Wednesday, 12 November 2025

 Georgie CROZIER (Southern Metropolitan) (13:49): I rise to speak to the Voluntary Assisted Dying Amendment Bill 2025, and I do so as the first speaker in this house on this important bill. I can speak for myself, but I know all members of Parliament, no matter their view or their concerns around this piece of legislation – and there are many; I acknowledge that – understand that it is a sensitive matter and that it this a debate we are having given the passing of the initial legislation in 2017, when the Parliament debated the Voluntary Assisted Dying Act 2017. There are not too many of us here that were in the chamber then. Mr Davis was certainly here at that time. I do not think there are too many other current members that were here.

We had a very extensive debate. It was a very long debate. It was a very emotional debate at times. It was the first time that this legislation had been debated in this country. For me personally, I found it incredibly difficult. I found it an incredibly difficult debate and very confronting given the personal circumstances I was going through at the time and as somebody who has been a nurse on the other side in a caring profession and understands that the last thing you want is for anyone to be in pain or suffering. To be a legislator on this side was a different matter when we were putting in place this type of legislation, this new legislation for this country. It was a landmark piece of legislation for Australia. As I said, it was a sensitive and difficult debate. It went on for many, many, many hours. I think it was 28 or 29 hours or thereabouts; the clerks will correct me on that. It was exhaustive. There were members of the government who collapsed, and there were a lot of things that occurred throughout that debate.

I just want to place on record the many people that have spoken to me with really heartfelt concerns around either supporting this piece of legislation which amends that initial legislation – their support or their non-support for the bill we are debating today.

Voluntary assisted dying effectively came into effect in 2019. The first bill provided that there was to be a review undertaken after five years. I want to acknowledge the work – I should have done so in my commentary before – the information and the discussions provided by the government and the minister’s office as some clarification. I had many concerns with the first piece of legislation. I was concerned about the safeguards in the legislation, and I voted accordingly. I was very concerned about those issues. I had some concerns, and I still have a number of concerns with some elements of this legislation. I will be asking a couple of questions, not many, in committee. I will be looking at the amendments. The government is aware of most of my concerns around elements of this legislation.

Voluntary assisted dying came into effect in 2019, as I said. Since then 1683 people have died in Victoria using this option. In 2024–25 there were 389 deaths, which accounted for 0.8 per cent of all deaths in Victoria. It is an option that is being used. As I mentioned, the initial act required a review to be undertaken by the Voluntary Assisted Dying Review Board in the fifth year of operation, and the findings of that review have informed the amendments in this bill. The government has also cited and drawn on experience in other jurisdictions where voluntary assisted dying is in place. It is now in place in all states in Australia, the ACT and New Zealand. When developing the amendments to the initial bill, that is what they have gone on.

The aim of these amendments is to reflect the comparison and provide a more consistent approach across the nation. I acknowledge that, and I acknowledge the work described to me through various stakeholders and through the briefings that have been provided. I might add that there have been significant briefings, and I have been very pleased to organise and coordinate those on behalf of the coalition so that members were informed and could have the information that they required when debating this bill. Some people have very strong views for and against, and they do need to have that ability to be informed, given it is, on our side, a free vote. I understand that on the government’s side it is also a free vote. Therefore members need to have that information and be able to question stakeholders as they wish. I have been very, very grateful to all of those stakeholders that have requested those briefings, and I have been able to coordinate those on behalf of the coalition.

Obviously a lot of the amendments that have been put in this bill came from the evaluation that the review undertook. It did evaluate the systems, processes and practices involved, and it found that generally the framework supporting voluntary assisted dying is working appropriately. However, it also identified areas for improvement, including addressing barriers to access, support for the health workforce and maintaining safeguards. As I said earlier, in the initial debate I had real concerns about those safeguards, but I have to say, given the time that has gone on – and I will say more about the safeguards later on – I am pleased that the government is putting in a further safeguard around family members not being able to be directly involved. I think that was probably an unintended consequence or an oversight in the first place. I am pleased that the government is doing that. I will speak to that clause in a moment.

The review found that there was high compliance with the legislation – 99.3 per cent for all completed applications. Only 14 cases, or 0.7 per cent, were noncompliant. One case, 0.05 per cent, was referred to the Australian Health Practitioner Regulation Agency, the regulatory body that oversees misconduct of practice and registration of health practitioners. That case involved noncompliance with the permit application process for which the medical practitioner involved was fined. You can see that it was working from a regulator’s point of view. Half the cases of noncompliance involved the contact person not returning the substance within the prescribed 15 days following death. These were found to be procedural delays in cases where the grieving relative, as the contact person, had not been able to manage returning the substance in the specified timeframe. I think that that is perfectly understandable  – when somebody is grieving the loss of a loved one, perhaps that time elapsed and therefore they did not comply with that 15-day timeframe. That is understandable in terms of that one case of noncompliance. It is my understanding that there have been no reported instances of mishandling or misuse of the voluntary assisted dying substance.

As I said, this bill will introduce a range of amendments – 13 amendments – to the Voluntary Assisted Dying Act 2017. The aim of these amendments is primarily to address accessibility and support the health workforce by maintaining safeguards in relation to voluntary assisted dying, which is in place and has been in place for six or so years now. I want to just go to the main clauses now and outline those in the time I have, because I think it is important to understand the various amendments and where there has been quite a lot of discussion. I have been very pleased to have those discussions and understand some of the reasons why the government is proposing various amendments.

Clause 2 provides for the 18-month implementation period, which will allow the Department of Health to prepare voluntary assisted dying health practitioners and the broader health sector to understand and implement the amendments, prepare administrative systems and processes for the implementation of the amendments and prepare the broader community to understand the amendments, and I will ask a little bit more about that in the committee stage.

Clause 7 of the bill – and this is one of those areas on which there has been quite a significant amount of discussion – relates to health practitioner-initiated discussions. The current law in Victoria prohibits health practitioners from starting a conversation about voluntary assisted dying with a patient, while a practitioner may raise all other options for someone with a life-limiting condition, such as palliative care or treatments, and those treatments can be radio or chemo to ease pain. But an individual still may have a terminal illness where those treatments are not going to cure them. Those treatments are about providing less suffering in many instances. So they are options that are often discussed by medical practitioners. VAD cannot be offered as part of this discussion unless the patient raises it first, and that is the issue. This new provision is intended to ensure clinicians are able to provide a full range of choices for individuals during conversations about end-of-life care. That is the important part that I want to emphasise, which I think is actually quite reasonable: if your medical practitioner is talking about end-of-life options –VAD has been operating for six years in Victoria – then clearly they should have that ability to speak freely about this and not be breaking the law.

Clause 7, new section 8A, further allows registered health practitioners who are not medical practitioners and nurse practitioners, such as allied health professionals regulated by AHPRA, the Australian Health Practitioner Regulation Agency, to initiate discussions about VAD under a number of conditions – so in the context of broader end-of-life conversations – but in doing so, they must also say that the patient needs to speak to their treating doctor about VAD. Breaches of these requirements constitute unprofessional conduct and may be referred to AHPRA. But I do have some concerns around this area, I have to say. I do have concerns with the breadth of the health practitioners that are currently listed with AHPRA. I understand, though, that palliative care can last for not just weeks, it can last for months or years. In many instances, people might be going to a physio to have assistance with mobility or easing of muscle pain, or any number of reasons to have physio during palliative care, and they may have a very close relationship with that physio. Therefore it seems quite sensible for that physio to be able to discuss end-of-life care options. But I do have a problem with others that are listed in this scheme, who are registered with AHPRA, and I do not think that is entirely appropriate. I do think it should be the patient’s medical treating doctors and their teams listed, not random allied health professionals that they might come across. I will have a look at that, and I know that there are people that are raising concerns. I will be interested to see the full suite of amendments when we get them – I think they are still coming in.

Clause 6 relates to conscientious objection. Currently there is no obligation for medical practitioners who have a conscientious objection to VAD to provide any information to patients on this subject, even if requested. What this bill does is it changes the position to ensure people seeking information about VAD are provided with minimal information on how to make inquiries and access information and services. That is what this bill does. So it is unlike the scenario of a woman seeking advice about termination from a doctor who has a conscientious objection where they must refer them on to another doctor.

This does not go to that extent. A doctor has every right to have a conscientious objection and has every right to not agree with VAD, and I fully support anyone being able to have a conscientious objection, but I do think that it is reasonable for somebody who does have a conscientious objection to say, ‘Look, I can’t discuss this with you, but here is information around the navigator system that will provide the information you need.’ It is that simple, and I think it is fairly reasonable in this day and age that somebody can do that, a doctor or a nurse, if they have an issue. I certainly understand that many people do have a strong belief in conscientious objection, and I understand the reasons why, but I do want to make the point that this is not as significant as those seeking advice on termination. It is just providing information that they can get from the navigator service, which runs out of the Peter MacCallum Cancer Centre. I might add that this clause will only apply where a patient makes an inquiry about VAD.

The other important part about this area is in clause 6(2), which provides that objecting practitioners must advise a patient seeking information on VAD that another practitioner would be better placed to assist them. That does not mean that that practitioner is required to refer them to another practitioner, as I have explained; it is to provide that minimal information. Again, I do have concerns around providing the minimum information approved by the Secretary of the Department of Health, which includes contact details for the statewide care navigator service and a link to the Department of Health VAD webpage. But I do have concerns about the unfettered power of the secretary to determine what this information consists of. Given what we went through in COVID and given the powers that the department had and the information that Victorians were being provided with and those decisions being made by bureaucrats, I am not at all comfortable with the secretary having that unfettered power. We saw what happened with the so-called advice that was coming from the CHO to the government. The CHO recently came out and said, ‘Well, actually, that wasn’t fully accurate,’ although he was unwilling to even provide to Victorians how the decision-making was taking place. So I am not at all confident with this requirement in this very important piece of legislation. I was going to move an amendment to not support this part of the bill, but I understand that Mr Mulholland will be moving that, and I will be supporting that amendment.

Clause 8 has the Australian residency requirements. I think that is another very straightforward amendment to the act. People have been denied access to VAD despite living in Australia for many years, particularly those from New Zealand and those who are post-war migrants. I believe that this is a sensible update. We go to citizenship ceremonies all the time and there are people that have been living in this country for decades, and for them to be able to access this as a part of their choice for end-of-life care I think is a very sensible amendment.

Clause 9 relates to the Victorian residency requirement and introduces compassionate exemptions to the Victorian residency requirement for people with a strong connection to Victoria, including living close to the Victorian border, being a former Victorian resident, having family or work ties to Victoria or receiving medical treatment in Victoria. I just think this is a compassionate component of those issues that have obviously been raised through the review process.

Clause 8 also relates to prognosis requirement standardisation and sets a consistent 12-month prognosis window for all applicants, instead of having a distinction between neurodegenerative illness and other conditions. While I am on this, I want to just mention that I did listen to Emma Vulin’s very powerful and moving speech on this bill in the other place in the last sitting week.

What an extraordinary woman, given the circumstances that she faces. I could not but be moved by her very powerful and compelling contribution to this debate, and I have taken it on board.

I got an email today from a man who has just lost his wife to MND. He wrote to me and told his story about how his wife Kate died. These issues have to be looked at in the context of what is happening to people that are suffering with these life-limiting illnesses and very severe and debilitating illnesses. This bill replaces the current threshold for eligibility, which is an expectation of dying within six months, or 12 months for neurodegenerative conditions. A 12-months prognosis reduces urgency, improves access and prevents the unintended effect of the six-month limit resulting in applicants being unable to access VAD. I know there is quite a lot of debate about this. I have had doctors ringing me and expressing their concerns: ‘You know, as a healthcare worker, that prognosis cannot be accurate in 12 months.’ Yes, I do know that. But I know that palliative care can last for years, and I know that something like a neurodegenerative illness is incredibly difficult to manage at the best of times. For this to extend out to that, I see as no problem at all, because with the six-month limit the review board found that many patients started the process very late in their illness – 171 applicants died before receiving a permit last year.

Clause 10 goes to medical practitioner eligibility. This is another contentious issue, but I think it is a misunderstanding about specialists. They go through significant training. They are not newly graduated doctors that are coming out and have a year or two of practice. They have been in the field and undertaken extensive training over a number of years. This clause amends the requirement for a medical practitioner to have five years of experience practising as a specialist to one year. This provision expands the eligible workforce, increasing access, especially in regional Victoria. I have heard the argument around that and understand that for many people that have chosen this option that has been a barrier. I do not think that is fair given this is in place and it is working.

Clause 15 is the removal of the third prognosis assessment. This removes the requirement for a third medical practitioner’s assessment for people with neurodegenerative conditions to confirm that the condition will result in death within six to 12 months. As I said, I think this helps reduce the burden for those applicants. Clause 28 concerns the shortened request interval and reduces the minimum time between the first and final VAD requests from nine to five days. This is to allow compassionate consideration for a small number of applicants who experience rapid deterioration in their health and prolonged suffering while are waiting for the minimum time to elapse. The administration methods and permits, again this is a commonsense, I think, amendment to the current act, because it allows people to have just one permit, not apply for multiple permits if they are unable to administer the VAD substance themselves. I do understand why this amendment has come in.

The interpreter accreditation, I have concerns about. I am not entirely happy that if an interpreter that has been accredited by the National Accreditation Authority for Translators and Interpreters is not available, that cannot be applied on another day. I am not entirely happy with this clause of the bill. The conflict of interest safeguard, which I have spoken about – that is a good move that prohibits practitioners from participating in a VAD application if they are a beneficiary or family member of that applicant. That probably should have been in the first piece of legislation. Nevertheless that is a good safeguard. Clause 79 provides that form templates used in the VAD process will be prescribed in regulations rather than the act so they can be improved and updated more easily.

The final amendment relates to the ongoing review and mandates a review of the act within three years of commencement and at intervals of no more than five years thereafter.

I wanted to go through those because I wanted to explain the situation, having been in this debate the first time around. In the six years that this has been in place and in my time as Shadow Minister for Health no-one has come to me and said ‘This isn’t working’ or ‘The safeguards are not working’ or ‘My family member has been coerced.’ I have to look at this through that prism of the responsibility that I have also as shadow health minister. I can only say that, yes, I have had a lot of people contact me in recent weeks, but I have not over the period of time that I have been shadow health minister while this has been in operation.

I know there have been people, like me, who were very concerned about this legislation coming into place. I was concerned about the safeguards, as I said in my contribution. I was very concerned, and my good friend and federal colleague Jane Hume was the same. She spoke so eloquently in the federal Parliament, and she spoke to me about her experience with her father using this option. She said it was incredible in terms of what his wish was and how it helped the family. She said, ‘I changed my mind on this option,’ and I think that is very powerful. There are many stories like that. I think that it was right to be questioning this legislation at the start when we were first debating it. It was right to question the safeguards and it was right to have a very extensive, long debate, because this was the first time this legislation was coming into the country. We were the first state, and we did not know. There were strong arguments for and against this legislation, but it is in place, it is working and the review has undertaken its work, as the first piece of legislation required to be done. These amendments are building on those reviews, and I see that there are some issues.

The final thing I wanted to mention before my time runs out is Palliative Care Victoria, who I have worked with closely and who have provided some very helpful feedback. They did, in summary, say that overall their members were supportive of most proposed changes where these align with other jurisdictions and simplify access. They did outline some concerns, which I have expressed also as my concerns, but I think it is important that this works in conjunction with palliative care. This is about providing options for people who choose to use this as an option in their end-of-life choice, in those discussions with those who are looking after them and caring for them. We all know that it can be an incredibly difficult time for any loved one who is going through a very significant illness or a terminal illness and is facing very difficult decisions. Certainly, as I said, I was just so moved by a number of those people who spoke in the lower house. Emma Vulin, I will not be getting in your way and I will be supporting this bill.

 Sarah MANSFIELD (Western Victoria) (14:19): I rise to speak on the Voluntary Assisted Dying Amendment Bill 2025. From the start, I want to state our clear support for this bill, and I would like to thank everyone who has been part of years of advocacy and consultation that has informed not only this bill but the introduction of the standing legislation eight years ago. I particularly want to pay tribute to my Greens colleague Colleen Hartland, a former member for Western Metropolitan Region in this place, who played a key role in the campaign to legalise voluntary assisted dying in Victoria and continues to advocate for improved access. I also want to pay tribute to the many people who have advocated for the needs of those wishing to access voluntary assisted dying, including Go Gentle, Dying with Dignity Victoria, VADANZ and the many wonderful healthcare workers my office has had the pleasure of interacting with over several years.

Importantly, I really want to acknowledge the patients and their families who have been willing to share their stories to help us understand how voluntary assisted dying is working and, importantly, not working in Victoria.

When I was still in primary school in 1995 the Northern Territory was briefly the first jurisdiction in the world to have a voluntary assisted dying scheme, but its power to legislate on this subject was removed by the federal government within a couple of years. While other places around the world began to introduce their own laws, it would take another 22 years for it to be legalised in Australia again. This meant that for most of my medical career voluntary assisted dying was not legal. From the early days in my work as a hospital-based doctor, as a junior doctor, to my work in the community as a GP, death and dying – from the diagnosis of a terminal illness through to providing palliative care, to certifying a death and to supporting a family in their grief – have been integral parts of that job that I have undertaken. It is a huge privilege to be part of these very intimate and difficult times in people’s lives, and while it is often tremendously rewarding, it can also be very traumatic. What I learned from these experiences is that every person’s journey to death – the nature of their illness, their response to treatment, the degree of their suffering, the adequacy of the palliative care in relieving that suffering, their view on the meaning of that suffering – is different. Fundamentally, people’s feelings about what a good death means for them are very personal. It was not uncommon for patients to ask whether there was anything I could do to hasten death for them.

I recounted a story about a patient of mine, who I renamed Grace –not their real name – in a speech in this place about voluntary assisted dying earlier this year. She desperately wanted to access assisted dying. It was not something that existed yet, but she wanted to access it to avoid what was going to be an inevitably drawn-out death. But there was no legal avenue, and she suffered tremendously with exceptionally difficult to manage symptoms, even with the very best palliative care. I often think of her and the many others whose deaths could have been that little bit easier if they had been afforded the agency that they so wanted.

