31 Aug 2021
In Ahpra’s second conversation on Voluntary Assisted Dying (VAD), Taking care host Tash Miles speaks with television and podcast presenter and founder of Go Gentle Australia, Andrew Denton, oncologist Dr Cameron McLaren and regional Victoria GP Dr Nola Maxfield.
They speak candidly about what life and healthcare looks like in Victoria following the implementation of VAD laws in 2019.
For Andrew, a known VAD advocate, the law is a response to unnecessary suffering by patients and their families.
‘VAD law is about power. If you’re at the end of your life and you’ve run out of medical options, before VAD laws, you had very little power in the system.
‘But, it’s not a golden ticket: you still have to die. And I don’t know anyone who thinks dying is an easy thing to do,’ Andrew adds.
And what is it like on the ground for the medical practitioners accessing and assisting patients with end-of-life care?
Working in regional Victoria for many years as a GP, Dr Maxfield has worked across many areas of medicine, including terminal illness and death. The ability to further support her patients at the end of their lives made complete sense to her when she decided to sign up for training in VAD.
'We have to be honest with our patients. I do see people get what I would call futile care because people haven’t had that discussion,’ Dr Maxfield said.
Working with cancer patients, oncologist Dr Cam McLaren is used to having to difficult conversations. Like Dr Maxfield, VAD training felt like a natural extension of his work.
‘You’re providing the control, you’re providing the comfort, and you’re providing them support,’ he said.
Both found the training confronting while also being a profound and hugely rewarding experience to offer that support.
Dr McLaren believes the introduction of VAD in Victoria is having a positive effect on the families of terminally ill patients. He has embarked on a PhD on the subject and believes there is already anecdotal evidence to suggest a big improvement to the grief process and reducing ongoing trauma for families who were able to support the wishes of their dying family members.
He finds the work rewarding, but that’s not to say it hasn’t taken a person toll:
‘It’s incredibly rewarding work, it’s incredibly taxing work. I’ve just come off a month where I’ve asked for no referrals… I don’t think I realised how much of a toll it was taking and after having come up for air for after a month, I think it certainly was.
‘We need more people trained to share that load, more doctors to take up this role, more doctors in rural areas to take up this challenging aspect,’ Dr McLaren said.
Working regionally, Dr Maxfield also points out the struggle to get through the VAD applications, especially as patients must have two specialists to consult under the Victorian law. While not allowed now, they hope telehealth might become an option in the future, particularly for regional and rural patients.
Greater awareness of the legislation among the public and improved doctor training are high priorities, and Andrew Denton’s message for practitioners is:
You can listen to our first conversation about VAD with Dr Charlie Corke and Dr Scott Blackwell on the law and patient choice here.
If you have found themes of this episode upsetting, please contact Lifeline on 13 11 14.
DRS4DRS offer an independent, safe, supportive and confidential service for medical practitioners drs4drs.com.au.