Australian Nurses Urge Albanese Gvt to Lift Telehealth Ban on Assisted Dying

Sydney — The Australian College of Nursing (ACN) has urged Prime Minister Anthony Albanese to amend federal law that exposes registered health practitioners to criminal prosecution and fines exceeding AU$360,000 for providing lawful voluntary assisted dying (VAD) care through telehealth.

In a letter to Albanese, the college said provisions of the Commonwealth Criminal Code were restricting communication between nurses and patients seeking voluntary assisted dying, particularly those living in rural and remote communities.

The provisions, sections 474.29A and 474.29B of the Criminal Code Act 1995, were introduced in 2005 to address the promotion of suicide through websites and online chatrooms.

However, following a 2023 Federal Court decision, the provisions also apply to communications related to voluntary assisted dying, which is lawful under state and territory legislation.

ACN Chief Executive Officer, Adjunct Professor Dr. Kathryn Zeitz said the restrictions were an unintended consequence of legislation introduced before voluntary assisted dying laws existed in Australia.

“This represents an inadvertent drafting artefact, rather than an expression of policy intent,” Dr. Zeitz said.

“No Australian jurisdiction had a voluntary assisted dying law in 2005. Parliament cannot have intended these provisions to reach a clinical process established twelve years in the future," she said.

The college said the legal position had created a contradiction for nurses who may lawfully administer VAD substances in several jurisdictions but risk prosecution when discussing the same care with patients by telephone or responding to emailed enquiries from families.

Chair of the ACN End-of-Life Care Faculty, Professor Jason Mills, said clear communication was essential when providing nursing care at the end of life.

“Clarity and continuity in communication is vital to nursing care at the end of life,” Mills said.

“Models of care such as VAD are no exception, where the need for nurses to communicate with calm, compassion, and confidence is paramount," he said.

The college expressed particular concern about patients in rural and remote areas, who already face longer waiting times and greater distances when accessing specialist healthcare.

“It is people at the end of their lives who wish to access VAD who pay the price for this inconsistency. It means agonising trips for people too unwell to travel,” Dr. Zeitz said.

“Australians in the bush already wait longer and travel further for almost every form of specialist care, Federal law should not be making that worse," she said.

ACN further said its proposed amendment would not weaken existing safeguards under state and territory voluntary assisted dying schemes.

These safeguards include multiple independent assessments, formal witnessed declarations, repeated confirmation of decision-making capacity and voluntariness and mandatory reporting to review boards.

The college also clarified that it did not take a position on whether individuals should choose voluntary assisted dying, saying the decision rested with the person, their family and their clinicians within the legal frameworks established by parliament.

“ACN’s concerns are for people enduring needless suffering at the end of their lives who wish to access VAD, their families and for nurses,” Dr. Zeitz said.

“Nurses should not face federal criminal liability for care their own state or territory authorises," she said.

Dr. Zeitz said nurses had called for Australians seeking voluntary assisted dying to be able to access the service through telehealth, urging the government to consider their experiences when reviewing its position.

“Nursing is consistently the most trusted profession in Australia,” she said.

“Advocating for the best outcomes for patients is core to nursing practice.

Nurses have been clear that Australians who wish to access VAD must be able to access it by telehealth, and we ask that their experience inform the Government’s position,” Dr. Zeitz said.

The letter was also copied to Attorney-General Michelle Rowland and Minister for Health and Ageing, Mark Butler.