In 2017 Victoria was the first state in the country to establish a legal voluntary assisted dying scheme, and the passage of that legislation showed tremendous leadership by this Parliament. It was something that made me really proud to live in Victoria. It paved the way for the rest of the country. Now, ironically, the Northern Territory is the only place without voluntary assisted dying, although it is currently in the process of exploring establishing its own scheme. The original bill that was introduced and was then further amended in order to pass through both houses here was very cautious, and understandably so. Being the first and given the seriousness of these laws, ensuring safety and rigour in the process was paramount. Other states, after seeing how the laws were operating in Victoria, decided to do some things differently. So we find ourselves years down the track with a good understanding of not only how the laws are operating in Victoria but how they compare with other states. What is clear is that many of the restrictions in Victoria’s laws, rather than acting as safeguards, are acting as barriers. Fewer people are able to access voluntary assisted dying in Victoria compared with other jurisdictions, and more die before completing the process, largely because our laws create situations where people are typically commencing the process very late in their illness and running into bureaucratic roadblocks along the way. This means that people with a terminal illness are spending some of their last precious time on this earth dealing with a stressful and difficult-to-navigate process instead of with their loved ones doing the things that they want.

Many of the very people these laws were designed to help are not able to access it. This is something I was aware of working as a GP for the first couple of years of the operation of these laws, starting with the fact that I was never able to raise the subject of voluntary assisted dying. It was unclear whether I was even able to discuss it if someone raised it in a sort of obtuse way without specifically mentioning that they wanted to access voluntary assisted dying. I wonder how many people would have wanted to have a further discussion or explore that option if it had been something I was able to say was legally available to them. Other issues within the current act were brought to my attention early in my term in this Parliament. I and my office have been actively working on how we can improve these issues over several years. It culminated in a private members bill that we introduced earlier this year. So when the government announced that they would be amending the laws, we really warmly welcomed that move.

The bill we have before us is a good bill. It addresses many of the identified issues with the standing legislation. Importantly, it removes the gag clause that I just talked about, which will allow healthcare workers to raise voluntary assisted dying in the context of end-of-life discussions. It improves eligibility criteria by increasing the prognosis to 12 months instead of six and allows for compassionate exemptions to the strict residency requirements. It simplifies administration permits and choices and ensures people who want to know about voluntary assisted dying are provided with at least some basic information. It also makes some sensible changes to the requirements for doctors who are providing voluntary assisted dying. These changes will bring us closer into line with most other states, and they are welcome improvements.

Importantly, it also retains core safeguards. Fundamentally, people must provide consent at every step of the way. They must have capacity to provide that consent, and the consent must be enduring over a period of time. Disability and mental ill health cannot form the basis for a request for voluntary assisted dying. Health practitioners who do not wish to provide voluntary assisted dying, for whatever reason, do not have to.

I have personally long supported voluntary assisted dying, but it is not a position I arrived at quickly or without a lot of deep reflection. It is a very challenging subject. While the majority of Australians support voluntary assisted dying, it is important to acknowledge and respect that people, including health practitioners, have a range of views based on their faith, morals, ethical values and experiences. They should be allowed to hold those views, and our laws, rightly, should not compel them to provide a service that they do not agree with.

However, there are still some unnecessary barriers in our act that do not exist in other places. So I will be moving a number of amendments that seek to make the bill more equitable, accessible and safer for those who choose to participate in any part of the voluntary assisted dying process. I would ask if those amendments could be circulated now, please.

The PRESIDENT: Could the amendments be circulated, please.

Sarah MANSFIELD: Can I just acknowledge my policy staff at this point, especially Georgia Lennon and Jasper Lees, who have been so patient and thorough in their work on these amendments. These are all based on the work we did on our private members bill, but it was very difficult legislation to work with. It involved a lot of consultation. I just really want to acknowledge the time and effort that they put into that.

The second amendment on this sheet removes the eligibility criteria that requires that death is expected to occur within a specific timeframe. Providing a time-based prognosis can be exceedingly difficult and is often arbitrary when considering the suffering a person may be facing. The ramifications of potentially getting a prognosis wrong are enough to cause many practitioners to err on the side of caution and wait until they are certain that death is very close, in effect potentially denying an individual who is otherwise suffering from an incurable illness that is advanced, progressive, will cause death and is causing intolerable suffering. This is one of the factors that is causing people to enter the voluntary assisted dying process far too late, and for some it means they are unable to complete it.

While extending the timeframe from six to 12 months is a very welcome change, it is still likely to create barriers for some. For example, I am aware of a family member of a friend of mine who had motor neurone disease, which actually already allows for a 12-month prognosis. He lived regionally. He had to travel to Melbourne for a voluntary assisted dying assessment. It was something he very much wanted to do. His initial neurological assessment estimated his prognosis to be greater than 12 months, so he was not eligible to start the process. Shortly after this he deteriorated rapidly and had to once again travel to Melbourne for assessments. This time around it was very difficult due to his significant symptoms. This was distressing for him and his family and seemed unnecessary given the inevitable outcome of his illness and his very clear wishes.

A time-based prognosis is asking a practitioner to estimate something that is very, very difficult to predict, and providing a prognosis was never meant to be a legal test by which a practitioner’s assessment is judged. It is a general guide provided to individuals to inform their treatment decisions and to help them with planning for their lives. We believe that fulfilling all of the other eligibility criteria, excluding the time expected before death, constitutes sufficient safeguards. They are more than enough to improve an individual permit to choose when and where they would like to end their suffering. The ACT has actually done this. They have removed the time-based prognosis. The Northern Territory’s Legal and Constitutional Affairs Committee has just recommended the same for any VAD laws that jurisdiction introduces. Should this amendment fail, my colleague Ms Copsey will move an amendment that at least enables the secretary to grant a compassionate exemption to the 12- month prognosis criteria. This is the approach that is currently used in Tasmania and creates avenues for those like the man I was just speaking of to prevent them from having to go through multiple assessments.

Our third amendment would remove section 10.3 from the act, which is the requirement that the coordinating medical practitioner or consulting practitioner be a specialist in the illness from which the individual is dying. The interpretation of this clause in Victoria has been quite narrow and limits this to non-GP specialist consultants. Everyone here would appreciate that it is really hard to get in to see a specialist full stop, let alone a specialist who is the right type, who is willing and able to participate in voluntary assisted dying. This interpretation creates significant access barriers for people, especially in rural and regional Victoria, who typically have to travel to Melbourne to access assessments, because telehealth is illegal under federal law for voluntary assisted dying, which in turn creates stress and suffering and, in some cases, completely prevents access to VAD due to their frailty, their health condition and cost. It also means there is a very limited pool of practitioners willing and able to participate in voluntary assisted dying for some conditions, leaving many of them at capacity. Experienced GPs and general physicians who know their patients and their illnesses are well placed to provide voluntary assisted dying, and our amendment would allow for that. Should this amendment fail, Ms Copsey will move an amendment that would alter the wording to enable broader interpretation of the existing requirements for specialists.

Our first amendment is in a similar vein, further improving accessibility of the scheme and workforce sustainability by allowing nurse practitioners with at least one year of relevant experience to be either the coordinating practitioner or the consulting practitioner. Nurse practitioners already play an important role in the voluntary assisted dying process. We really welcome the government’s changes in this bill that allow them to fulfil the newly created administration practitioner role, but we believe that nurse practitioners can and should be able to take on other roles. This amendment would still require one of the two consulting or coordinating practitioners to be an appropriately qualified doctor.

In our fourth amendment we are seeking to shorten the legislative review period from five years to three years. This is in recognition of the fact that voluntary assisted dying is a policy area that has evolved rapidly over the past eight years, since the laws were first passed in this place, and reviewing the legislation a bit more frequently will allow the laws to be more responsive to feedback from practitioners and patients and ensure the act continues to adequately serve the people that need it.

Finally, we will seek to amend the act to create a new obligation on health services, including aged care facilities, to provide access, where reasonable, to voluntary assisted dying care. This amendment is intended to establish a universal framework for reasonable access to care. For many individuals facing terminal illness, aged care facilities are their homes. It is where they live. To be told that you will not be able to access voluntary assisted dying in your home would be extremely distressing. This would mean that health services must allow reasonable access to voluntary assisted dying for residents, as is the case in several other jurisdictions in Australia. Challenges accessing voluntary assisted dying in residential aged care facilities are a significant and widespread problem in Victoria. According to Go Gentle’s recent report, 90 per cent of Victorian aged care providers either deny access to voluntary assisted dying in their facilities or do not provide any public information about voluntary assisted dying access. This amendment would make it an offence for a health service provider to withdraw a health service from a person, or refuse to provide a health service to a person, on the basis that that health provider knows the person has made or is likely to make a request regarding voluntary assisted dying.

Together with the changes proposed by the government, we believe that our amendments would better align Victoria with other states and reflect the feedback and experiences of those who have been trying to navigate or administer our existing laws. Like many in this Parliament I have been on a journey when it comes to the issue of voluntary assisted dying, and it is the stories and experiences of terminally ill people and their families that have played the most significant role in shaping my views and commitment to improving access to voluntary assisted dying.

I want to end my contribution by sharing one such story, that of Fraser Cahill. Earlier this week I had the privilege of speaking with Fraser’s sister-in-law, Ange, who told me about a beautiful young man whose story deserves to be immortalised in Hansard. Fraser was the son who always bought flowers for his mum. He was an adored son of Doug and Mandy, a much-loved brother to his siblings Quinton, Nellie and Wes, and a dedicated uncle to his nieces India, Kitty and Peggy and his nephews Archie and Hugo.

Fraser, by all accounts, was a kind-hearted and vibrant young man. Up early each morning to exercise, Fraser was a successful auctioneer and real estate agent who, according to his family, loved to contribute to what he called the circle of life by getting everything he could out of every day that he had. Fraser’s loved ones described him as someone who never failed to bring joy and laughter into life. He was always thinking of others and actively showed his care and affection for the people around him.

At the age of 38 Fraser was diagnosed with duodenal cancer. He was initially very positive about his diagnosis, reassuring his loved ones that they were all going to get through it. Fraser received six months of chemotherapy and oncological care at a hospital in Melbourne, and everything was looking good when scans in December last year showed that these treatments were working. Fraser and his family had a wonderful Christmas where they could look ahead with optimism that he would be able to live a long and healthy life. But in January of this year, only a couple of weeks later, he began to experience pain again, and after another scan he received the news that a tumour that had been too small to show up on the earlier scans had grown rapidly. He was told he likely had around two to three months to live.

Fraser had always lived a big life and was certain he did not want to shrink into a painful and prolonged death. When a family friend who had recently lost their partner to cancer mentioned voluntary assisted dying as an option, Fraser found the one thing that would allow him to have some control in his final months. Unfortunately that was when Fraser and his family hit a roadblock all too familiar for anyone with experience with this scheme in Victoria, the so-called gag clause. Many doctors, including his GP, and nurses he spoke with were reluctant to speak about voluntary assisted dying with Fraser, citing the laws against initiating discussion. Then there were the institutional barriers to providing information and access. Fraser asked his oncologist about voluntary assisted dying and was told it was an option for him but that oncologist was unable to assist him in accessing the scheme.

According to Fraser’s brother Wes, ‘The hospital did not want to know about VAD. As soon as we mentioned VAD, they scattered in all directions. When you spoke to anyone, they said not in here.’ So began the stressful process of trying to find a specialist who could help him. In light of his prognosis, and determined to spend time with his loved ones while he could, Fraser went on his last holiday with his family and friends, to sunny Queensland for 10 days. On a holiday which should have been a time to focus on being with his loved ones, Fraser was forced to continue his search for practitioners who would participate in the scheme. Finally Fraser found an oncologist willing to help him, so Wes snuck Fraser out of the hospital without telling the staff where they were going. Wes recalls that Fraser was feeling very unwell that day but said they had to do it – ‘There’s no time to waste.’ And so they did, and Fraser was finally able to have a conversation about how he wanted to end his life, including the option of voluntary assisted dying. He decided to start the voluntary assisted dying process that day.

After Fraser was assessed he and his family waited, but no news came about the approval of his permit, so Fraser and his family began calling anyone they could to try and get some information, a process that was distressing and drawn out for everyone involved. Eventually Fraser received his permit. Fraser checked out of hospital and relocated to his holiday home on the Bellarine Peninsula so that he could be closer to his family. As his condition continued to deteriorate he could no longer enjoy many of the things he loved, like going for a swim and getting an ice cream after. Knowing he was coming to the end of his life and not wanting cancer to decide how he went, Fraser expressed his desire to pass away on a beach on Victoria’s south-west coast. His community palliative care nurse Beth knew this would be hard, but she did what she could to help Fraser and his family achieve this wish.

On 17 March this year Fraser was told by Beth that he was no longer staying ahead of his symptoms. Fraser’s response was simple, ‘It’s time. Let’s make it happen.’ Beth ensured there would be no members of the public around and informed the police. That Friday, 21 March, Fraser walked arm in arm with his siblings and parents to the beach, where his closest family members and some of his best friends were waiting. Looking out at Victoria’s wild and beautiful coastline, Fraser and his loved ones listened to his favourite playlist. They chatted and laughed and shared last cuddles as Fraser lay on a chair under an umbrella.

Fraser was not scared. It was his last wish to die in the comfort of his family and friends, looking out at the ocean, and despite being robbed of so much time, he got that wish. Fraser’s last moments were on his terms, and this was only possible because of voluntary assisted dying, something for which his family will be forever grateful. But the process for him and his family should have been so much better. In his final moments Fraser asked his family to make this process easier for anyone else who has to go through it.

We owe it to people like Fraser, who have battled the current system, to listen to their pleas. This bill will get us closer to a system that does just that. Let me be clear: the Victorian Greens will support this bill, even without amendment. The proposed changes in it are so vitally important to giving terminally ill Victorians an opportunity to have choice, control and dignity at the end of their lives. This bill will ensure that end-of-life care can be holistic and transparent, where practitioners and patients can speak openly about all the options available to them. It will ensure people suffering from a terminal illness can make informed, individual decisions that will bring them the most comfort possible, whether that be access to voluntary assisted dying or properly funded palliative care.

This bill needs to pass for people like Fraser, who deserve to have a system that allows them to get the best possible care where they do not need to lead every conversation while their bodies begin to slow down, where they get to spend their last precious moments with their families and their friends, not facing the stress of navigating an unnecessarily difficult process. I commend this bill to the house.

 Sonja TERPSTRA (North-Eastern Metropolitan) (14:41): I also rise to make a contribution on the Voluntary Assisted Dying Amendment Bill 2025. Just before I commence my remarks, I just want to thank Dr Mansfield for a very considered contribution that really brought out the meaningfulness of not only the act and the scheme but the amendments that we are about to talk about today with the amending bill. Also, I would like to thank Ms Crozier for her considered contribution as well. The good thing about this is that both Ms Crozier and Dr Mansfield bring experience to this chamber as professionals working in the healthcare space. I thank them both for their insights as practitioners who have worked – obviously Ms Crozier as a nurse and Dr Mansfield as a doctor.

I am going to also talk about some personal experience that I have had with death and dying, as we all will at some point. The difference that this can and does make to people who are suffering from an incurable disease and faced with a painful death really can bring enormous comfort to them, but I will return to that in a moment.

The Voluntary Assisted Dying Act 2017 came into effect in 2019, but it brought a fundamental shift to end-of-life care in Victoria, offering people the dignity of a peaceful death on their own terms – an additional choice where previously palliative care was the only choice, but voluntary assisted dying offered another choice. Today we stand at a critical juncture. After five years of practical experience in this space, the Voluntary Assisted Dying Amendment Bill will offer the chance for reform and for this right to access medical treatment to ease suffering for people who may be faced with a painful death. This will enhance its accessibility and compassion for those people who are suffering.

In regard to the framework, I will just do a brief background to what the original laws were, because I think just reflecting on some of the contributions made already, I note that some of the feedback that I have received from my office has been from people who thought this was an opportunity to repeal the bill and to not have this option. That is not what this debate is about. That is not what this bill is about at all. The access to voluntary assisted dying as an end-of-life choice in Victoria is settled. It is not about repealing that. This is about, based on the five-year review of the act, making it easier because barriers to access were identified.

It is critical to understand that Victoria’s VAD laws are the most robust in the world, and they were built on 68 stringent safeguards, which were built to prevent coercion. To be eligible foremost, a person must be an adult – 18-plus – and a Victorian resident. They must be suffering from an advanced, incurable and intolerable condition and expected to die with six months or 12 months for neurodegenerative diseases.

The process demands a voluntary, repeated and fully informed choice, requiring those separate requests and confirmation from two independent specially trained doctors, and that multilayered process, overseen by the review board, has ensured that the system operates effectively, safely and ethically. And in fact, in looking at the review – and I have also read the annual general report of the board as well – from what I can see there were no instances where people had reported coercion or inappropriate conduct or behaviour of medical practitioners or anyone in the five-year period for patients who were wanting to access voluntary assisted dying. What that tells us is the framework we got right originally – that framework had those safeguards put in place and those safeguards have acted to protect people.

So while the very safe rigour of the initial act has been there offering protective barriers, there were unintended consequences for access, which have created undue stress and bureaucracy for terminally ill people. The most profound barrier of this, and Dr Mansfield talked about this, was the so-called gag clause, where medical practitioners were prevented from initiating a conversation with patients. This meant a patient who might have been suffering intolerably and perhaps might have been unaware of the option was forced to navigate a complex legal process without guidance from their trusted physician. This was a challenge that was compounded by severe access issues in regional and rural Victoria, which really resulted in a postcode lottery of sorts, where a shortage of trained doctors and difficulty securing timely assessments undermined the principle of equity in health care.

The amendment bill is a direct and compassionate response designed to make the system fairer, clearer and more accessible without weakening those core principles, and as I said, one of the recommendations, and again, this came from the five-year review, was that we needed to ensure that we abolish the prohibition on doctors having ethical freedom to discuss VAD – voluntary assisted dying – as a part of comprehensive conversations about all end-of-life options, ensuring the patient is fully informed. As I said, this is an option for people – they may want to take palliative care, and often people will engage with palliative care in a very long and meaningful way, but when their suffering is obvious and their suffering becomes so intolerable, it is an option that should be there and should be able to be discussed with the treating physician.

