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I've seen good deaths, seen
some not so good deaths.

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Seen some terrible deaths.

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Having seen now numerous VAD deaths.

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I can tell you how I wanna go.

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It's peaceful, it's lovely.

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It's a celebration of life.

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You choose the time,
the location, the music.

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We had one family that was
blasting highway to hell in the

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background for the entire afternoon.

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For that person.

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That was their sendoff.

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That was the celebration of who they were.

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And as much as there's tears, there's
often laughter and joy and people

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with love surrounding that person,

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almost at the end of the first assessment,
we're hugging and crying, breaking all

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the kind of boundaries you're supposed
to have about doctor patient interaction,

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but it's such an intimate, profound.

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Experience and it matters
so much to these people.

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Welcome to Don't Be Caught Dead, a
podcast encouraging open conversations

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about dying and the death of a loved one.

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I'm your host, Katherine Ashton, founder
of Critical Info, and I'm helping to

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bring your stories of death back to life
because while you may not be ready to die.

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At least you can be prepared.

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Don't be caught dead.

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Acknowledges the lands of the
Coolen nations and recognizes their

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connection to land, sea, and community.

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We pay our respects to their elders
past, present, and emerging, and

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extend that respect to all Aboriginal
and Torres Strait Islander and First

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Nation peoples around the globe.

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Today I'm speaking with Dr.
Nick Carr and Dr. Kane Treble.

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So Dr. Nick Mayer, you may have heard
of before, he is a Melbourne-based

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general practitioner with over
30 years experience in currently

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practicing at St. Kilda Medical Group.

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He has a background in medicine from the
University of Cambridge and has built

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a diverse clinical practice focused on
men's health, psychological medicine, aged

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care, and ethical medical decision making.

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He is one of the first GPS in Victoria
to be involved in the voluntary

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assisted dying and is a vocal
advocate for compassionate end of

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life care beyond his clinical work.

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Nick is a respe respected medical
educator, broadcaster, and former A BC

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presenter known for engaging the public
in health and ethics conversations.

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Thanks for being with us, Nick.

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Oh, thank you for having me on, Catherine.

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And now Kane, we move to you.

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Dr. Kane Treble is a general practitioner
based in Mildura Victoria with special

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interests in emergency medicine,
palliative care, and medical education.

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He began his career as a paramedic
before training in medicine and has

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worked across rural and regional
settings, gaining extensive experience

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in both hospital and community care.

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Kane is passionate about teaching
and mentoring the next generation of

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doctors having received recognition for
ECU excellence in clinical education.

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His work bridges the gap between
frontline care and medical training with

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a strong focus on delivering quality
healthcare in underserved communities.

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Thanks for being with US Kane,

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and to be here.

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Thanks very much.

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Now, tell me what motivated you,
firstly to become medical practitioners.

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Nick, if we can start with you.

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Oh, it's terribly dull.

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I'm afraid.

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I, my dad was a doctor and I
saw what he was doing and I

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thought that looks quite fun.

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And as a sort of dumb English
schoolboy, I never really

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thought of doing anything else.

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And I was fascinated right from the side.

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Actually, I wasn't too
good at science at school.

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Languages were really my thing.

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And so my teacher said, well,
you'll be doing French, German,

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Italian, Latin for A levels.

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And I said, no.

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So I'm going to do chemistry,
biology, and physics.

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Whoa.

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We somehow managed to scrape through,
became a doctor, which was actually

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the best decision I'll ever made.

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How about you, Kate?

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I actually took the exact opposite
path where I actually started

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off as a scientist, a research
scientist in biochemistry, but

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it doesn't get you invited to as
many parties as you might believe.

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I ended up jumping ship, becoming a
paramedic, as you mentioned before,

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but before long was, was dropping
patients off to emergency and I thought

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that that next bit looks like fun.

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So that's what actually made me decide.

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I, I did want to become a doctor,
do medicine and then after my wife

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had children, I realized I wasn't
spending much time with them.

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I thought I'd give this general practice
thing a go some work life balance

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just fell absolutely head over heels
in love with you a bit of a more.

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Bendy path, but, uh, I think I've
ended up exactly where I need to be.

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And I'm, I'm actually
with you on that, Kane.

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I mean, I loved every bit of medicine.

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I did.

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I loved doing pediatrics.

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I miss the old people.

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I really enjoyed geriatrics.

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But where were the other people?

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Psychiatry fascinated me, but, oh.

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Sometimes I launch someone,
just have a sore throat.

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General practice was obviously begging
for me and best, best decision I ever made

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because you'd probably say the same thing.

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I've worked in general
practice for nearly 40 years.

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Never had a dull day yet.

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How many, how many people can have the
privilege of saying that about their work?

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Definitely

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very few.

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I would say, Nick, to be perfectly honest.

