End-of-life care

Lung cancer top of the list for assisted dying


Lung cancer is the leading reason for people with terminal illness to seek medical assistance to end their lives, according to the latest figures from Victoria’s Voluntary Assisted Dying Review Board.

However other serious respiratory conditions such as COPD were infrequently cited in applications for the assisted dying program.

In its latest report covering the period up to December 2020, the VARDB reports that a total of 328 people with a voluntary assisted dying permit application had died, of whom 77% had a cancer diagnosis.

Of those with a malignancy, 21% had lung cancer, 11% had breast cancer, 11% had pancreatic cancer and 9% had colorectal.

Of the 23% of people who had a non-cancer diagnosis, most (62%) had a neurodegenerative disorder, while a minority had other diseases such as pulmonary fibrosis, cardiomyopathy or chronic obstructive pulmonary disease.

In its report, the VARDB noted that more than 450 medical practitioners had registered for training in the program, and an increasing number were becoming actively involved in cases of medically assisted dying. In the previous six months there was a 26% increase in the number of practitioners who were acting as a co-ordinating or consulting  medical practitioner for a patient with terminal illness.

Of the 157 active practitioners, 122 were GPs, 36 were oncologists, 10 were neurologists and six were respiratory specialists.

Around 20% of people were referred to the scheme by their hospital or treating specialist, and a similar proportion from palliative care clinician, while about  10% found the service via their GP.

After an initial peak in applications in April 2020, the VARD was now receiving around 30-40 applications for medical assisted dying each month, the report showed.

Of the 328 people registered in the scheme who had died to date, 56% administered the medication themselves and 12% had the medication administered by a medical practitioner. The remaining 32% died before the medication was dispensed, or did not take the medication,. Less than 2% withdrew after deciding not to proceed.

In the foreword to the report, Betty King Chair of the Voluntary Assisted Dying Review Board said the latest figures for the first 18 months showed that access to the scheme was increasing, the number of medical practitioners involved was increasing and that compliance was high.

“As the program continues to mature, information and feedback reiterates how voluntary assisted dying provides Victorians suffering from a terminal illness a genuine and compassionate choice at the end of life,” she wrote.

However she noted that access to assisted dying was still limited by a the lack of medical practitioners in specialities such as neurology, particularly in rural and regional areas.

Assisted dying laws have also been enacted in WA and Tasmania, whereas debate over similar laws continued in the states of Queensland, South Australia and NSW. However the Territories are banned from legislating on assisted dying by a Federal government Bill brought in by Liberal MP Kevin Andrew in 1996, in response to the NT’s voluntary euthanasia laws.

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