The other reform is the extension of the prognosis period. The required prognosis period is extended from six months to 12 months for most conditions, and this allows for earlier planning and a more humane process that removes the immense pressure on patients and doctors to meet a short, rigid deadline. We are also clarifying conscientious objection. This is a doctor’s right to object, and that remains absolute. However, the bill now requires an objecting practitioner to provide minimum information, such as contact details for the voluntary assisted dying care navigator service, ensuring that a personal moral objection does not become an insurmountable roadblock for that patient.

Also, expanding the voluntary assisted dying workforce will improve rural and regional access. The bill introduces the new role of the administering practitioner, allowing trained nurse practitioners and registered nurses to assist with the practical administration of the voluntary assisted dying substance, and also compassionate exemptions, where the bill will allow for such exemptions to the strict 12- month Victorian residency requirement, ensuring that a deeply personal choice is not unfairly denied to long-term Australian residents. Those amendments are the core of what the review found and consequently why we are bringing these reforms to the Parliament.

In having a look at the Voluntary Assisted Dying Review Board annual report 2024–25, there are some statistics that were published in that report as well. What you can see from this report is the response from people accessing it: from July 2024 to June 2025 there were 821 people.

The vast bulk of people who were accessing voluntary assisted dying were over the age of 50, with the bulk in the 60 to 79 years age bracket. 821 people accessed VAD in 2024–25. But overall, for the entire period from June 2019 to 30 June 2025, 3653 people have been eligible to access voluntary assisted dying.

We have also heard from Dr Mansfield some of the patient stories that she is aware of and some of the difficulties people have had in accessing the service. I do not have the same amount of time – I only get 15 minutes while Dr Mansfield got half an hour, obviously being a crossbench member she gets longer – but I do want to just remark, as a person who has seen both of my parents die, on my personal experience. My father dying when I was 17 left an indelible mark on me. This is difficult for me to talk about, because even though he passed 40 years ago, as a child of 17 I had to witness him suffer what could only be described as a very painful and intolerable death. My father had lung cancer. It was incurable. I had to witness him suffer. He was fully cognitively aware of what was happening to him and what he was going to face. He had restricted breathing in the end, and I could only imagine what it would have been like. I witnessed it obviously as his daughter, and watching someone who was fully cognitively aware of the fact that they were likely going to suffocate and be restricted from being able to breathe to sustain life, I could only imagine the torment and the horror that would have brought to him.

At that point in time there was no voluntary assisted dying available to him. It left me with a very clear position if I was ever going to suffer from some intolerable, incurable disease. This is the conversation that I seem to have with most people who have talked about VAD. Once they have experienced a family member going through a painful death, it leaves them with a very clear position about what their actions might be should they be put in the same position. It almost always is that they would avail themselves of VAD should they be faced with a painful death that there is no medical treatment for, to relieve the suffering.

What is not talked about with VAD is the trauma that is often left behind with the families who have had to watch a person that they very much love not be availed of any relief of suffering from that death. It is terrible. It left me probably with PTSD – undiagnosed, of course. Getting phone calls in the middle of the night leaves me with my heart bursting through my chest. Those sorts of things are not considered. Of course it is about the patient and their death, but we need to consider the impact this has on families as well and children. Back in those days I do not think any social worker spoke to us. That was just how it was back then. But it is something that has stayed with me for 40 years, and it is still quite triggering, even in this debate, listening to people’s stories. It is quite triggering. In regard to my dad, what I witnessed was someone going through and suffering a very painful and intolerable death. However, with my mum, in contrast, when she died, she had a quick death. We were all around her in the hospital and we were able to be with her, and that is probably what I would call a good death. It goes to what Dr Mansfield talked about with the case study she gave about someone dying while surrounded by people, being in a place that they loved and being able to reflect on that.

Again I will not have time, but I just want to finish my contribution. I could talk about the experience that I had, my family had and my dad had for a long time, but I will not have the time. I just want to put on the record some of these reflections that came out of the Voluntary Assisted Dying Review Board annual report. They exemplify why this is so important and why we need to make the ease of access better for people. This, from an applicant, is in the report:

My intention is to go down the path of VAD. The people involved in that have been outstanding and I feel most confident in their ability to execute this programme as I await the outcome. Their excellent work has offered me the choice of going ahead or not.

Another example:

We found all the medical professionals involved to be caring and dedicated individuals.

Another example:

I am very grateful to be able to access VAD. When I was 17, I saw my brother die a painful death from a brain tumour. My disease has taken so much from me, but it is great comfort to know that if my application is approved, I will have control over when I die. I thank all those who actively advocated for these laws. It significantly bolstered human rights in Victoria. Finally, I support further improvements to the laws, including allowing appropriate medical professionals to raise the option of assisted dying with terminally ill patients.

There is also this one – this one really nails it for me – from a contact person:

She passed away with her cat on her lap, looking across our backyard at the dam with me holding her. It doesn’t get better than that.

When we talk about dying, it is a normal, natural part of life. You can see what it means to people, not only the families but of course the applicants in this process, to avail themselves of a good death. There is a world of difference between a painful death and a good death.

The scheme is settled law. It is not about getting rid of the scheme. It is about accessing medical treatment. Any personal, religious or moral objections really have no basis or place in this debate whatsoever. It is settled law. What we are doing today is about making this easier for people to access their right to choose a dignified and pain-free death. I commend this bill to the house.

 David DAVIS (Southern Metropolitan) (14:56): I want to make a slow and steady contribution to this bill, reviewing some of the history but also looking at what has changed and what we know. To be clear with the chamber, when the bill came last time I would say that my philosophical position was in favour of patient sovereignty, but I did have concerns about how the bill would operate and how the regulatory environment around the bill would operate. I was very concerned, and I might say remain in certain respects concerned, about the potential for misuse and about how the bill could be overused. In that circumstance I voted against the bill, and I moved an amendment. I moved a single amendment which sought to ensure that the treating practitioner, whoever that might be, went to some effort – not heroic efforts – to give consideration of whether there may be elder abuse involved. As a former Minister for Ageing and a former health minister, I was very concerned that this issue of elder abuse had not been squarely focused on by those who were framing the legislation, and I remain still concerned that people can get pushed and moved. That still sticks in my mind. I have seen many things in health services that make me very cautious on this matter. Notwithstanding that, I am happy to put on the record that I think the bill that went through has worked better than I had hoped, or than I had imagined I guess is the best way to describe it, and there are some positive points in this set of amendments here. To be clear for those who may listen to this at some point or read this, this bill does not fully reprosecute the issue of voluntary assisted dying (VAD). It builds on a bill that is already there and some experience and some analysis. I think that is very important.

There are 13 amendments. I am just going to talk about these slowly and methodically. There is the conscientious objection. This is clause 6. Currently there is no obligation for medical practitioners who have a conscientious objection to VAD to provide information. This tightens the requirement and provides that they may be required to provide a minimal set of information. Clause 6(2) provides that objecting practitioners must advise the patient seeking information on VAD that another practitioner would be better placed to assist. I think that is very reasonable.

To a certain extent – and I say this as a former health practitioner – some of this is obvious and maturity related. If you have got someone who has got a set of conditions that you are not equipped in whatever way to provide the best care for, for whatever reason, it seems to me you do have a duty to that person to assist them to find someone who will provide that best quality service, but I think that would occur in any event. It says you have got to provide minimal information approved by the Department of Health secretary, which includes contact details of the statewide care navigator service and so forth. The long-term future of these sorts of navigator services and devices is also a point of question. So I still have a concern about anything that forces a practitioner to act against their conscientious position. Notwithstanding that, I would say a mature practitioner will help their patient in some way, whatever the particular conscientious position they adopt.

Clause 7 is on health practitioner–initiated discussions. The patient must always raise it first. This says the current law prohibits practitioners from starting a conversation about voluntary assisted dying. The new provision is intended to ensure clinicians are able to provide a full range of choices for individuals during conversations, and it allows registered health practitioners to do so. I think this is probably too broad a category actually. I am a former chiropractor. I do not believe that in general we would have been having these discussions – it is possible incidentally, and you do perhaps know individuals and their families, so there might be a contextual thing, but I just think this is a step too far.

Clause 8, the Australian residency requirement, updates the residency requirement to include someone who has been ordinarily resident in Australia for at least three years. The Victorian residency requirement, clause 9, introduces a compassionate exemption to the Victorian residency requirement for people with a strong connection to Victoria. I think all this is somewhat tinkering, but nonetheless, I understand what is being proposed in a number of these points.

Clause 8(2), on prognosis requirement standardisation, sets a consistent 12-month prognosis window for all applicants instead of distinguishing between neurogenic illnesses and other conditions. I did always think in this particular earlier bill that there was an excessively sharp distinction made on certain conditions, noting the variation in conditions and responses and the inherent uncertainty in how long people will survive or how they will progress. These are inherently uncertain matters. I did think there was always an excessive split that was introduced in that bill. A 12-month prognosis reduces urgency, improving access and preventing unintended effects of a six-month time limit. I think it is probably okay.

On medical practitioner eligibility, clause 10 amends the requirement for a medical practitioner to have five years experience practising as a specialist to one year. I do not quite understand the focus here on specialists. To be honest, I have always believed that actually in our health system, and contrary to what we heard in the chamber today, the primary care practitioner, particularly the GP, who has actually got an understanding of a person’s full context, their family, their location, their work, all of those points, is often the best placed. The legislation still requires independent assessment by two specialist medical practitioners. I have actually never understood why GPs, that are the person’s primary practitioner often over many decades and have a close relationship with them and their family, would not be the persons who would be giving many of these pieces of advice. There is a question in my mind as to how that is worked through.

Clause 15, on removal of third-party prognosis assessment, I can understand why this has been put there. I also understand the great caution that I feel and others would feel.

The shortened request interval – again, I can see how this arises, and I am not unsympathetic. I should say at this point that I am familiar with a number of people who will seek to use these provisions, and I have the highest respect for them, despite my own inherent caution here, if I can put it that way. That caution is, I think, partially religiously based but also partially a cautious scepticism of how things can go wrong. But I do want to put on record to some of those that I know and some who have asked me to assist them on occasions and potentially assist them near the end of their life that I would do this with absolute integrity with their wishes, their concerns and their understandings at the fore of my mind, whatever my personal cautions. So in a sense I am able to differentiate my own views and say, actually, my duty here is to help that person or another person in their specific circumstances. I think it is important to have that clarity. I do have that, as I say, strong view on personal agency and control, which is an important point for people. That, as I said at the beginning, has always with this bill been balanced with the fear of misuse. So that is in a sense my deeper position on this.

Administration methods and permits – I am concerned about this. It allows a person to make a decision in consultation with their coordinating medical practitioner and to self-administer. On self-administration, again, agency is important, but it does seem to me to make it just that little bit more risky.

On the interpreter issue, I understand why the changes are being made there. I sort of agree with them, but I also think there are risks. The example that is given is of rare languages where there is no accredited interpreter, and I understand the points here, but I also register those cautions.

The conflict of interest safeguard expressly prohibits practitioners from participating in a VAD application if they are a beneficiary or family member of the applicant. I can understand where that arises from.

Clause 79 – forms. I am never one to think that forms are the solution to these things, to be honest, and I think this is the bureaucrats having far too much to say.

The review is something that I support. I was aware of the article by Natasha Michael and others in the BMJ from 2024, ‘Does voluntary assisted dying impact on the quality of palliative care? A retrospective mixed-method study’, and I find that study is actually very informative. It is Victorian, it is closely argued and it is in a high-quality publication. It does draw attention to some things we need to be cautious of, like the presence of depression and anxiety in a significant number of patients.

Patients sought VAD because of a desire for autonomy …

I can see the figures: 68 per cent for autonomy; suffering, 57 per cent; fear of future suffering, 51 per cent; and social concerns, 22 per cent.

VAD enquiries impacted multiple quality domains, both enhancing or impeding whole person care, family caregiving and the palliative care team. Open communication promoted adherence to therapeutic options and whole person care and allowed for timely access to palliative care. Patients sought VAD over palliative care as a solution to suffering …

These, I think, are significant results.

Studies are necessary to explore how to ensure the quality of palliative care remains enhanced …

I should say here that I have always supported palliative care. I remember in 2010 as a shadow ministry we made a commitment to fund all of the requests of Palliative Care Victoria and put enormous new money into palliative care. I note the concerns about support for palliative care under the current government. I am going to make a political point here – I refer back to the recent Public Accounts and Estimates Committee report that laid out concerns about palliative care funding in Victoria.

I have already put the details of that report on the public record in this chamber, so people can look that up there, but suffice to say that I take this as very strong evidence that palliative care funding is insufficient. I do not see palliative care and voluntary assisted dying as mutually exclusive – of course they are not. You want people to have the choice of palliative care, but you do not want them to move in another direction because there is not that support there. You do not want patchy or insufficient palliative care to leave people in a position where they do not have the support that they need. Both, I think, would have to be regarded as important. I think the government’s focus on VAD has seen some slippage in its focus on palliative care, and I think that that is a serious concern.

I should note the pastoral letter from the Catholic community and the Catholic Health Australia contributions – I am just conscious of the time I have got – and the communications of 14 April this year by many different religious communities. I understand the concerns and the assessments of voluntary assisted dying never examine what it means for the deeply religious view that values life in a very clear way. That is a failure of the assessments, I think, to understand that there is a broader context and there is a broader history to our attitudes to these areas, mine included. Whilst, as I say, I am a person who looks at individual agency as a key, I am also concerned about the broader impacts. On this bill, I will oppose it, but I will support some of the amendments that are being proposed.

 Georgie PURCELL (Northern Victoria) (15:12): I welcome the opportunity to make one of the earlier contributions to what has so far been a deeply personal and largely respectful debate on the Voluntary Assisted Dying Amendment Bill 2025, and I hope that throughout the evening it does remain to be that way, because debates like these bring out the best in places like ours. This is the first conscience vote of this term, and it does make me wonder what our politics and our Parliament would look like if other issues of significance were treated with the same respect and the same consideration.

As others have reminded this chamber, we are not here to debate the morals and merits of voluntary assisted dying – that is determined law. And as shown by its operational review, it is operating safely. Victoria led the nation in creating a legal, tightly regulated pathway for voluntary assisted dying when the Voluntary Assisted Dying Act was passed in 2017. I want to recognise the tireless work of all of those involved in that process, including Jill Hennessy, Gavin Jennings and of course my very good and dear friend Fiona Patten. Since its passage 1282 Victorians have peacefully ended their lives using a VAD substance. Although the review found that the system was operating safely, it also found that many of the safeguards are unnecessarily restricting access for those the law was intended and designed for.

We have all been contacted by countless Victorians who have been forced to watch a loved one endure a prolonged and distressing death because they were unable to access VAD under the existing legislation that we have right now in Victoria, and I am sure throughout today we will hear many stories of people watching on whose loved ones and family members have passed. The reality is that death is inevitable in life. For many of us a good death is not guaranteed, but it is one of the things that we would hope for for our friends, for our family and for our loved ones. I myself have watched on as people in my life have not had good deaths. I have watched on as people in my life have passed before voluntary assisted dying existed in Victoria, and I know that it is a pathway that, if they had the option, they would have taken, to have that control, that autonomy and that ability to make the final decision on their own life – to end it in a way that is free from pain, free from suffering and on their own terms with their families, their friends, their pets and their loved ones.

Many of us would have heard the heartbreaking case of Julian Bareuther, whose inoperable pancreatic cancer made him clearly eligible for VAD. He ended up taking his own life because even though he had lived in Victoria for 40 years, he had never taken out Australian citizenship. His is one of several suicides identified by the coroner to be because of the significant impact of VAD refusal in Victoria.

As the rest of Australia has enacted VAD legislation, it has become perfectly clear that we are no longer nation leading in this space like we once were. In fact we are quite the opposite. The operational review of the Voluntary Assisted Dying Act 2017 largely recommended changes that are already in effect in VAD schemes in other states without evidence of unintended consequences along the way. I want to commend the government and the Minister for Health Mary-Anne Thomas for accepting all recommendations of the review and for promptly bringing these changes forward to our Parliament.

Before I go into some of the key reforms to be brought about by this bill, I want to address something that has been heard far too often in the debate since this bill was proposed. The framing of voluntary assisted dying as an alternative to good palliative care is a false binary. People who seek VAD often also receive palliative care. The decision to seek VAD is usually made because even with palliative supports suffering remains intolerable. We can and we should be making these humane reforms to assisted dying while also improving the provision of palliative care. It does not have to be one or the other.

Unsurprisingly, an amendment I particularly welcome is a newly included requirement for health professionals who conscientiously object to VAD to provide contact information for a service that will assist a patient, just as they are required to do for reproductive health care. However, as I have raised in here countless times before, requiring referral with no oversight leaves far too much room for practitioners to delay or to obstruct patient access.

Increasing the prognosis requirement to 12 months for eligible conditions is an important change which will hopefully reduce the stress and burden for patients and their families. Making people start the process late in their disease’s trajectory disadvantages those without easy access to health care. I will be supporting the Greens’ amendment to remove the requirement to demonstrate an explicit timeframe to death, like is in operation in the ACT. As Dr Mansfield has highlighted, time-based prognoses within assisted dying schemes are clinically and legally challenging. It is incredibly difficult for a medical practitioner to provide specific estimates, especially if there is a reasonable fear of legal repercussions in doing so.

The mandatory third assessment for neurological conditions is a perfect example of something intended to safeguard vulnerable individuals that has proven to be cruel and unnecessary. Finding doctors willing to do VAD work can be a challenge at the best of times, so finding three doctors, two of them being specialists, within the required timeframe is near impossible. Of the 15 specialist neurologists that are trained to provide VAD assessments, only two of them are located in regional Victoria.

The changes in this bill will particularly improve accessibility in regional and remote areas, including in my electorate of Northern Victoria, recognising that your postcode should not dictate your right to a good death. The Commonwealth prohibition on VAD telehealth consultation remains a key barrier to regional accessibility, and I am glad to hear that the state government is also advocating for changes to the Criminal Code Act 1995 alongside these changes today.

