, she told the ABC through her lawyer. ‘My life should not be left in the hands of legislators as this decision should be entirely mine.’
To protect the anonymity of those involved, this is a fictionalised account drawn from an amalgamation of real-life stories, experiences, and testimonials gathered during the research process for this brief. Any resemblance to actual individuals is purely coincidental.
Conflict of interest/acknowledgment statement:
N/a
Support
If your organisation would like to add your support to this paper or suggest amendments, please email Info@foreaustralia.com.
Reference list:
Cohen, I. G., Adashi, E. Y., & Pope, T. M. (2022). Traveling Across States for Prohibited Treatments: Medical Aid in Dying and Looming Battles Over Abortion. Journal of General Internal Medicine, 38. https://doi.org/10.1007/s11606-022-07898-3
Directorate, J. and C. S. (2023, February 7). Voluntary assisted dying laws in the ACT. Www.justice.act.gov.au. https://www.justice.act.gov.au/justice-programs-and-initiatives/voluntary-assisted-dying-laws-in-the-act
End-of-Life Choices (Voluntary Assisted Dying) Act, 2021 (TAS).
Go Gentle Australia. (2024). Submission to the Victorian review of the operation of the Voluntary Assisted Dying Act 2017.
K, W., K, D. V., L, W., & BP, W. (2023). Voluntary assisted dying in Australia: a comparative and critical analysis of state laws. UNSW Law Journal , 46(4).
Keane, B. (2024, July 11). Voluntary assisted dying almost universally available in Australia, but residency requirements block some from accessing it. ABC News. https://www.abc.net.au/news/2024-07-12/residency-requirements-blocking-access-to-vad/104050352
Submission to the Centre for Evaluation and Research Evidence at the Victorian Department of Health. (2024). Dying with Dignity Victoria . https://www.dwdv.org.au/wp-content/uploads/2024/02/DWDV-submission-to-Victorian-VAD-5-Year-Review.pdf
Vermont Ethics Network (n. d.). Medical Aid in Dying, Act 39: Patient Choice and Control at the End of Life. www.vtethicsnetwork.org https://vtethicsnetwork.org/palliative-and-end-of-life-care/medical-aid-in-dying-act-39#:~:text=In%20May%20of%202023%2C%20Vermont,in%20which%20they%20legally%20reside.
Voluntary assisted dying (VAD) in the Northern Territory | Have Your Say Northern Territory. (n.d.). Haveyoursay.nt.gov.au. https://haveyoursay.nt.gov.au/vad
Voluntary Assisted Dying Australia and New Zealand. (2024). Submission to Review of the operation of the Voluntary Assisted Dying Act 2017 (Victoria). https://www.vadanz.com.au/content/uploads/VIC-VAD-Review-VADANZ-submission.pdf
Voluntary Assisted Dying Review Board. (2020). Report of operations. Safer Care Victoria.
White, B., Jeanneret, R., Close, E., & Willmott, L. (2023). Access to voluntary assisted dying in Victoria: a qualitative study of family caregivers’ perceptions of barriers and facilitators. The Medical Journal of Australia, 219(5). https://doi.org/10.5694/mja2.52004
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