New push on Prime Minister to let telehealth for assisted dying

Death and Dying

South Australian Health Minister Blair Boyer co-penned the letter. (ABC News: Justin Hewitson)

In short:

South Australia's Labor government has openly defied the prime minister's position on telehealth in voluntary assisted dying (VAD), calling for urgent change to a federal law.

It comes weeks after the ALP national conference endorsed a motion committing Labor to removing telehealth restrictions, despite Anthony Albanese's own personal opposition.

The state government has called on the Commonwealth to amend the definition of "suicide" in the criminal code to exclude VAD care.

South Australia has become the first state to formally urge the Commonwealth to change a federal law preventing doctors from using telehealth in voluntary assisted dying (VAD), openly defying the prime minister.

In a letter to federal Attorney-General Michelle Rowland, senior ministers in the Malinauskas government have "implored" the Commonwealth to "take immediate action", arguing the restrictions disadvantage terminally ill people in regional, rural and remote Australia.

"I doubt that I will be the only health minister advocating for this change," SA Health Minister Blair Boyer told ABC News.

The letter argues that restriction telehealth counselling disadvantages people in rural and remote areas. (ABC News: Natasha Johnson)

The SA ministers' letter said a provision in the Commonwealth criminal code was preventing doctors from using telehealth for VAD and forcing patients to travel long distances to attend appointments, with some dying before being able to access the care.

The intervention puts the SA government at odds with Anthony Albanese, who has expressed personal opposition to changing the law, concerned about the risk of coercion and elder abuse if telehealth replaced compulsory face-to-face consultations.

The letter comes just weeks after the ALP national conference endorsed a motion committing Labor to removing telehealth restrictions, despite Ms Rowland — the highest law officer in Australia — voicing strong concerns on the conference floor.

A Labor push to lift the ban on accessing voluntary assisted dying through telehealth has triggered a warning about unintended consequences for vulnerable Australians.

Penned by Mr Boyer and state Attorney-General Kyam Maher, and co-signed by VAD practitioners, clinicians and advocates, the letter calls for the Commonwealth criminal code to be amended so VAD care is not treated as "suicide" under federal law.

Some states and territories permit limited use of telehealth in VAD, but the federal code overrides those provisions by prohibiting the use of a "carriage service" to counsel or promote suicide.

It means doctors risk $220,000 fines and a criminal record for using phone, email or video to discuss the self-administration of VAD medication.

"We suggest a targeted amendment to the definition of 'suicide' under the criminal code such that the definition explicitly excludes conduct authorised under a state or territory VAD law," the letter said.

"We now implore the Federal Government to address this issue and amend the criminal code to better reflect contemporary healthcare practice and to reduce unnecessary disparities between jurisdictions.

The move fits a pattern of the Malinauskas government pursuing its own agenda on contentious national policy debates.

In recent years, South Australia has outlawed political donations, established a royal commission into artificial intelligence and spearheaded the development of a teen social media ban, an initiative followed by the federal government.

Mr Boyer predicted other states would soon join the push to change the criminal code, signalling broader pressure could build.

"This is not an attempt to water down safeguards that were put in place. It is simply an attempt to make good on the commitment that was made," he said.

Blair Boyer is predicting other states will soon join the push. (ABC News: Daniel Taylor)

The federal government recently blocked debate of a VAD telehealth bill pushed by independent MP Kate Chaney, with Health Minister Mark Butler telling parliament he was "not convinced" telehealth was "well suited to VAD right now".

Doctors divided

Views on telehealth in VAD care are also divided within the medical community.

While the Australian Medical Association (AMA) has backed calls to change the federal law, some doctors remain opposed.

Ballarat geriatrician Mark Yates argued the risks of elder abuse and coercion outweighed the benefits of expanding telehealth access.

Professor Yates said data showed rural, regional and remote Australians were accessing VAD at rates proportional to the population, suggesting there was no widespread access problem, and that individual cases of people missing out highlighted broader failures in regional health services.

Professor Yates said telehealth made it harder to detect coercion or abuse and argued the risk was compounded by the small number of doctors providing VAD.

"When we started the VAD debate, the idea was that it would be your friendly GP who's known you for 30 years who would help you with this. That's clearly not the case. There are one or two practitioners that have [overseen] 300 people with VAD in the short time we've had it.

"To appreciate where coercion or abuse sits without being face-to-face, I think is incredibly difficult. That is where the risk lies.

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