In referencing the amendments moved by the Greens, I particularly want to recognise Dr Mansfield’s work, expertise and passion in this space and for speaking with us all on the crossbench throughout this process. I also want to recognise the work of Go Gentle for their advocacy and support in understanding these complex legislative changes; Dying with Dignity Victoria, particularly its president Jane Morris and vice-president Michelle Hindson, for their compassion and guidance. I know many members benefited from Jane’s and Michelle’s visits.

This is not an abstract policy debate. Many in this chamber and in the other place have reflected on their experiences with terminally ill loved ones.

And of course in our own Parliament this conversation has touched us all on a deeply personal level. Our friend and colleague Emma Vulin, the member for Pakenham, was diagnosed with motor neurone disease in April 2024, and I have watched on in awe as Emma has handled this life-altering diagnosis. Rather than letting it define her, she has taken this truly heartbreaking situation and turned it into proactive advocacy. Not only has she done so much in raising awareness and money towards a cure for MND, but she has also shown exactly why voluntary assisted dying is such a vitally important option for all Victorians. In Parliament last month Emma made the point that knowing she could one day access VAD brought her comfort in her battle with the beast. She said:

Choosing VAD is not about losing hope, it is about shaping hope into something deeply personal: the hope of a peaceful passing, free of unnecessary pain … Some will choose palliative care alone. Some will choose to fight for every last breath. Some, like me, may one day choose to say ‘enough’, on their own terms.

And as Emma rightly pointed out:

Each of these paths deserves equal dignity and respect.

I want to again acknowledge the responsibility felt by all members in this debate. It is clear that we all do feel its gravity. The amendments made by this bill are measured and they are worthwhile. They maintain the necessary safeguards but ensure that the law works for the people it was designed to help. Just as we trust in Victorians to be able to make decisions regarding the end of their own life, they must be able to trust that we will ensure a system which protects those most vulnerable is consistently and always improved. Most importantly, this bill gives terminally ill Victorians greater compassion and dignity at the end of their lives. It provides their families comfort, knowing the ones that they love have choice. How we respond to suffering wherever it appears reveals the moral architecture of our society. In saying that, I commend this bill to the house.

 John BERGER (Southern Metropolitan) (15:22): I rise today to contribute to the debate on the Voluntary Assisted Dying Amendment Bill 2025. I want to begin by acknowledging that many may find this topic upsetting. To think about the death of a loved one and their end-of-life care is something that is very close to the heart for many people, and it is an incredibly personal experience. For many in this Parliament it has been the experiences which have shaped over time how we view this issue.

It is in the late stages of advanced disease or illness where someone in Victoria can ask for a medication that will bring about their death. Voluntary assisted dying, also known as VAD, is for those in late stages of advanced disease. Patients who are suffering from these sorts of diseases, conditions or illnesses may take the decision to voluntarily terminate their lives. There are various deeply personal reasons why someone may choose to do so, but often it is to alleviate suffering in the face of an incurable degenerative condition. There are very strict rules and conditions in place to pursue this path, and there are a lot of safeguards to ensure that the decision to terminate one’s life is made by the person voluntarily, without coercion or abuse. It involves a considered application process, during which there are not only written requests for assisted dying from the patient, but also written confirmation from two doctors authorising it based on those strict parameters.

Patients are not compelled to follow through after supplying the paperwork and being granted approval, and it is always the choice of the patient whether to move forward. At any point they are allowed to abandon the process. The process is overseen by the Voluntary Assisted Dying Board, which reviews all of these instances ahead of moving forward. The board is essential to ensuring that the best care and consideration is given to each of these cases, but more importantly, it is to ensure that everything is in order and that there is no abuse or adverse pressure involved. It is to ensure that everything is proper and appropriate.

Victoria was the first state in Australia to legalise voluntary assisted dying back in 2017 under the then Andrews Labor government. It was a landmark reform, and it was the first jurisdiction since 1996 in Australia to pass such a piece of legislation. The remaining states and territories, with the exception of the Northern Territory, have followed on and passed assisted dying legislation of their own, often building on the substance of our framework. In Australia our federal structure allows for states and territories to continuously improve legislation by always comparing against each other and building on the work of others.

Many states and territories have expanded on the rights of patients beyond what was contained in the 2017 legislation. It is only right, as this state was the first to introduce voluntary assisted dying laws, that we now move to bring ourselves in line with the rest of the other states. That is why this bill is here today. The bill aims to improve patient access and to bring Victorian legislation in line with other Australian jurisdictions with respect to VAD. There is a list of various amendments being put forward in this bill, which I would like to discuss in further detail.

But first I would like to talk about a story. I remember in 2018 a beautiful story to do with voluntary assisted dying. Many in this place remember David Goodall, who was then Australia’s oldest scientist, who decided at the ripe old age of 104 years old to end his own life at a clinic in Switzerland. David was surrounded by family and surrounded by the ones he loved. We know that people can take that drastic measure to end their life when they are in pain. You should not need to go all the way to Switzerland to make it possible. In Switzerland he was surrounded by loved ones and was able to enjoy his last few months in dignity and comfort. He was empowered by the ability to choose what happened next and at a time of his choosing rather than having to suffer as time went on. In Victoria that is what we are planning on doing.

I have had numerous emails and personal meetings with constituents and other community groups who are not supportive of the amendment. They are not happy with it, and I understand that. There are people who have written to me, and I have listened to all of their points. It is important to understand and acknowledge that this legislation is very personal and contentious for a lot of Victorians. It is important to listen to all of them and their very real concerns. A lot of Victorians may not feel at ease with these reforms, but I can say that the substance of this amendment bill is carefully considered and articulated legislation that contains numerous provisions and safeguards for all.

I would like to briefly address some of those amendments in this bill. The first is the change which now extends access to voluntary assisted dying to more Victorians, with the prognosis timeline being extended from the current six-month projections to 12. Extending the eligibility criteria for the projected death from six months to 12 is both a compassionate amendment and a commonsense move. Unfortunately, many terminal illnesses and diseases rapidly deteriorate in a short timeframe, and in those six months people living with terminal illnesses and diseases are often suffering greatly and facing significant impairment. It is not reasonable or practical for people to engage in heavy levels of bureaucracy when seeking voluntarily assisted dying. Extending the eligibility criteria through this bill to 12 months gives terminally ill patients time, and critically it grants them dignity in their final months. It allows these people to spend quality, meaningful time with their loved ones while they still have that capacity. The new eligibility requirements for voluntary assisted dying with these new amendments would then be that the person seeking VAD has an advanced disease or illness of the sort that is expected to bring about their death in 12 months based on the view of medical professionals; they must be over 18 years of age; and most importantly, they will still need to have the ability to make and communicate all the decisions about voluntary assisted dying throughout the formal request process. It is a strict but fair set of conditions subject as well to written perspectives of the patient, two doctors and final approval of Victoria’s Voluntary Assisted Dying Board.

Another important reform in this bill is the ability for registered health practitioners to now initiate discussions about VAD within the broader end-of-life discussions. Under the existing legislation there is a clause which specifically bans or otherwise prohibits medical practitioners from raising VAD as an option when exploring end-of-life care with loved ones and carers. This bill will remove this, allowing for medical professionals to respectfully inform patients, loved ones and carers about their options, including voluntary assisted dying. This is, again, only within the parameters I have already outlined, such as when the expected death is within 12 months or it is a disease or illness which will cause an unacceptable amount of suffering for the patient. While I understand that this is a confronting prospect to be raised, it is only right when assessing someone’s end-of-life care that they be given the list of possible considerations, including the potential path of voluntarily ending one’s own life earlier to avoid further suffering.

It is important that the public be informed about the available paths forward so that they can make the best decisions in their judgement. The proposed new provision, which requires at least a minimum basic amount of information to be provided, is a step in the right direction to empowering patients through choice. It is important to note that medical practitioners who conscientiously object to voluntary assisted dying are not compelled to perform or aid administration of VAD. They will, however, be required to provide basic information about VAD. This is not anything new to the health profession. We already have similar provisions in other respects where if a medical professional is unable or unwilling to perform a particular medical procedure, they will provide information to the patient. Because it is important when making serious medical decisions that patients and carers have all the information they possibly can in order to make the best decisions for themselves.

This amendment bill also extends access to Victorians who are not necessarily citizens. This bill will amend Australian citizenship and permanent residency requirements for voluntary assisted dying in order to permit access to people who cannot demonstrate over three years of Australian residency. This is a commonsense reform. Medical needs and requirements do not discriminate by nationality, geography or anything else, and it is in that same spirit that the right to medical care is a universal right. That is why this provision will be extended to those who have lived here for an extended period of time but may not have citizenship, because the difference between permanent residency and citizenship should not be the reason why someone is denied the right to seek voluntary assisted dying, particularly as a means of avoiding a more traumatic and painful terminal illness.

This legislation also introduces several means of ensuring we treat patients with respect and the dignity they deserve. When it comes to some particularly harsh conditions, patients may only have a few months left when they apply, so it is imperative that we make the approval process as simple, clear and quick as possible. Through this amendment we will be helping facilitate a greater set of choices for applicants when it concerns the administration method, again giving patients more choice in their paths forward. We will also be simplifying permits in the application process. This will help prevent delays and ensure that applications can be processed in a more timely manner. This will be aided by the introduction of a new administering practitioner role, which will expand the workforce able to support voluntary assisted dying. Again, this is about ensuring the system can move through these processes quickly and ensure that patients have more choice over what happens.

Under these changes to the principal legislation, there will now be an additional review of the Voluntary Assisted Dying Act three years after commencement of these new amendments. It will then be reviewed again repeatedly at five-year intervals to ensure it is always fit for purpose given the sensitivity of the issue. This allows for the legislation to be routinely scrutinised by Parliament, and if any further changes are deemed necessary for the continued orderly and dignified carrying out of these functions, they can then be considered by the government of the day at these intervals.

As I have said, there are many in my community of Southern Metro and abroad who have come to speak to me or have written countless letters and emails expressing their concerns about this legislation. There are various aspects of this amendment bill which will seek to strengthen protections for patients. For example, the bill includes a section to prohibit practitioners from being beneficiaries or family members of an applicant. This is to say that should the medical practitioner or professional be someone from their family or someone who stands to be a direct beneficiary of the patient, they will not be able to weigh in on the decisions or be involved in any way. It is a commonsense measure which will go towards protecting patients and ensure that they are not being exploited or abused.

While I understand that many in the community still do not feel at ease with this legislation, this amendment bill contains these commonsense yet strong reforms which continue to protect the rights and dignity of patients. This bill ultimately concerns one of the most personal and serious decisions anyone can possibly make: the decision on how to end their life with dignity in the face of a terrible illness. It is incredibly personal and confronting, and I would like to thank my colleagues for upholding what has been a respectful debate in this issue. I would like to mention one speech in particular. In the other place the member for Pakenham, who lives with motor neurone disease, delivered a passionate, heartfelt message to the Assembly on what voluntary assisted dying means to people living with incurable progressive disease and terminal illness. I want to thank her from the other side of the Parliament for showing us that this bill should matter to everyone.

Many of us will know that at some stage, faced with the toughest and most personal medical decisions that anyone will have to go through, this bill either will or will possibly impact our loved ones or our communities, wherever we are. Many of our colleagues on both sides of the chamber have noted how, since the last vote on the issue, in 2017, they have been given more time to think about the issue, and it is important that we listen to all voices and perspectives on this issue and make a well considered and respectful decision. This amendment builds on the landmark report delivered in 2017 and continues to strengthen both patient care and choice.

In saying that, I want to acknowledge that not everyone in this chamber or the community are convinced, and I respect their position. I will continue to listen and acknowledge their concerns. But this amendment bill is a step in the right direction, protecting patients and empowering them to make the right, informed decisions. It has, in my view, adequate protections both for patients and against any potential bad actors. The procedures and levels of review remain in place so that cases are not rubberstamped but rather given careful consideration by the Voluntary Assisted Dying Review Board. It is a substantial bill which only strengthens the ability for Victorians to seek voluntary assisted dying in a manner of their choosing, at the time of their choosing, and for that I commend the bill to the house.

 Melina BATH (Eastern Victoria) (15:36): I rise today to make a contribution on the Voluntary Assisted Dying Amendment Bill 2025, a bill that seeks to refine and improve or evolve the framework that was established under the Voluntary Assisted Dying Act 2017. This legislation certainly touches on the very essence of a profound aspect of our humanity. It touches on how we respond to suffering, how we honour free will and how we uphold compassion in the final stages of life.

Harriet Shing interjected.

Melina BATH: No, I am fine. I am good, thank you. I do this because eight years ago I was one of the few, I think, in this house that stood and debated that bill, and it was a deeply moving and thorough process. We heard from many and varied people – many and varied constituents, religious organisations, groups, doctors and advocates – and it should have and did weigh very heavily. It is about life and death, and these issues are very rarely simple. We come into this world in a perfect state, ‘perfect’ meaning we are perfect when we come in, whatever our state and whatever our being. Over time we can try and keep that body in the best possible shape, but genetics, environment or spiritual impacts on mind, body and soul have a way of wearing and tearing down this very beautiful and perfect body that we all have.

In doing that last time, I shared my father’s death – it was 32 years ago, and I could go back to the last moments in a blink of an eye. I am not going to prosecute all of my speech, but I think one of the things that I just wanted to touch on, which I reflected in that last contribution, was about the important role that our medical profession has in our lives and in our deaths and how grateful we are that people take on this very sincere and heavy burden of looking after the human frame and all its attributes. But I am also hoping that following those last 30 years, as doctors are becoming doctors through that learned institution of university study, there is a greater influence now that when a stoic and crusty farmer comes to the doctor and says, ‘I’ve got a grit in my stomach,’ or ‘I don’t feel well,’ that that is taken up very quickly and not potentially delayed until such time that they have got stage IV cancer. I thank the medical profession. I am sure it has evolved in many ways to the betterment of humanity.

I also want to put on record that when we look at regional health, our system still has a long way to go, certainly in terms of palliative care, and I recognise the fact – and people made that contribution today – that accessing voluntary assisted dying and palliative care are not necessarily mutually exclusive.

In fact I believe that report confirms that of those who accessed voluntary assisted dying 80 per cent of them had also accessed palliative care. But there is a need for that service to be very improved, and I will speak to that a little bit later.

If I could go back and ask my father if he would he have used voluntary assisted dying – well, he was a very pragmatic person; maybe he would have. He also held on to life and had a spirituality, so he could have also potentially thought, ‘No, I’m going to hold on with each breath.’ These are the things that we grapple with, both on a personal level but also in recognising other people’s journeys and respecting and honouring them. We are to legislate today, and that is where we need to drill down and look at it clause by clause, which I want to do now.

Back then I opposed the bill. Today I recognise that although I am here with the same sense of seriousness and cautiousness, this landscape has changed, and indeed we are not debating the actual principle. We are debating amendments, and we have five years of lived experience and cases and growing evidence that there are other jurisdictions that potentially are doing it better than in Victoria. Again we should look at the principle of choice here. The act is built around the idea of people facing intolerable suffering with a terminal illness, and those people having the right to make decisions – informed decisions – about their life.

One of the barriers that we spoke about in the original bill debate was prognosis requirement. I expressed my concern around the difficulty of how that choice is made and how doctors predict life expectancy. The original act had six months for most conditions and 12 months for neurodegenerative diseases. This bill standardises that to 12 months for all applicants, and I have certainly listened to many members in my community who have expressed their desire for this amendment to pass and for there to be a broader, longer timeframe so that there can be that assessment in a better place.

The bill also removes the requirement for a third prognosis assessment for neurodegenerative conditions, and it looks at streamlining and aligning with other jurisdictions. If we do want to see courage, we just need to look at the face of Emma Vulin. I respect her, and in a way – and I mean this in the most loving way – she is a guinea pig in this institution, this Parliament, and is providing real-life feedback for this legislation. We should all, and I am sure we all do, respect her position, her thoughts and her values on this bill.

In terms of palliative care, I also really want to address that. In terms of clauses 9, 10 and 13, it reduces the required experience for medical practitioners from five years to one. I have some concerns that that is a big reduction in experience. I have heard arguments, and I also respect them, about the fact that they are not fresh out of university or medical school and that they do have that added layer, but I also feel that from five years to one is certainly a large leap.

I also acknowledge the administrative role – around trained nurse practitioners and registered nurses to administer VAD. This is certainly taking it to another level, but also if you consider the person who has made that choice, who has gone through the process and who does not feel that they are able to administer it, then that is why this clause and the amendments are there. It still sits very challengingly with me, making that decision to request somebody else to take your life; however, I understand again that these are seen as improvements.

The simplification of the permit process so that patients can change their administration method without needing a new permit I think is a reasonable change, particularly in regional communities. I have heard examples where the arduous nature of getting those permits has been very, very challenging for people seeking to access this action.

In terms of expanding location and residency, there are some sensible clauses in there about those people who live on the borders – and I certainly have a long border in Eastern Victoria Region – being able to access VAD in Victoria, and also about Australian residency requirements. That just seems to be sensible. We have heard examples of how people have been denied even though they have been members of the community and lived in Australia for many decades.

The role of the health practitioner in initiating discussions about VAD: I expressed my concern back in the initial bill debate in relation to coercion and the potential for coercion. We still do not want, collectively, people to be in any way coerced, whether it be by elder abuse or by family interactions or by the medical profession. I am not saying that happens, but we need these safeguards. I understand that the amendments in this bill will provide that a registered health practitioner will be able to raise this form as part of discussions about other treatments and palliative care. I also note that Dying With Dignity have been advocating for this for some time.

