Maryland has so far been resistant to passing a voluntary assisted end of life law. The state of Victoria in Australia recently enacted a Voluntary Assisted Dying Act law which is more elaborate and detailed than similar state laws in the United States. These laws require that the patient be diagnosed as having a remaining life expectancy of no more than six months, although Victoria's law increases this to twelve months for neurodegenerative diseases. Also, unlike here, Victoria's law has a provision to allow someone other than the patient to sign the patient's written request and to assist with administering the drugs if the patient is unable.
Victoria's law requires doctors to complete training in the end of life options law to be eligible to participate. The law establishes a Voluntary Assisted Dying Review Board to help administer the law. The initial physician receiving a verbal patient request can volunteer to be the coordinating physician who makes an assessment that the request complies with the law. The coordinating doctor is sometimes required to obtain the assistance of specialists. The assessment results are given to the Board. If the coordinating doctor accepts the request then a second assessment begins by another doctor. A third assessment is allowed if the second assessment conflicts with the first assessment.
If the assessments accept the request then the patient can submit a written request with two certified eyewitnesses together with the coordinating doctor as a third witness. The patient makes a final verbal request to the coordinating doctor and identifies a contact person. The contact person is responsible for returning unused dispensed drugs to the pharmacy. The coordinating doctor certifies the request in writing, notifies the Board, and applies for a permit to prescribe the drugs. The Secretary of the state department of health may refuse to issue the permit if legal noncompliance is suspected.
It may be worthwhile for lawmakers submitting "end of life option" bills in states like Maryland to consider including the additional procedures and safegaurds found in Victoria's law. The additions of a board, formalized written assessments, required specialist evaluation if warranted, a permit, a person designated to return unused drugs, and 12 month availability for neurodegenerative diseases, may convince more lawmakers that the proposal merits adoption. State government employees should consider the forms included in Victoria's law for ideas when writing regulations for implementing their state's end of life options laws.