A push to lift the Commonwealth ban preventing voluntary assisted dying (VAD) consultations via telehealth has been promoted as a way of improving access for patients in rural and regional Australia.
But the change is unnecessary and would undermine the therapeutic approach needed for life-and-death situations, says Michael Quinlan, emeritus professor of law at the University of Notre Dame Australia.
Why do you think that amending current legislation to permit telehealth for VAD is unwise?
The Commonwealth Criminal Code Act 1995, as interpreted in Carr v Attorney General of the Commonwealth, currently effectively prohibits the use of carriage services for the provision of VAD. This prohibits the use of telehealth for voluntary assisted dying.
Decisions about VAD are life or death decisions. They involve the consideration of many aspects including diagnosis of a life-threatening illness within the scope of the relevant State or Territory VAD legislation, assessing mental health and ruling out coercion from relatives or others.
A meaningful therapeutic relationship is key to these assessments. Face to face communications are the best means to develop such relationships. As Dr Brian Grim recently observed in another context: “while digital platforms help us exchange information, relationships – especially across belief systems – are built most powerfully face-to-face.”
A recent Healthed poll of around 1400 GPs found that 69 per cent are generally unsupportive of telehealth for VAD assessments and only 8 per cent were generally supportive.
What about people in regional and remote Australia who cannot see a doctor face-to-face?
There is a range of approaches to the provision of health care services to facilitate access in Australia. In NSW several programs exist.
The Isolated Patients Travel and Accommodation Assistance Scheme (IPTAAS) provides financial assistance towards travel and accommodation costs when patients need to travel more than 100km one way or 200km within a week for specialised medical treatment that is not available locally. Patients can apply to IPTAAS for VAD-related appointments.
Medical services are also provided by outreach services which aim to increase access to medical, allied health and nursing services for people living in remote, rural and regional areas. Health professionals – including the Flying Doctors – travel into the regions to provide medical services.
There is a VAD coordinator in each of the 15 local health districts. NSW Health has employed a number of visiting medical officers who are available to travel to regional and remote areas to deliver VAD to patients who have no other access to a VAD provider.
All this suggests that regional residents have access to VAD services.
Is VAD disproportionately accessed by rural and regional residents?
While it is claimed that telehealth is required to make VAD accessible to remote and regional communities, this is not borne out by the evidence.
The most recent statistics indicate that a proportionately higher number of regional residents have accessed VAD.
Of patients who had a first assessment for VAD in NSW in the 2025 financial year, 67.5 per cent were regional residents even though only 38.8 per cent of the NSW population were regional residents. The latest VAD annual report from Victoria provides similar results.
What do you think is the most compassionate avenue for end-of-life care for people in remote and regional Australia?
The most compassionate avenue for end-of-life care for people whether they live in remote and regional Australia or here in metropolitan Sydney is the same.
They deserve access to high-quality medical care, high-quality palliative care, high-quality pain relief and high-quality aged and nursing home facilities. There is also a need for significant work to be done to address suicide risks in rural Australia.
Those who choose VAD because they do not have access to all of these facilities should not be falsely characterised as exercising free will or choice.
Has the public been well-informed about telehealth VAD?
There has been a flood of pro-VAD articles and broadcasts in the media. Much of it is misinformation, distortion of truths, and misrepresentations. Why has there been no publicity given to funding cuts to palliative care in aged care at the same time that VAD funding and availability have expanded?
Recently $1 million in federal funding for palliative care in aged care in Tasmania was slashed – while the number of VAD deaths rose by 73 per cent.
Lobbyists for VAD assert that it is a matter of choice, but if services are not available to choose from, it is basically a form of coercion.
Professor Quinlan will deliver the University of Notre Dame Australia’s 12th Annual Religious Liberty Lecture on 17 September, addressing state interests and freedom of thought, conscience and religion in NSW. The university’s Annual Religious Liberty Conference follows on 18 September, with panels examining religious liberty, faith schools, public safety and social cohesion.
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