The bill also looks at conscientious objection. As a doctor, if you make that Hippocratic oath not to take life and you have strong objections, I endorse those. We respect those, and they must stay. Indeed, respecting that, this legislation looks at providing minimum information, such as details of the statewide navigator care service. Whilst this is there, I think there are some good amendments coming through that I want to see. I am very keen to assess each amendment on its merits. Around the definition of who decides, the department secretary, what sorts of information and just the level of power that the department secretary can have, I will be keen to support some of those amendments that are coming through. We have had good conversations about this. There is no point bringing a seventh amendment on the same topic. It is reasonable to adopt somebody else’s amendment. I think there needs to be that balance between practitioner rights and patient autonomy, and to get that balance right I think there need to be some changes in this bill before us. I want to raise my appreciation of constituents, professionals, faith-based organisations and former colleagues who have reached out to me with their views.

In relation to the gag clause, this clause amends section 7 of the act, which will allow registered medical practitioners and nurse practitioners to proactively raise VAD. I am concerned – and I think we have heard from quite a few others both in the other house and this one so far – about the level of allied health professionals being enabled. People have quoted various types. I think that is an overreach, and I will be supporting amendments to reduce or remove those.

In relation to the last few moments that I have in this contribution, I do want to turn back to palliative care. I recognise that they can exist –voluntary assisted dying and palliative care – as an integrated approach. I am also glad that only very, very, very few Victorians have used voluntary assisted dying. The importance is around palliative care in our regions, and particularly in my electorate, my experience is that it is not equally supported and accessible across Eastern Victoria Region and there needs to be a greater investment in palliative care. Before I finish, I do support the sensible changes in this bill around prohibiting practitioners from being a beneficiary or a family member. I think that makes sense. I also think we need to have that review, and I will support recommendations that reduce that timeframe as well, because it is really needed.

This is a live issue – and I do not mean that in a comical sense – and this is a key issue, and we need to be able to assess that. The fact that we have all got free votes across the house I think shows the level of gravity that this issue requires and the diversity of views in our society. When we look at unbearable pain, when we look at loss of autonomy and when we look at terminal illness, we need to respect that individual. We also need to respect the fact that they should be cared for well in our hospitals, in our community settings. Palliative Care Victoria produced a very comprehensive report a few years ago talking about the shortfall in funding and the need for better in-home, at-home palliative care. I want to reiterate that any good legislation should be followed by better legislation and funding for palliative care.

In closing, I will certainly work through each amendment, and I thank all of those who have provided insights to me. I respect the fact that we need to have these individual decisions. Voluntary assisted dying is here; how do we improve the system that already exists?

 Katherine COPSEY (Southern Metropolitan) (15:51): I rise to speak on the Voluntary Assisted Dying Amendment Bill 2025. As has been stated by my colleague Dr Mansfield, the Greens will be supporting this bill, and I acknowledge Dr Mansfield has spoken at length on our position and given a lot of insight, so my comments today will be brief. However, there are amendments from the Greens to this bill in my name, and I ask that they be circulated at this time.

In speaking to this bill, I also want to take time to recognise those joining us in the chamber, those watching the debate online and my colleagues in this place who have made really personal contributions so far. Certainly I think we can all acknowledge that whether you are supportive of or have reservations about the content of this bill, the convictions that people hold on this topic are sincerely and passionately held, and you are all welcome here today, whether you are watching along online or here in person, as we all approach this debate with a really welcome sense of sincerity and compassion in the chamber.

As the first state in Australia to introduce voluntary assisted dying, Victoria’s legislation was quite cautious and set the standard at that time. What we have seen since those laws came into operation, and from other jurisdictions that have now introduced voluntary assisted dying, is that there are some provisions that were considered appropriate by this Parliament 10 years ago which now we understand to be unnecessarily restrictive. So the changes being proposed in this bill are welcome, and they will bring Victoria roughly into line with what has been determined in other jurisdictions that have followed on from that groundbreaking legislation. Rather than acting as safeguards, we have seen that some of those provisions are, in practice, creating barriers that mean people who the laws were intended to help are being unnecessarily prevented from accessing voluntary assisted dying, and that some of those original provisions are creating additional distress or meaning that people are trying to access voluntary assisted dying when it is too late. Some people, sadly, are not able to access this service and die before they can complete the process.

This bill is very welcome. There are still very strong safeguards in place to ensure that the person who is applying for voluntary assisted dying is certain; that they can provide clear, informed consent free of coercion; and that health workers involved are appropriately qualified and do follow rigorous processes. One thing that has become clear is that rural and regional Victorians face additional postcode barriers to access, given the sometimes narrow range of health practitioners who can provide voluntary assisted dying services and the lack of availability of those services and practitioners in these areas.

We believe that the government’s bill could do more to address these barriers, and Dr Mansfield has spoken about this. We have put forward some amendments seeking to improve the bill before us in this respect.

Briefly touching on the amendments in my name, which we can come back to further in committee, they broadly cover two areas of improvement that the Greens would like to see in the bill. The first area is the enabling of the secretary to grant an exemption in exceptional circumstances on compassionate grounds in relation to the 12-month prognosis requirement in the bill. The government’s amendment to change the prognostic window to 12 months is very positive. However, there are some conditions where there is inherent uncertainty around timeframes to death but all other eligibility criteria may be met. Our amendment will enable a person who meets all eligibility criteria except for the 12-month prognosis requirement to apply to the secretary for an exemption. The secretary would then be required to seek certain information in order to inform any decision, including relevant parts of the person’s medical record, and seek expert advice. This is a process that is similar to what takes place currently in Tasmania. Creating this sort of exemption would allow some data and experience to be gained regarding the number and nature of such applications, and this could in turn inform future reviews and amendments to the law with respect to eligibility criteria.

The second set of changes that my amendments seek to make deals with the proposal requiring the coordinating practitioner or consulting practitioner to have relevant expertise and experience. The amendments in my name simply change this to ‘expertise or experience’. These amendments broaden the interpretation of the minimum requirements for the coordinating and consulting practitioners. This wording would allow, for example, GPs with relevant experience to meet that criterion. Particularly in some of those locations where there is a dearth of practitioners who are able or willing to provide VAD services, it will mean that that is not a practical barrier to a person who rightfully needs and wants to seek information and support to access voluntary assisted dying. It will provide more options for them in practice.

I will leave my brief comments there. There have been, as I noted at the outset, some very compassionate and personal stories offered in this debate, not only here but also in the other place. I thank members for the caring way that we are approaching this issue today and commend the bill.

 Jacinta ERMACORA (Western Victoria) (15:58): I am pleased to speak on the Voluntary Assisted Dying Amendment Bill 2025. From the outset I want to take a moment to reflect on those Victorians who are currently battling a life-ending illness or simply facing the end phase of their life. For those individuals and their families and friends it is a distressing and devastating experience. For many the experience of pain and loss of capability is frightening and awful. Many of us have experienced the loss of someone close, and I certainly have, with the loss of my father to a painful cancer death in January 2022. I acknowledge my parliamentary colleague in the other place Emma Vulin. Emma described her own consideration of voluntary assisted dying as she confronts the relentless impact of motor neurone disease. She said:

Knowing that voluntary assisted dying is there means that I, and people like me, can spend less time fearing the end and enjoy the remainder of my life without worrying too much about what the end may look like.

It is the experiences and views of Emma and many others that drive the need to ensure that our Victorian health system offers a full range of end-of-life options.

After much consultation, listening and debate the Victorian Parliament passed the Voluntary Assisted Dying Bill in 2017, and in doing so it led the nation in providing a compassionate and dignified end-of-life choice to Victorians who have what is commonly referred to as a terminal illness. The act came into effect in June 2019, and between June 2019 and 30 June 2025 – that is six full years – over 1600 people used the voluntary assisted dying option, and 2758 people applied and were approved. This means that not everybody used the option in the end. I think this is what Emma was referring to: there is a level of comfort in knowing that it is available at the end if needed. For many it was the fact that the option was there that was a comfort. For others the process was not timely enough to allow that choice. Hence we are here today in this chamber making some amendments.

It is important to acknowledge that Victoria was the first jurisdiction in Australia to introduce voluntary assisted dying, and therefore it makes sense that refinements are needed. That is why the Voluntary Assisted Dying Amendment Bill 2025 was subsequently introduced, on 14 October this year. The amendments uphold the values and principles underpinning the existing legislation. The bill seeks to make a number of changes, which have been mentioned already by previous speakers: removing the gag clause prohibiting medical practitioners from raising voluntary assisted dying (VAD); ensuring that practitioners who conscientiously object provide minimum information to patients about accessing VAD; amending VAD eligibility in terms of residency and prognosis timelines; reducing the timeframe between first and final requests – and that is certainly in response to bureaucratic delays; removing the need to obtain a specific administration method permit; expanding the administering practitioner cohort to include nurse practitioners and registered nurses; and also allowing a broader range of health practitioners to raise it with their patients, often people who might have a very close relationship with their patient, whether that is a podiatrist or a physio or a range of other practitioners.

As a social worker myself, I support talking about issues, particularly difficult issues, so I think more ability to be open and frank about end-of-life options is a good thing, and I do not believe that it increases the risks associated with abuse of the system. Also, we know that all of us have different practitioners, and some of us are closer to or have a better clinical relationship with some than with others. Sometimes you might feel more comfortable raising an issue or discussing personal matters with an allied health practitioner that may not be a doctor or a VAD specialist, so being able to kick off that conversation and to know that option is there I think is a good thing.

These changes remove arbitrary barriers to access based on citizenship status and lengthen the prognosis requirements to 12 months. The amendments prevent administering health practitioners from being related to or a beneficiary of that subject person. That is definitely a tidy-up. Very importantly for communities like my own, they improve access to voluntary assisted dying in regional communities by broadening the eligibility of practitioners. I think the number ‘one’ in the bill is quite deceptive really. To have been qualified as a specialist for one year, you have to have had almost a decade’s experience in the health system as a doctor, so I think the one year’s experience is really a bit deceptive. I think people can be very confident in the specialists and the speciality areas that are required – so if your terminal illness relates to lung cancer, for instance, they have to be an oncologist specialising in that.

I think, having reviewed that, that is comfortable for me. And for regional communities, you know, sometimes we do experience health services differently, and it is often impacts like missing out on health services in the city – it is quite similar. What I am saying is: what is applied in the city does not always work in the country, and the tyranny of distance often impacts people’s access to health services.

It improves the review process by requiring continual review and improvement.

In closing I just want to thank everyone who has called me and my office and emailed me to express their view. I have appreciated listening to and reading all of the different views, for and against, and I respect those views too. It is a really important process, to make sure that all views are heard out.

I believe the Victorian system is robust and accountable and has strong integrity systems. Our system is compassionate and puts the patient first in all the decisions. I want to thank Minister for Health Mary-Anne Thomas and her team for the work done and for their open provision of information about these changes. Mary-Anne Thomas thoughtfully acknowledged that the bill builds on what voluntary assisted dying is about. It offers choice, not about whether to die but how, where and with whom. So thank you everybody. I want to also acknowledge all of the colleagues present here in the chamber but also those not here, who are taking this very seriously and listening to each other. It is a very special process that we are going through, and I commend the bill to the house.

 Gaelle BROAD (Northern Victoria) (16:07): I rise to speak on the Voluntary Assisted Dying Amendment Bill 2025. This is a challenging bill, as Ms Ermacora just referred to. It is one that we are debating, and it has been good to hear the discussions in the chamber today and also in the lower house. I want to thank all those that have contacted me on this issue, because I have received phone calls and letters and emails, as I am sure many have had, and I have also reached out to people that have worked in the industry, just to get their understanding.

I know that in the discussion that we are having today we are not re-examining voluntary assisted dying. It was a debate that was held at length in 2017, and it passed by a very small margin. I believe it was just four votes. It is not an easy discussion or topic. There is a time to live and a time to die, and death often brings a new perspective – certainly to let go of the small stuff and gain perspective on what really matters. We approach this debate with a conscience vote, and many have shared their own experiences and those of people they know, which are going to influence their decision today.

I had a very unusual situation in that I had all four grandparents live into their 80s, which is not always the case. I had one, my grandfather, who was very keen to live till he was 120, but my own father died much younger. He had cancer; I remember it was when we got engaged that he learned that he had cancer, and it was 14 years that he lived with that cancer. I remember speaking to the doctor after he passed away, and he said that he had actually lived a lot longer than they had expected – and it was long enough to see our three children born, which was very, very special. But I have witnessed close friends whose lives have been cut short much sooner, and I know people who have chosen to navigate voluntary assisted dying. It is a service that is available and one that more people have accessed than the government thought when it was first introduced.

The challenge with this debate is that we can end up narrowing our focus. It is important, as my colleague Ms Bath talked about in her contribution, to think about the valuable services of palliative care, particularly in regional areas. There are professionals that are focused on alleviating pain and providing that relief to help people to focus on living and to be comfortable wherever they choose to be – at home or in care. I know that there are inequities that we see in our health system. I think of MND, and I know the disparity in support for people who are over 65 who get diagnosed with MND and how expensive it is for them to access those critical services, which are needed to help them to be able to live with MND, and the costs of equipment compared to people that are under 65 who are able to access support much more easily.

I think one of the challenges that I have had with this legislation is that there was a review conducted by the Department of Health back in 2023–24, and it found that after the first four years of operation voluntary assisted dying was working as it was intended. Initially when that review was put out it was indicated that they were not going to consider legislative change as part of that. I have heard from a number of people who have raised concerns saying that stakeholders would have actually participated and got engaged a lot more in that process had they been aware that legislative change would be forthcoming.

We have heard it said that the initial debate back in 2017 did come up with numerous safeguards. I think there were about 68 safeguards that they talked about in 2017 when voluntary assisted dying was first introduced. But we have heard it said in the chamber today that now those safeguards are being referred to as barriers, and I think that is a concern, given the shift in the consideration of this. Also I remember that a while ago the Greens put forward a private members bill, and I was very concerned to read that in the review of that – they were wanting a review in three years – it would look at whether or not children could have the capacity to consider voluntary assisted dying. That is certainly not a direction that I want our state to head in.

This bill that we are considering today passed the lower house 64 votes to 14. There are a number of amendments that have been put forward here today, and I think it is important in this chamber to do what we can to contribute to improving legislation. The first thing that I am proposing – well, I think it is a double-up, because Ms Blandthorn has put in a similar one – is a reasoned amendment. I think the need to debate or have greater consultation on the bill is really important, and that is not something that we have seen, as I have mentioned, with the review. It was not meant to be about legislative change, but we now have the bill before us today.

There are also a number of textual amendments that talk to the conscientious objection in clause 6. It talks about the minimum information that is provided in the act, and I think being able to specify that information is really important. Also, I guess I am really keen to ensure that doctors do have the right to conscientiously object. That is just so important. I think if we are being given a free vote in this chamber, they need to have that freedom as well.

I think the ability to initiate discussions is something that will be talked about during the committee stage, and that restriction on raising the issue is a really important point. I attended a doctor’s appointment recently with a specialist for my son, and I was hanging on every word the specialist said. I think what is said by a doctor is really important, and raising this could put additional pressure on people. I think that is possibly a consequence that we have not focused on enough in this debate. I have seen the impact that this decision can have on people and their family and friends, and it is not an easy decision.

It is one thing to know that you are going to die, but to choose a date – who, where, when, how – is a whole nother pressure. It is a very difficult one for families to navigate. Life expectancy, that threshold moving from six to 12 months – I think we should be retaining that safeguard that was put in place initially, because I have heard from doctors that have said with the longer timeframe it is hard to be accurate with the diagnosis. And then there is the minimum consultation period that we see shifting in this bill; I think retaining that would be a better approach. The experience requirement of five years dropping down to one I do not think is necessarily a good approach, because this is not selling a house or buying a car; this is quite a significant decision that people are considering. My concern is that as the door opens just that bit wider, if doctors and others raise it as part of an end-of-life-care discussion, it will have unintended consequences, as I said. Also, I do want us to consider the vulnerability of people who face the decision. It does have that added burden on the family. Also people could be pressured by family members, because I know as people become aware of the costs – of $750,000 for a room or access to services – you certainly do not want them to feel that pressure to end their life sooner.

I know this conversation does raise that whole quality-of-life issue, and people respond very differently – what someone might consider a quality of life factor, someone else has no issue with that. I remember listening to a conversation once about a family who had a child born with disabilities. They were talking about how it is like being on an aeroplane and you think you are going to Europe where it is all flashing lights and very busy and going to be a pretty amazing holiday, and then suddenly you hear the captain come on and talk about how you are going to Holland. Holland has got windmills and tulips and it is very different and a slower pace of life, but they just talked about still valuing life in that and how precious life is, whatever situation people find themselves in.

This debate made me reflect on my own name, because people often ask me ‘How do you get Gaelle, G-A-E-L-L-E?’ I actually had a sister who died before I was born, and her name was Danielle. As a result my parents chose to call me Gaelle, because funnily enough, I was actually due to be born on the day of her birthday. Every day when I spell out my name, I guess I am reminded of how short life is and how precious it is, because she passed away when she was just three.

I do stand here as someone who respects people’s decisions and their choices in very exceptional circumstances, but I also want to protect those, particularly the elderly, who may feel pressure to go down this track if the option is presented to them. I received a letter from a person who pointed out that as politicians we are getting a conscience vote, yet this legislation takes away the conscientious objection of doctors who do not wish to provide that minimum information about voluntary assisted dying.

In closing, I do really want to thank all those who care for people at the end of their life, however long or short it is. They are incredible individuals. I have witnessed their work, and I am absolutely in awe of it. In regional areas I would love to see expanded access to palliative care services, to have that focus on holistic care, to provide support for people who are close to death – that psychological support, the social support, the emotional support and often cultural and spiritual needs as well, to help people relieve their pain, their stress and their suffering. Whatever the outcome today, I hope to be around when this legislation is next reviewed, and I will be watching closely to see what impact these changes make.

I move:

That all the words after ‘That’ be omitted and replaced with ‘this house refuses to read this bill a second time until adequate time is given to allow full consideration of the anticipated and unintended consequences of changes to the Voluntary Assisted Dying Act 2017, and until further and broader consultation is undertaken.’

I am happy to circulate the other amendments, but if there is a double-up, I will have a look at them in detail and we can sort that out later.

 Rikkie-Lee TYRRELL (Northern Victoria) (16:21): One Nation Victoria will be supporting the Voluntary Assisted Dying Amendment Bill 2025. At the heart of this bill lies a simple but profound principle: compassion for those enduring the final stages of terminal illness. This legislation recognises that care takes many forms. For some it means the best palliative support, the presence of loved ones and the dignity of comfort, but for others, those whose suffering cannot be eased, whose pain persists despite every effort, care must also mean the right to choose a peaceful and dignified end. Voluntary assisted dying is not about giving up on life; it is about giving people the agency to make deeply personal decisions when death is near and suffering is intolerable. It ensures that terminally ill Victorians are treated with the same respect and compassion that we would wish for ourselves and our families. This bill strengthens safeguards, improves access to support and makes the process more compassionate and humane. It upholds the values of autonomy, dignity and mercy that sit at the core of end-of-life care. For those facing the final chapter of life, this reform ensures that they are not abandoned to pain or fear but accompanied with empathy, choice and respect. That is what true care looks like. I commend the bill to the house.

 Lizzie BLANDTHORN (Western Metropolitan – Minister for Children, Minister for Disability) (16:22): The preamble to the United Nations declaration of human rights confirms that:

… recognition of the inherent dignity and of the equal and inalienable rights of all members of the human family is the foundation of freedom, justice and peace in the world …

Article 1 of the Universal Declaration of Human Rights states that:

All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.

A belief in the dignity of the person is an acknowledgement that all human beings are inherently worthy, their status is equal and it cannot be diminished by circumstance, including by disability or illness. That brings a moral and ethical responsibility to provide for the dignity of the person without compromise or abandonment. At every stage of development and at every stage of life, from the very beginning, including death, we should provide every person with the necessary support and assistance to achieve standards that are consistent with human dignity. This inevitably means that we should provide vulnerable people with more support and assistance than others, particularly children, the elderly, people with disability and those who are sick. We should invest in the supports and services that allow people to live happy and fulfilling lives and achieve their full potential, from the early years to their end of life.

I have the great honour and privilege to serve as the Minister for Children and Minister for Disability, and I previously served as minister for the aged. I continue to meet amazing individuals, advocates and organisations. I see them working together in the same spirit of brotherhood referred to in the UN declaration of human rights for better outcomes not only for individuals but for their communities, indeed for society. I share their hope for better outcomes still.

There is so much more we can and should do for people at all stages of life, and in the name of human dignity, of human worth and value at all its stages, in spite of complications, we must do it before we assist people to die. To quote the Honourable Lindsay Tanner in the Australian Parliament on these matters:

Why is it that, on one hand, we put so much effort and concern into telling some people, ‘Don’t kill yourself,’ and we have so much concern now about youth suicide, yet on the other hand we are now shifting into a pattern where we are going to help certain other people, in effect, to commit suicide? There is an inherent subjectivity in all of this, and that is about the quality of life for people. It involves a subjective judgement which says that certain people in certain circumstances of a particular nature inherently have a lesser quality of life and therefore we are going to permit assisted suicide for those people, but not for other people.

This Parliament has provided for the establishment of a euthanasia and assisted suicide scheme. It represented a fundamental shift in end-of-life care in Victoria. I know it was not an easy question for many. During the 2017 debate, and again through this subsequent debate in 2025, members spoke both inside and outside of this chamber about their own individual experiences. Many indicated that those experiences were the reason for their support or their opposition to the bill. But neither the 2017 bill nor this 2025 bill are about any of the individuals that any of us have known, or know, or even individuals we love who lived or are living with terminal conditions. It is not about the individual stories that are generously shared with us directly and indirectly. As a Parliament of a civil society we have a responsibility to act as representatives of the community, not as a delegate for an individual. We have an obligation to make decisions in the best interests of the society, not in the best interests of an individual. Again the Honourable Lindsay Tanner put it well when he said:

I accept that on occasion there are situations where it is clear that death is inevitable; that the person has a terminal condition against which nothing can be done to prevent death; and, that the person concerned is suffering so badly and is in such extreme circumstances that they desire death, they hope for death, and that somebody does assist them – a doctor or another medical professional – in attaining release. It is very difficult for any of us to regard that as in some way morally wrong.

But there is a very different question at stake here; that is, not whether in some individual circumstances there is something morally wrong, but whether the state should legalise and indeed can safely legalise such practices. This debate should not be about one or two individual experiences, not about our own experiences, but about the broader social question.

He went on to urge:

We must look beyond those experiences to the broader view of the interests of society at large and the interests of the individuals who make up society.

He also went on to say:

I regard individual freedom in our society as essentially very fragile, as very vulnerable to misuse of state and bureaucratic power. Intrinsically, the state assuming the right to sanction killing of a citizen, for whatever reason, troubles me a great deal. Even with apparent consent, it worries me.

As is well known, I opposed the 2017 bill. My view on this issue is formed by an absolute belief that we have an obligation to protect and care for those who are most at risk in our society. And I believe that the measure of a civil society should be how we treat those who are most vulnerable. This is a progressive agenda, not a conservative one. I do, however, respect that there were several representatives who, coming from the same philosophical place, drew the very opposite conclusion on the 2017 bill, and I respect their deeply held positions. I also know that there were many members of Parliament who struggled to reconcile these issues. For many, the necessary reconciliation was established on the basis that the 2017 bill included extensive safeguards. Proponents of the bill described it as the safest scheme in the country. You only need to read the second-reading speeches that people gave in 2017 to see how much anxiety was relieved through the promise of these safeguards. These are the very same safeguards that this 2025 bill now seeks to dismantle. It is the slippery slope that many of us were assured would not eventuate, and I question the motivation.

The bill we have before us today follows the recently released five-year review of the operation of the Voluntary Assisted Dying Act 2017, which found that the scheme is working as was intended, providing a safe and compassionate end-of-life choice to eligible Victorians. Notably, until the day the review was published, the Department of Health website stated that as the legislated five-year review was operational, it was not considering changes to the legislation itself. The review did not consult on or recommend change to the existing legislative parameters. Many stakeholders, as would be expected, submitted in accordance with the terms of reference of the review, so they did not address the need for legislative change or the need to protect the legislative status quo. Some, however, ignored the terms of reference for the review and submitted in favour of legislative change – and now here we are. In announcing a plan for legislative change, the VAD team at the DOH wrote to stakeholders on 17 March advising them that they had until 31 March to make a submission – 10 working days. Indeed in this Parliament there is now an attempt to rush this bill. This has been justified on the basis that the changes are minor. However, I have grave concerns regarding the diminution of safeguards.

Firstly, I am fundamentally opposed to restrictions on conscientious objection. The Victorian charter of human rights provides that:

Every person has the right to freedom of thought, conscience, religion and belief, including –

…

the freedom to demonstrate that person’s religion or belief in worship, observance, practice and teaching, either individually or as part of a community, in public or in private.

The bill compels practitioners to provide information about accessing euthanasia and assisted suicide against their free will. In restricting conscientious objection, the bill would compel practitioners who conscientiously object to act contrary to the right of freedom of thought, conscience and belief contained in the Victorian charter of human rights consistent with core democratic principles.

Further, in the limited time available to me, I do call out the following, and I note that they have a compounding effect. The required years of experience of participating medical practitioners is being reduced from five years to one year. The less experience a medical practitioner has attained, the less equipped they are to properly advise patients and to assess factors such as lack of capacity, mental illness or coercion. The bill also allows registered health practitioners – which includes Chinese medicine practitioners, dentists, osteopaths and podiatrists, among many others – to initiate discussions about euthanasia and assisted suicide. The broad cohort of health practitioners, while not generally trained in end-of-life care, often has the trust and confidence of their patients, clients or customers. This could mean that their inexpert advice is given more weight than that which it should be afforded, and this is particularly so when the patient, client or customer is vulnerable and may be feeling like they are a burden. Notably, overseas data shows that considering oneself a burden on family, friends, community, the health system or society indeed is very often the reason for seeking euthanasia and assisted suicide.

I am concerned about shortening the time between the first and final request to access the scheme from nine days to five days, which includes the day of the first and last request. It is also dangerous, particularly in relation to vulnerable people who may be feeling like a burden. I am concerned about the update of the prognosis requirement to 12 months, particularly when we are reducing the experience required of medical practitioners and writing health practitioners into the scheme.

I did intend to move a reasoned amendment, but I note that Ms Broad has already moved a reasoned amendment virtually the same as mine, and I indicate that I will support her reasoned amendment. I also indicate that, should the bill indeed be read a second time, I will support other amendments that may be put on the table that improve the direction of the bill, but I will ultimately not support the bill. My remarks are a mere summary of my concerns, given the limited time available to me. But in closing, I remind the house that the review found that the scheme was working as intended by those who proposed it, many of whom remain in this place today. I question why we are rushing to provide for the diminution of essential safeguards when the proponents of the 2017 bill heralded the scheme as the safest in the country.

 Evan MULHOLLAND (Northern Metropolitan) (16:34): I rise to speak on the Voluntary Assisted Dying Bill 2025, and I want to acknowledge from the outset the thoughtful contributions made by members on both sides of this debate, as well as in both chambers of Parliament.

I am a big believer in our democracy that you can have a different view while recognising that all sides come from a good place, and they come from a good place in their point of view on these kinds of issues. That is the way I have always approached this role as a member of Parliament.

I particularly want to thank my friend Georgie Crozier for the diligent way in which she has navigated this debate and assisted colleagues with briefings on all sides. In doing so, I want to be clear and up-front at the beginning of my contribution to this debate that I will not be supporting this bill and that I do not support this bill because I do not support assisted suicide. Assisted suicide is not health care. No legislation defines assisted suicide or voluntary assisted dying as health care. This is not just my point of view but the view of millions of Victorians who fundamentally disagree with the government on this issue, and I am proud to represent their voices in this debate.

It is important for members, especially those who were not here in 2017, including me, to note that this bill is not about casting a second vote for voluntary assisted dying. This bill is about the removal of safeguards and conscientious objections. Many colleagues on both sides of this debate have given thoughtful contributions and personal stories, so I want to provide the chamber with my own.

My late nonna Teresa Caruso was like a second mum to me. With my mum having four kids under five, including twins, my nonna was a constant in my life. She was a migrant to this country from Italy. When she arrived in the 1950s she did not speak any English, but she was a very strong Catholic Italian woman. Around 2015 she was diagnosed with dementia, an incredibly difficult experience for me and my family. There were good days and there were bad days. There were horrific episodes and there were peaceful moments. After she had a fall and was in hospital, unaware of her surroundings, the only thing that would keep her calm was reading passages from the Bible in her hospital bed.

I recall the debate around voluntary assisted dying in 2017. As some will recall, it was all over the news. Nonna knew that she had dementia. She knew it was taking hold of her, and I remember it being on the news and Nonna turning to the family and saying, ‘Do not do that to me.’ It would have been the easiest thing to give up. The doctor’s prognosis was saying that she was not going to live for another 12 months. My nonno Domenico Caruso actually passed away before her, at 92 years old in 2018 after over 60 years of marriage. She did not even realise, lovingly referring to any old man that sat down next to her at her nursing home in Reservoir as Domenic, and when I arrived, asking the random old man, ‘Domenic, would you put on the percolator for some espresso, because your grandson has arrived.’

As many migrants who suffer dementia experience, she lost her English and referred back to her Italian language, a southern Calabrian dialect, which I got much better at understanding during my regular visits, as my wife and I lived around the corner from the aged care facility in Reservoir. These visits were such an experience, particularly because on each of our regular visits we got to retell her that my wife Brigid was pregnant. She would glow and cheer with excitement every time, and it would make her day. My nonna, despite being given a 12-month prognosis in 2017, lived until 2021, four years beyond medical expectations. I am so happy that she got to meet my first child Teddy, her great-grandson. It was a moment I will never forget. It is a photo I will always cherish. She was mostly non-verbal by then. I remember clear as day – it was delayed due to COVID – that this enormous, chubby six-month-old she described as ‘delicato’, saying that he was delicate or fragile, but she held him so tightly knowing that it was her great-grandchild.

What we are asking in this bill is to make a guess at a 12-month diagnosis, which everyone knows is unreliable, as the member for Broadmeadows pointed out in her thoughtful contribution. Everyone, every single member of this chamber, everyone in Victoria, would have a story about a family member or a friend who got told they had a certain amount of time to live, only to live two, five or sometimes 10 years longer, as do I. It is because I have witnessed the frailty and vulnerability of my loved ones facing the end of their earthly lives that I am opposed to this bill. There will never be enough safeguards. There is healing to be found. Hope for peace still exists even in the midst of illness, even in the face of mortal death.

These laws are being rushed through with limited consultation and insufficient sector input. Stakeholders were given just two weeks to make their views known on the bill. This followed the release of the five-year review of the act, which considered no legislative changes, consulted on no legislative changes and therefore did not propose changes.

This bill also compels health practitioners who hold profound personal reservations to assisted suicide to provide information about it. This requirement forces them to go against their deeply held ethical beliefs by discussing something they do not regard as health care and which the law does not describe as health care. Such provisions risk driving principled professionals out of the healthcare system.

I want to thank the over 3000 people who signed my petition opposing this legislation. I know many of them. A large number of them are from the outer northern suburbs – a huge number of them, over a thousand, are just from the one seat of Kalkallo. And I particularly want to acknowledge the extraordinary joint submission from the Catholic Archdiocese of Melbourne, the Board of Imams Victoria, the Hindu Council of Australia, the Sikh Interfaith Council of Victoria, the Victorian Sikh Gurdwaras Council, the Greek Orthodox Archdiocese of Australia, the Chaldean diocese of Australia, the Syro Malabar Eparchy of St Thomas the Apostle, the Coptic Orthodox Diocese of Melbourne and the Maronite Eparchy of Australia for so diligently representing more than two million Victorians on this issue. I would also like to thank some other faith communities I have been speaking to about this: the Syriac Catholic Church, the Syrian Orthodox church, the Assyrian Church of the East, the Antiochian Orthodox church and all the other Catholic parishes, Christian parishes and Hindu temples across the state that have expressed their opposition.

These amendments were not recommended by the government’s own five-year review, yet weaken protections that were deliberately built into the original legislation. When passed in 2017, Victoria’s assisted suicide laws were described by the Labor government and some in the Labor government as the safest in the world, with 68 safeguards. Removing or weakening those safeguards without clear justification risks undermining public confidence and exposing vulnerable people to harm, as Dr Stephen Parnis, former AMA president – very respected on the Labor side of politics – recently told the Curtin’s Cast podcast, referencing his warning in 2017 that safeguards will inevitably be redefined as barriers to access, which is exactly what the government is doing. We heard in the other place the Greens member for Melbourne saying the quiet part out loud: that these safeguards, which were designed to protect the vulnerable, are now barriers to access. Safeguards, whether in the law or on the factory floor, are by their nature barriers to access, so by this logic, it is a wonder why they accept any at all beyond those deemed important for political expediency.

The first and perhaps the most dangerous proposal would allow registered health practitioners to initiate discussions about assisted suicide. This was explicitly prohibited when the law was created, because it was recognised as a key safeguard against coercion. Patients who are frail, isolated or fearful may feel their doctor is suggesting that their life is no longer worth living. They may feel or be led to feel that they are a burden on their family, who would be better off without them. In fact, the experience of feeling like a burden was one of the primary reasons those accessing the VAD system provided to a Canadian study. That is not a choice, that is the implicit pressure of a system and a society that is failing people at a critical point. It is not compassion, it is abandonment.

The second change would require health practitioners who hold a conscientious objection to provide information about assisted suicide. At present the law includes safeguards for those with strong ethical or religious convictions, such as Christians, Muslims or Hindus, or simply with deep reservations to decline involvement. Under the proposed changes health practitioners who do not comply with the new requirement to provide that information could face suspension or loss of registration with the Australian Health Practitioner Regulation Agency or may risk losing their insurance coverage. Any health practitioner registered under the Health Practitioner Regulation National Law will be able to raise assisted suicide with their patients without any training required or offered. This includes professions like Chinese medicine practitioners, chiropractors, dentists, midwives, occupational therapists, optometrists, osteopaths, paramedics, pharmacists, physiotherapists, podiatrists, psychologists and others. I have significant concerns about diluting this to such a broad list of professions with limited support or guidance. I will be moving an amendment to deal with this, similar to my friend in the other place Jess Wilson, and I ask for that amendment to be circulated. I will flag, though, that I may withdraw this amendment in committee in order to support another one moved by, I believe, Michael Galea.

It is also unfair to suggest that health practitioners are denying a service. They are not. For example, Catholic services like Mercy, St Vincent’s and Villa Maria already have an existing practice to provide minimum information to residents or patients in their care, where they are able to seek out the subject matter expertise in relation to VAD if they wish from the Victorian Department of Health’s care navigator service. This process was developed in close dialogue with the Department of Health in 2018–19 as part of their models of care taskforce, and I plan to move an amendment to clause 6(2)(b) setting this in stone. My amendment would set an upper limit on the material that has to be provided by practitioners to the voluntary assisted dying care navigator service, and I ask for that amendment to be circulated. The intent of this amendment is simply just to set in stone what the government has already written in its explanatory memorandum. For colleagues, the impetus is on the government to explain why the secretary can provide information but the definition of that is limitless. The secretary, without coming back to this Parliament, could come back in a year and completely redefine what the minimum information is. As Ms Crozier diligently pointed out, we know what happened during COVID where the secretary and the CHO were giving so much advice that turned out to be wrong – that was later admitted to be wrong. So the impetus is on the government to explain this, and I ask for colleagues to support that amendment. We know that the World Medical Association and the Australian Medical Association do not publicly endorse euthanasia.

Another proposed change would expand eligibility to 12 months to all applicants. This means a person who may have a year or more left to live could be eligible for assisted dying. The prognosis at that distance is uncertain, as I mentioned before. True patient choice cannot exist where palliative care is harder to access than assisted suicide. It is worth noting that in many regional areas it takes longer than five days to arrange basic palliative support. Our society should offer support for people who are suffering without being overwhelmed by it, accompanying those who suffer rather than eliminating the sufferer.

I am deeply concerned about the provision in the bill to allow exemptions to using an accredited interpreter service for such weighty decisions, literally on life and death. We know the government’s own multicultural review recommended only using NAATI accredited interpreters, something that even the assistant minister for multicultural affairs agrees with.

True compassion is not found in ending a life but found in providing care, dignity and companionship at the end of life. I hold, and continue to hold, deep reservations about assisted suicide and its place in our healthcare system. I will not be supporting this bill. I strongly urge all colleagues to do the same and consider amendments.

 David LIMBRICK (South-Eastern Metropolitan) (16:49): I would first like to acknowledge all the people that have contacted my office on this issue, on both sides of the issue, and also the engagement of various people that I have spoken with about this issue. Obviously it is a very weighty decision that we are faced with as members of Parliament here – literally life and death. Like all things, I must approach this according to the principles on which I was elected, and that is around the principles of individual liberty. Fortunately I have those principles to guide my views on this bill, and I will say that this bill does some things to improve the rights and freedoms of Victorians and does some things to limit them. Like many bills that I face in this place, I must ultimately make a call on where I land with that.

In principle our party have long supported voluntary assisted dying, and that is because we believe in self-ownership, in the principle of bodily autonomy and that people should own their own body and should be able to make decisions about what they do with that body, including the biggest decision of all if they choose to end their life through this sort of process. With that fundamental belief, there are also other problems that this bill introduces, such as overriding, in a way, the conscientious objection of people who do not want to be part of this process, and therefore I have concerns with the bill.

I will go through some of the things that the bill does and my thinking on where they land in terms of enhancing or restricting the rights of Victorians. I will start with the biggest one, which is the updating of the prognosis requirement from six months to 12 months for all applicants. Both sides of this debate have shown scepticism about how scientific the prognosis in these cases is, and indeed I am sceptical as to whether this prognosis requirement is required at all because of that. However, in my view, updating it from six to 12 months does increase the accessibility for people that want to access this. I have heard of cases where this has been a problem, and therefore I have a supportive, positive view on that because I believe it enhances the rights of people that want to access this.

Similarly, on introducing exemptions to the Victorian residency requirements, I am highly supportive of this. My understanding is that when the bill originally went through, there was concern that people would travel to Victoria specifically to access this, and people did not want that to happen. But as this type of scheme has been rolled out in other states, I see that that is not really much of a concern at the moment. Therefore introducing that exemption on compassionate grounds enhances the rights of people.

Another thing that this bill does, which I think is good, is it amends the Australian citizenship and permanent residency requirements for people who can demonstrate that they have lived here for three years or more. For people that are ill and find themselves in this situation, it may be impossible or prohibitive for them to travel to another jurisdiction to access this type of scheme, or this type of scheme may not exist in another jurisdiction. Therefore removing those requirements enhances the rights of Victorians.

Similarly, reducing the time period between the first and final request from nine to five days, although it is a small thing, does enhance people’s accessibility and ability to access this type of scheme. Another thing that I am very supportive of in this bill, and it is surprising that it was not included in the first place, is the prohibition on practitioners being a beneficiary or a family member of the applicant. This seems like a very sensible safeguard. I am very supportive of that being in the bill, and I think even the opponents of the bill probably support that safeguard.

Now to some of the points in the bill that I have concerns about. The largest concern I have is the requirement for health practitioners who object to provide minimum information.

It has been put to me that if they provide no information, they are hiding access from people and they should be forced to provide that. I do not agree with that. I think that if someone, due to their sincerely held beliefs, does not want to take part in this at all, then they should be afforded that ability according to their conscience, so I am opposed to this part of the bill. I think it is wrong to do that.

One part of the bill which I do have some concerns about, but not huge concerns, is allowing health practitioners to initiate discussions. I think it is sensible in the context of having discussions with health practitioners that if an option is available, then that should be made known to the patient. I do have concerns, as others have brought up, about the power imbalance between the health practitioner and the patient. But this exists in all situations with health practitioners, so I am not sure that that alone is enough to think that it is a highly negative thing.

I will note that for many of my concerns there are amendments, and I will be considering those. For example, in relation to the requirement for registered health practitioners who object to provide minimum information, I will be supporting the amendments put forward by Mr Erdogan and Mr Mulholland. Mr Erdogan’s amendment effectively removes this and provides protections, interestingly, using anti-vilification laws. I was quite impressed with that innovation. Mr Mulholland is attempting to make the scope of the information very clear, which I also think is quite a reasonable thing to do. With the issue of allowing health practitioners to initiate discussions, I note that Mr Galea will be proposing an amendment to narrow the scope of the type of practitioner, so allowing doctors and nurse practitioners to initiate discussions but not other health professionals. I think that this is a sensible amendment, and I will be supporting that also.

Another access issue which this bill addresses is to change the eligibility requirements for practitioners from five years to one year. It also updates some things about terminology. There has been much discussion about this and whether five years is necessary or whether one year is not enough. Ultimately I accept that the five-year minimum at the moment is limiting access for people that want access. One year may be too short. Therefore I note that Mr Galea has an amendment to change that to three years. I see that as trying to strike a balance between those positions, and I think that that is a sensible move, and I will support that also.

Ultimately I need to come to a position on this bill. It is my opinion that, although I have reservations about this bill and I am disappointed that the government is forcing people to act against their conscience in this bill by providing information where they do not want to do that, I have to weigh that up against the rights of the patient and their ability to access this scheme. I place great weight on that. Therefore, even though it is a close call for me, I will be supporting this bill. I am hopeful that many of these amendments I have spoken about pass, because if they pass, they will alleviate many of the concerns that I and members of the community have about this bill. I will leave it at that. I look forward to the committee stage of the bill.

 Enver ERDOGAN (Northern Metropolitan – Minister for Casino, Gaming and Liquor Regulation, Minister for Corrections, Minister for Youth Justice) (16:59): Few matters that come before this chamber carry the weight of what we are discussing today. When we speak of voluntary assisted dying, we are speaking about the end of life itself – of pain, care, fear and love. Those experiences shape not only our politics but also our humanity. I do acknowledge the hurt these deliberations can open for families who have faced or will face unbearable suffering, for health professionals who walk beside them and for Victorians whose faithful philosophy frames these questions differently. I extend my respect to all of them and to every member of this chamber, who will wrestle sincerely with their conscience before casting a vote on this matter. I rise today not to relitigate the question of voluntary assisted dying but to confront a narrower yet no less complex proposition: whether we are, in tinkering with a well-received system, beginning to unpick the very safeguards and civic principles that made it acceptable in the first place.

When this Parliament passed the Voluntary Assisted Dying Act 2017 it did so after one of the longest and most conscientious deliberations in our state’s history. There were years of inquiries, reports and hearings. It was in every sense a conscious debate, one in which members were asked to look inward before they voted outward. The sentiment that emerged from that process was principled. It was built on two pillars: that voluntary assisted dying would be permissible only within a cautious and carefully defined set of circumstances, and that those who could not, in conscience, participate would be protected from coercion or sanction. As the member for Greenvale in the other place stated, those safeguards were not administrative details, they were the moral foundation of public consent. They allowed this Parliament to legalise a practice that touches the deepest questions of human dignity without fracturing public trust.

After several years of operation, it is right that the department reviewed how the framework was functioning. The department’s five-year review found the system was safe, compassionate and working well, with high compliance and no evidence of ineligible access. Importantly, it did not propose amendments to the conscientious objection provisions of this act. Yet the bill before us recasts safeguards as barriers and treats conscience as an inconvenience to be managed. That is why this debate matters. I do want to acknowledge that some technical refinements in this bill may help address practical challenges identified by clinicians and patients operating within the current law. Examples that I do think are positive and do make the bill better include the application of a 12-month consistent prognosis for all diseases, illnesses and medical conditions, and a sensible change in preventing the administrative practitioner from benefiting in any way by the VAD applicant’s death. But this bill before us introduces changes that go well beyond these refinements. Clause 6, in particular, alters the ethical boundaries that the Parliament put in place in 2017, and much of my contribution in this place will be on clause 6 in light of the time-limited debate before us.

Under the current law, a registered health practitioner with a conscientious objection may decline to participate in any part of the voluntary assisted dying process. They are not required to refer, advise or distribute information that would facilitate any act they cannot, in conscience, support. That protection is deliberate. Some will argue that this requirement merely ensures access, but access to voluntary assisted dying has already expanded far beyond expectations, and no evidence suggests that conscientious objection has obstructed it. The state has multiple channels to connect eligible people with willing providers. It does not need to conscript those unwilling to do so. This bill, by recasting conscience as a problem to be managed, weakens the trust on which the entire system rests. For patients to have confidence that their choices are free, they must also know that their clinicians are acting freely. A coerced conscience cannot deliver compassionate care.

Freedom of conscience is not a decorative phrase in our laws; it is a living principle that allows difference to exist without fear. Victoria’s Charter of Human Rights and Responsibilities protects freedom of thought, conscience, religion and belief. It does so because democracies are sustained not by coercion but by accommodation. The charter reminds us that the dignity of the individual does not depend on conformity, and that the right to abstain from an act can be as important as the right to perform it.

That protection is not a privilege reserved for the religious alone, it is a civic guarantee for all of us – for the secular ethicist as much as the person of faith, for the pacifist who will not bear arms and for the clinician who cannot facilitate deliberate ending of life. We cannot have a democracy that values freedom of choice but scorns freedom of conscience; both are oxygen of a plural society. In a state as diverse as Victoria pluralism is not an abstraction, it is a daily practice of our institutions. Our world-class healthcare system is sustained by people from across the world, whose beliefs and traditions span every faith and philosophy. They work together because the law makes room for difference. If Parliament starts demanding uniformity of conscience, it hollows out the very diversity it claims to value. Compassion ceases to be compassion if it demands complicity.

Freedom of thought, conscience, religion and belief enshrined in the charter is not theoretical, it is lived in Victoria’s multicultural workforce. These are the people who hold the hands of the dying and comfort the families left behind. Many come from communities where faith and moral duty are inseparable from service. For them compassion and conscience are not competing instincts, they are the same. To compel them to act against their conscience is not a minor administrative tweak; it is a direct challenge to the values that brought many of them into caring professions in the first place and for some, and many in my electorate of Northern Metropolitan, into this country. We cannot claim to honour multiculturalism while drafting laws that punish its practical expression. A policy that narrows conscience rights will fall hardest on new Australians in my view – the doctors, the nurses, the carers who brought their skills, beliefs and culture to this country. When we narrow the moral space in which people can work with integrity we do not make the system stronger, we make it smaller and more brittle. Victoria’s health system depends not just on professional competence but on moral diversity – on the understanding that people from many traditions can serve the same public good in diverse ways. That is the true face of pluralism – not uniformity but cooperation grounded in mutual respect. I will therefore be moving two amendments that seek to restore the integrity that was enshrined in the 2017 act and to protect those who act according to conscience within it. I do ask the clerks if they could be circulated now.

I want to be very clear that my amendments are not attempts to roll back voluntary assisted dying, they are attempts to ensure it continues to rest on the balanced footing that earned this Parliament’s and this state’s trust. I was not here in 2017 when the Voluntary Assisted Dying Bill was debated, but as the member for Ivanhoe, who was there, stated in the other place, the conscientious objection was not a peripheral matter then and it is not now. It was central to the debate. My first amendment will restore the genuine right of conscientious objection that exists under the current law. It will remove the new requirement that an objecting practitioner must advise a patient of another provider and must distribute information approved by the secretary. It makes clear that a person who in good conscience cannot take part in any aspect of the voluntary assisted dying process may decline to do so without fear of civil, criminal or disciplinary sanction. It is a reaffirmation that our current act is working well; it ensures that conscience remains a shield, not a hindrance; and it leaves access untouched. Those who wish to proceed with voluntary assisted dying can continue to do so with the wide network of information and support already in place.

My second amendment will ensure that a person’s conscientious objection cannot become grounds for discrimination or vilification and will insert a new section 7A into the act, applying the principles of the Equal Opportunity Act 2010 and the new anti-vilification provisions in part 6A of that act. The amendment will ensure that a person’s conscientious objection cannot become grounds for discrimination or vilification. Without that, the promise of freedom becomes a permission slip that disappears the moment it is exercised. If we believe conscience is worth protecting under one law, we should not punish it under another. At its heart the bill forces us to decide whether compassion can coexist with conviction, the dignity of the person who seeks to end their suffering and the dignity of the person who cannot in good conscience assist them in doing so.

Equality before the law does not mean sameness of conscience, it means that each person – patient and practitioner alike – can act freely within the law without fear of penalty or shame. When we remove that right to act or not act according to conscience, we erode the principle, which runs deeper than this or any Parliament, that the state governs conduct, not belief. If we reduce conscience to mere compliance, we risk hollowing out the very pluralism that gives democracy its moral depth.

I remain committed to ensuring that Victorians facing end of life have access to compassionate, lawful and safe choices, but I am equally committed to ensuring that those who care for them are not coerced into acts that transgress their conscience. It is a balance of those values, not any single one of them, that earns the confidence of this state. This bill risks upsetting that balance. It redefines a safeguard as an obstacle and recasts conscience as an inconvenience. It cuts across the principles we affirmed in our own anti-vilification and social cohesion reforms.

My amendments do not seek to deny access to voluntary assisted dying for those who lawfully qualify. That right exists and will continue to do so. We cannot legislate compassion by stripping away conscience, nor can we build inclusion by erasing difference. The measure of a mature democracy is not how it treats those who agree with it but how it protects those who cannot. That is why I urge all members to uphold both their compassion and their conscience in voting on this bill. There will be many opportunities to make the bill better and make improvements. That is why I am moving these amendments, and I urge support from all members in this chamber.

 Trung LUU (Western Metropolitan) (17:11): I rise to add my respectful remarks to the Voluntary Assisted Dying Amendment Bill 2025. I truly appreciate the opportunity to speak in this debate and listen to members from across the political aisle. This has been a very respectful debate, and I thank the house for that. I want to especially acknowledge the outstanding leadership of my colleague Georgie Crozier, our Shadow Minister for Health, for the amount of work she has done on this bill and for the way in which she has facilitated numerous briefings from various groups and organisations for the opposition. I also want to thank those groups for the respectful way in which they presented their case to the opposition on a very important debate. I also want to acknowledge those colleagues of mine from all parties – both sides of the chamber – and the other place who have shared deeply personal stories, including some cases where their loved ones and their constituents have battled terminal illness and endured struggles at the end of their lives. Some did not get the opportunity to end their lives using voluntary assisted dying but would have done so had they had the option available to them at the time. Also I would like to acknowledge that I understand that for those families of loved ones who may no longer be with us, this debate might trigger some anxiety and discomfort.

While I was not a member of Parliament in this place in 2017 when the initial legislation was debated and passed, I have listened intently to this debate and learned a lot about the impact that the initial legislation has had on the broader Victorian community. The Voluntary Assisted Dying Act 2017 was a first for our country, and we now see that every state and the Australian Capital Territory have passed legislation that has given effect to people ending their lives using voluntary assisted dying. By all accounts, the legislation that was debated and enacted roughly six years ago is working, barring some very minor exceptions.

Today we are now debating numerous amendments to this bill, and I will go through a few of the critical aspects of this amendment bill in a moment, especially the ones that I am personally concerned about. But before I do, I want to thank the government, the opposition and the crossbench for their considerations and contributions so far. We have kept the debate respectful, in line with Victorian community expectations. From the outset I will say I absolutely stand by and defend people’s right to determine what is right for them, especially at such a vulnerable moment in their life, and to not have legislation dictate how they should end their life.

For individuals and families, the end of life can be a very difficult time, and we should be in the business in this place to provide support and all options available to people to make an informed choice. I joined my party, the Liberal Party, because I support the empowerment of individuals – the absolute right to choose is part of our fundamental commitment to individuals. The fact is that he or she is best placed to determine what is right for them, including what is right for them at the end of their lives. The voluntary assisted dying legislation really does speak to the independence of individuals, providing dignity and reducing suffering for terminally ill individuals, which is why I do not oppose voluntary assisted dying as it stands.

I support the individual’s right to retain their agency over how they end their life on earth. I do, however, have concerns about some aspects of this bill that we are debating today, which I believe does not strike the right balance, instead pushing debate outside what was first debated in 2017 into a grey area. This is why I do not support the bill as it stands. The first thing I find most disturbing is that the terms of reference that triggered the five-year review under the existing legislation did not reference consideration of changes to this legislation. What it did, however, was reference that the legislation’s five-year review was of its operation. That is the key here – its operation stands part of the procedure. Therefore I am concerned that consultation on the amendments put forward by the government was substandard and rushed, and therefore the volume of respondents engaging in the review process was not as fulsome as it could have been. Had they known it would result in a possible legislative change, they may have been more forthcoming in providing their insights, concerns, perspectives and experiences.

Any legislative change to the Voluntary Assisted Dying Act 2017 must be rigorous and aligned with the community and their expectations. I do not believe this has occurred. I know, from the communication I have received to date on the amendments we are debating at the moment, that one of the strongest arguments, which I wholeheartedly agree with, is that the consultation phase has been non-existent and that the exposure draft of all the proposed changes should have been put on the table. We should have allowed Victorians more time to comment. Rushing through these changes could have significant unintended consequences.

I also object to the change whereby practitioners opposed to voluntary assisted dying must now provide information. Clause 6 of this bill requires that those medical practitioners who have an conscientious objection to voluntary assisted dying must now provide information to patients on this subject if requested. This is currently not the case, and there are no obligations. This worries me and concerns many constituents I spoke to on this bill. The bill seeks to change the current position to ensure people seeking information about voluntary assisted dying are provided with minimum information on how to make inquiries and how to access information and services. While supporting the individual’s right to choose how to end their life using voluntary assisted dying, not predetermined by others’ beliefs or values, I also support a medical practitioner’s right to not offer minimum information if their objection is on several personal grounds. Governments should not be in the business of imposing minimum standards in terms of what information medical practitioners must provide. I understand and appreciate that, under the change, there is still no obligation for any medical practitioner to provide assistance or a referral to another health practitioner in relation to voluntary assisted dying beyond the provision of this information, and for that I am pleased.

The information that a medical practitioner must provide under clause 6(2) is information provided by the Department of Health secretary, which details the statewide care navigator service and a link to the Department of Health voluntary assisted dying website. Again, even this information has raised concerns for me, and I believe it could lead to unconscious perceptions of going down a slippery slope.

I also want to put on record my opposition to clause 7, which inserts new section 8A, which allows registered health practitioners other than medical practitioners and nurse practitioners – such as allied health practitioners regulated by AHPRA, the Australian Health Practitioner Regulation Agency – to initiate discussions about voluntary assisted dying. This clause raises concern for me, and others have spoken about it too. I believe this needs to be tightened and more clearly defined, as it is open to assumption.

I am happy to see that the government has incorporated changes to the Australian residency requirement. The current requirements were not working. Opening it up to allow the residency requirement to include someone who has been in Australia for at least three years is a sensible move and one that I think has as close to universal support as possible.

In closing, for me personally I cannot in good conscience support this bill as it stands for the reasons I have outlined. I do want to reiterate that I stand by and would defend people’s right to make a determination on what is right, and I support the efforts the government is undertaking to strengthen the legislation in some respects and make it more sustainable. But the issues I have outlined are sticking points for me. For this reason, I cannot support this bill. I do thank the Council for indulging me and others in this place and allowing us to put our views forward on a deeply personal debate.

 David ETTERSHANK (Western Metropolitan) (17:22): I rise to make a contribution to the Voluntary Assisted Dying Amendment Bill 2025. Legalise Cannabis support these amendments, and I would like to acknowledge and commend Minister Thomas for her work in bringing these amendments to the chamber. The VAD scheme has been operational now for five years. This compassionate and well-regulated program has served over 2700 dying people, offering them relief from terrible suffering at the end of their life. It has also helped relieve them of associated emotional and mental anguish through having the knowledge that when they are no longer able to or prepared to prolong their physical suffering, they will be able to choose the time and the manner of their death. That relief is also felt by family members and loved ones of the dying person. As anyone who has watched a loved one endure excruciating pain will confirm, they want nothing more than to see an end to that suffering and to see their loved one at peace.

The Victorian Voluntary Assisted Dying Bill introduced in 2017 was the first of its kind in Australia. Its introduction was fervently supported by its advocates and deeply feared by those who imagined the worst possible outcomes for society if the bill succeeded. Every clause of that bill was subject to the most rigorous interrogation in both houses during a gruelling debate which apparently totalled around 160 hours. Understandably, the bill erred on the side of extreme caution, containing no less than 68 safeguards. None of the dire predictions that accompanied that first debate came to pass. This humane, modest and very safe scheme is strongly supported by Victorians, and indeed every jurisdiction in Australia bar one has since adopted its own voluntary assisted dying scheme. Other states learned a great deal from our scheme and improved upon many aspects of it, and the five-year review has given the government the opportunity to examine other state schemes and to respond to stakeholder feedback in considering the Victorian scheme. Seeing the laws in practice has provided a good basis for improvements to our scheme. The new amendments are modest in scope. There is nothing particularly radical, but they cautiously broaden access to the scheme and will hopefully further improve the experience for those people availing themselves of the relief that VAD can provide.

I would like to just talk for a minute about palliative care. The issue of access to palliative care was talked about a lot in the Assembly and to some degree here in the chamber, and there seems to be this theme around the idea that VAD will be promoted above palliative care by health professionals – that in removing the gag clause, doctors will only discuss VAD and not provide people with information on palliative care options – or that patients will feel compelled to opt for VAD over palliation. But let us be clear: it is not a binary choice. It is not one or the other. No-one – no-one – is denying the important role of palliation. In fact we desperately need to be investing more in palliative care services. Many Victorians are unable to access adequate palliative care when it is needed, and this includes community palliative care services at home. This issue needs to be urgently addressed at both the state and the federal levels.

Most people approaching death are not seeking to accelerate death, and they do not take lightly the decision to end their lives. Palliation is central to the quality of remaining life. Palliative care can and does ameliorate suffering, but there comes a time when for some people it is simply not enough. At a certain point it becomes about the quality of one’s remaining time, one’s remaining life, not the quantity.

As one who has worked in the aged care sector prior to entering Parliament, I recognise that there is both an informal VAD as well as a formal VAD. Generally, palliative care providers will maximise the treatment to remove pain, and often they will err on the side of removing pain over what might be a conservative prescribing limit even if it potentially shortens a life. That is as it should be. There is an inherent ambiguity in the palliation process which cannot be simply regulated by government. When the patient decides that palliation has reached its limit, there needs to be choice for that patient. They must be empowered. They must have the agency to make this most important choice: to continue palliation or to leave this life in a manner and at a time and place of their own choosing. Surely as a society we can offer an appropriate ending to dying people, to allow them to go gently into that dark night. If we are a humane and a caring society, surely – surely – it is the last and best action that we can do for someone.

We will be supporting the Greens amendments. We are particularly supportive of the amendments that would address the dearth of VAD providers across the state. There is an extremely limited pool of VAD practitioners, particularly in rural and regional Victoria, where the lack of local practitioners makes it very difficult for people to access the scheme. So the amendment to enable nurse practitioners to act as coordinating or consulting practitioners would be particularly welcomed in those areas. This is something that the Australian Nursing and Midwifery Federation supports as well. Nurse practitioners already have a lot of experience in the VAD space. Nurse practitioners would not be the principal consulting practitioner but would work alongside an appropriately qualified doctor, as defined in the bill. On this subject, I would note the proposed amendment from Mr Galea to more accurately define what constitutes a health practitioner, and we will also be supporting that amendment when it is circulated.

The Greens amendment to change the minimum requirements for coordinating and consulting practitioners would similarly help to reduce barriers for people in rural and regional Victoria in accessing the scheme. Tasmania and South Australia allow any doctor with experience in the condition to be a coordinating and consulting practitioner, and of course by the time a person gets to the point of needing to access the scheme, they have already spent a lot of time with doctors who specialise in that particular disease, and there are already sufficient safeguards in this area.

Why wouldn’t, for example, a patient want their GP to be one of their consulting practitioners? They are most likely the practitioner the patient has had the most contact with throughout their illness, if not throughout their entire lives. People place great trust in their GPs and have strong relationships with them.

As well as having a limited pool of VAD providers in the regions, access to VAD is then often compounded by the rigid prognosis timeframe. We acknowledge that the bill extends that timeframe from six months to 12 months, but with all of the other eligibility requirements, including that the person has an illness that is incurable, advanced, progressing and terminal, is it really necessary to impose a strict timeframe? Many clinicians are reluctant to provide an estimate of time remaining beyond days or weeks, and with a legally binding timeframe one can understand why they might err on the side of caution in their estimates, particularly if they fear breaking the law.

Thanks to Victoria’s groundbreaking legislation in 2019, voluntary assisted dying is an accepted end-of-life choice that people with terminal illness looking down the barrel of immense suffering can access. It has allowed thousands of Victorians to live and to die on their own terms – with dignity, with humanity and surrounded by the people they love. The amendments proposed in the bill will reduce needless suffering and remove unnecessary obstacles to VAD access so that more people can have the option to end their lives in a dignified and respectful manner.

We saw an overwhelming number of members in the Assembly use their conscience vote to pass these important reforms. Even those who did not support the amendments could not have helped but be moved by the extraordinary courage of Emma Vulin, the member for Pakenham, who I acknowledge here today and who spoke about living with motor neurone disease, a progressive and terminal illness, and the solace she derives from knowing she can access VAD. She said:

Knowing that voluntary assisted dying is there means that I, and people like me, can spend less time fearing the end and enjoy the remainder of my life without worrying too much about what the end may look like. It means that if I reach a point where my suffering becomes unbearable, I can make a choice on my own terms of when and where I would like to die, surrounded by the people I love.

I also want to acknowledge Leader of the Opposition Brad Battin, who having previously voted against the bill in 2019, voted in support of the amendment after experiencing two of his friends dying from cancer. To quote Mr Battin:

… it is about people … not politics … my position has changed on the facts of what I have done and what I have seen.

I understand that the numbers are a lot tighter in the Council than they were in the other place, but I sincerely hope that hesitant Council members will similarly draw on their reserves of empathy and be swayed to do the right thing by all Victorians.

In researching the bill, I read many heartbreaking and courageous accounts of people who have been through the voluntary assisted dying journey. None of them – not one – wanted to die. No-one undervalued the precious days of their life. They appreciated every moment they had left, but they knew what was coming and they knew there would be a time when it was enough. I want to quote Helen Andreoni, who was diagnosed with colon cancer and has written about her experience. She wrote:

I do not know how much time I have, no one does, I now realise. What matters most is the present.

She also noted:

Pain, loss of control, indignity, these are not abstract thresholds. You know them when you live them. The difficulty lies in recognising when the situation becomes intolerable. I have learned to trust my own sense of what is enough.

That is really what this is about: offering compassionate end-of-life care for when living becomes intolerable, for when it is enough and it is time to let go. I commend the bill to the house.

 Sheena WATT (Northern Metropolitan) (17:35): Over the course of this debate we have heard a wide range of opinions and deeply held views on this legislation before us. The diversity of perspectives expressed in this chamber is a reminder of how important this issue is not only to us as legislators but to Victorians right across our state. This is not a simple bill. It was never meant to be. It touches on life, death, dignity, faith, morality and compassion – matters that lie at the very heart of our shared community.

I have thought long and hard about this legislation. I have listened to my colleagues, to the community, to medical professionals, to advocates and to families who have lived through the realities of terminal illness and end-of-life care. I have considered this bill with the due process and respect that it so rightly deserves. This bill means a great deal to many different people for many different reasons, and today I stand here in full, unequivocal support of this bill and the changes it will make. It gives Victorians more agency in their lives and ensures that those facing the most difficult circumstances imaginable are treated with dignity, fairness and respect.

I would like to begin by acknowledging and thanking my friend and colleague here in the gallery the member for Pakenham Emma Vulin. Throughout this entire debate Emma has acted with a level of composure, compassion and integrity that has deeply moved not only myself but so many others in this place. Her experience and her strength have added an irreplaceable human dimension to this conversation, one that reminds us why this work matters. Because, as Emma said, this is not a political issue; it is a profoundly human one. Emma, I want to say thank you for your courage, for your grace, and for the example that you have set at such a difficult time in your life. You have shown us all what empathy in leadership looks like.

This bill, as we all know, means a lot to so many people. For some it will mean the difference between a peaceful, dignified end-of-life experience and weeks or even months of prolonged, unnecessary pain. For others it will mean the comfort of knowing that if that day ever comes, they will have a choice and the control to be able to make that decision for themselves. At its core this bill means choice. It is about giving Victorians the ability to make deeply personal decisions about their own bodies and their own lives. It is about respecting the autonomy of individuals, trusting them to know what is best for themselves and their families and ensuring that the laws of this state provide them with the dignity they deserve.

Crucially, this bill also addresses one of the most significant inequities that has existed in our voluntary assisted dying system since its inception, and that is accessibility. It gives regional and rural Victorians a fairer chance to access VAD services without the enormous logistical and emotional hurdles that they may face. No-one should be denied access to compassionate end-of-life care simply because of where they live.

Before entering this place I worked in the health sector for a number of years, and during that time I saw firsthand the enormous challenges, the heartache and the resilience of those facing serious illness. I saw how a diagnosis, no matter its severity, ripples through an entire family. It does not affect one person alone. It affects partners, children, siblings, parents, friends and colleagues. It tests relationships and it reshapes lives. I have had family members, friends and colleagues who have gone through palliative care. I have seen both the beauty and the limits of what modern medicine can offer, and palliative care can be extraordinary. It can comfort, it can relieve, it can support, but it cannot always eliminate suffering. There are some forms of pain – physical and emotional – that remain beyond even the best care. That is why this bill matters. Because when medicine has done all that it can, when care has reached its limits, what remains should be compassion and choice.

I recently had the privilege of meeting with the team from Dying with Dignity Victoria here in Parliament – Jane, Michelle and all their incredible advocates who have worked tirelessly to bring this issue to the forefront. I want to take a moment to thank them for their dedication, for their respectful advocacy and for the courage they have shown in sharing countless stories of those who have suffered and those who have found peace through voluntary assisted dying. Dying with Dignity has a simple but a powerful motto: respect for the right to choose. That sentence really captures the entire spirit of this legislation. It is about respecting people’s autonomy, their moral agency and their right to decide what happens to their own bodies at the end of life.

Over recent weeks I have received many emails, letters and calls to my office about this bill. Some expressed passionate support; others expressed deep concern or opposition. I want to say to every single person that reached out: thank you. Thank you for taking the time to share your views with me, whether we agree or not. Democracy is at its best when people engage in the issues that matter to them. So to you: thank you. I also understand the fear and uncertainty that sometimes surrounds this debate. Words like ‘assisted dying’ carry enormous emotional weight, and misconception can spread easily – and so can fear. I just want to let you know that this bill is not about coercion. It is not about pressuring people into decisions. It is not about doctors making premature judgements on the value of a person’s life. It is not about cutting corners or hastening death for the sake of convenience. It is about care – this bill is about care. It is about improving equity of access and ensuring that the voluntary assisted dying system is safe, compassionate, culturally safe and fair. It strengthens safeguards, enhances the experience of those who seek to access VAD and makes practical, humane improvements to the way the system operates for all Victorians.

The 2025 Voluntary Assisted Dying Review Board annual report shows that between June 2019 and June 2025 more than 1600 people accessed VAD care pathways. Of these, 24 people identified as Aboriginal or Torres Strait Islander and applied to access VAD, and I just want to make some comments on that now. You see, to strengthen cultural safety in the system additional funding has been provided to the statewide care navigator service in the 2025–26 and 2026–27 funding arrangements. This is for staff training and to develop culturally safe care pathways through partnerships with Aboriginal community controlled health organisations and hospital Aboriginal health liaison officers. Further improvements to practitioner training and guidance are also planned as part of this government’s response to the five-year review. I know that is something that came through rather strongly into my office.

These are just a few of the steps we have taken to ensure that everyone who faces the end of their life – no matter their postcode, their income, their culture or their circumstances – receives compassionate, dignified, patient-centred care. What is fair is giving people a genuine choice, supported by robust safeguards, medical oversight and the freedom to decide when enough is enough for them. It ensures that those living in rural and remote areas are not left behind. It reduces the barriers to access, such as strict in-person consultation requirements, which have proven really impractical for so many. It allows medical practitioners to use technology responsibly and to safely conduct consultations while still maintaining the integrity and oversight of the process. It also provides better support for the practitioners who participate in VAD. These doctors, nurses and allied health workers are some of the most compassionate and courageous people in our healthcare system. They deal daily with the most difficult ethical and emotional work imaginable. They carry the weight of their patients’ stories, the grief of their families and the moral responsibility of ensuring every step of this process is done with care and precision.

I want to take a moment to thank every healthcare professional across Victoria – in our hospitals, our palliative care units, our clinics and our community health centres – who continue to show up every single day. You do some of the hardest, most emotionally demanding work in our society, and you do it with professionalism, kindness and empathy. You sit with patients in their darkest moments, you comfort families when hope fades and you make an unbearable journey just a little bit lighter. For that, you deserve our deepest respect and sincere thanks.

This legislation recognises your work and provides a framework that helps you continue to deliver compassionate care while respecting the choice of your patients.

I know that not everyone will access voluntary assisted dying, and that is exactly as it should be. This bill is not designed for everyone. It is designed for those who need it – those whose suffering cannot be relieved, who have made a fully informed and voluntary decision and who wish to conclude their story on their own terms. For many others simply knowing that the choice exists brings comfort and reassurance even if they choose never to exercise it. The knowledge that the law respects your right to choose can in itself be profoundly empowering. At the end of the day it is about giving people the ability to write the final chapter of their lives with dignity. It is about compassion in the truest sense of the word – to suffer with someone, to walk beside them, to understand their pain and to honour their decisions.

None of us know what the future will hold. Illness can touch anyone at any time. You never know who will be affected next. It could be a colleague, a friend, a neighbour, a loved one or even yourself. That is why we must approach this issue not with fear but with empathy, not with judgement but with understanding. The bill does not ask us to devalue life. It asks us to value choice. It asks us to acknowledge that dignity at the end of life is not one size fits all. Some find peace in fighting until the very end. Others find peace in letting go. Both deserve respect. In this legislation we affirm the principle that every Victorian deserves compassion, dignity and respect from their first breath to their last.

This bill represents an important step forward. It reflects years of consultation, lived experience, advocacy and evidence. It builds upon the strong foundation of the original Voluntary Assisted Dying Act 2017, and it ensures that the system continues to evolve to meet the needs of our community. It reminds us that good legislation is not static. It grows as we learn, as medicine advances and as our understanding of compassion deepens. To everyone who has contributed to this process – the advocates, the healthcare professionals, the families who shared their stories and the parliamentarians who have approached this debate with open hearts – thank you. And to those who will one day find peace and relief because of the changes we make today, we honour you. I proudly commend this bill to the chamber.

 Ann-Marie HERMANS (South-Eastern Metropolitan) (17:47): There are times and seasons in life, and life is quite short. For some, unfortunately, it is shorter than for others. It is full of highs, lows, joy, mourning, loss and gain, comfort and suffering. There is a season for everything, and I firmly believe that life is a gift. It has become no secret in this chamber that I believe in a creator God and that I have been raised in a faith family, and I believe that this gift is worth protecting. But I understand that this debate is complex, deeply human and very personal. It asks us to balance autonomy with protection and relief from pain with responsibility. Each of us enters this debate with our own beliefs, our own life experiences and our own moral frameworks, and I respect those differences. I do not doubt for 1 minute the sincerity and the good intentions of many involved.

It is perhaps also not a secret to many people that last year I lost my father. He was probably the person that I was closest to in all the world. I slept next to his bed, in spite of my parliamentary duties, and I would be there awake all through the night. My father was in pain. He did have fourth-stage cancer, but that is not really what took him out. It was an infection that increased to a second infection, to a third infection and to a fourth infection in his leg that just continually progressed, and that made life very painful for him. My father was absolutely opposed to voluntary assisted dying, as was his mother, my grandmother, who I was also with, by her bed, at her last breath.

[The Legislative Council report is being published progressively.]