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So tell me as a, as a gp, what, when was
the first point in time where you heard

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about voluntary assisted dying, where
you became involved in, in the process?

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I would love to say that it was
a lifelong passion of mine, but

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it would be completely false.

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It was a patient of mine and.

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This is often the case that it's
patient experience that brings doctors

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into this kind of field, and it was a
wonderful patient mine called Beverly

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Broadband, who's very well known in
the news for having taken her own

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life because voluntary assisted dying
wasn't available, and did a series

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of interviews with the age newspaper.

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To be published after her death.

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Uh, Beverly was a profoundly independent,
very bright and determined person.

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We didn't have voluntary assisted dying
when she died, and it was Beverly's

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death was one of the sparks that really
began the conversation said, began.

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It's not quite been talking
about it for a long time.

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But Beverly's death and publicity around
it was one of the factors that built

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the momentum towards us getting to the
law here in Victoria, 1970, up to 1920.

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And just some.

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So Beverly, if you can remind us
what, what your sort of period that

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we're talking about that Beverly's
articles were published in the age,

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I think it was 2012, something like that.

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So, well before we had VAD legislation in,
in the state or in this country at all.

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And she, she didn't have a. Terminal
illness, so she wouldn't have qualified

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for voluntary assisted dying, but
she knew her faculties were failing.

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She was absolutely determined,
not trained up in aged care.

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She'd seen that happen to her best
friend Betty, who was also a patient

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of mine and talked to me many, many
times about the fact that that was

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simply not gonna happen to her.

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She had no dependent, she was a single
woman and she was able to make her own

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decisions and wow, what an impact she had.

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And Nick, do you mind sort of setting
the scene for, for someone who may

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be unfamiliar with just how voluntary
assisted dying, what it looked like

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before it was introduced and then and
what options were available and then

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the period of when for what it meant
for you as a GP when it was introduced.

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If you can just sort of set that
scene for us, that would be great.

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Because before we had the legislation,
which was passed at the end of 2017,

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there was no option for people who
said, I've done my time, and palliative

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care has always been available,
and they do a magnificent job.

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And they believe a huge
amount of suffering prop.

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Palliative care can't relieve all
suffering and really struggle sometimes

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with what we call the existential
suffering of when it's all too much,

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and getting the choice back is something
that voluntary assisted diet has done for

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people prior to it being a legal option.

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The choice people
sometimes made was suicide.

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This was one of the factors that
was used to bring in the law.

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The fact that the coroner reported the
number of deaths by suicide of people who

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had terminal illness, and to say, I can't
wait for this disease to take its course.

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I have to have another way out.

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That was one of the factors that helped
people push this legislation through.

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Rodney Simon was another very powerful
advocate for voluntary assisted dying,

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and he counseled a lot of people
at the end of their lives prior to

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the legislation being available.

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But that was one man doing this and
doing an amazing job for people.

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But there was no legislation to help him.

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So of course, where the law began,
this was an enormous relief to some

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of the people suffering from terminal
illness who said, I do not want to grind

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through to the end of this process.

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I would like to have the option.

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And so has been to this day.

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It's worked very well for this
small number of people who need it.

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And tell me, Kane, you are more in
a regional area, being in Mildura

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currently, how have you seen or have,
have you seen an increase in your

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patients expressing interest in that
as a, a voluntary assisted toine?

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As a, as an option.

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Coming from a rural background,
it's always interesting to find

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out how the rural grapevine work.

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That's ultimately how most of the news
gets out, and particularly when at the

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moment, it isn't something that we're
really loudly allowed to advertise.

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As doctors, we're not allowed to
initiate the discussion, and so in many

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ways, we're actually, depending on our
patients to kinda get the word out for us

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when we come from the stoic pharma
mindset of don't worry, she'll be right.

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That becomes a real struggle and I
think a lot of rural Australians don't

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even know that this is an option.

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This is something that's
even open to them and.

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There are times when you can see the
suffering, you see the pain and you just

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wish, if only I could say these words
that might alleviate that suffering.

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And again, with that arm stoicism, we,
we'll get people saying things like,

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oh geez, can't we just hurry it up?

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Or Can't we pull up a
top and it doesn't count?

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We, we need to kind of tease
out a very specific request.

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And when you often try to
engage them and say, you know,

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Hey, what do you mean by that?

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I might be able to, to
talk about some things.

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Oh, no, don't worry about it.

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Wow.

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That's must be challenging 'cause,
because as the current law stands from

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my limited understanding is that you,
you cannot mention the, the topic of

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voluntary assisted dying as an option
to a patient that comes and speaks to

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you at, at the current stage as it is.

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Yeah.

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So I, I think while Victoria
were, was really pioneering in the

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space of voluntary assisted dying.

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I feel like we're lagging a
little bit behind other states.

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Yeah, we still can't actually initiate
the discussion, whereas other states have

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opened it up to to allow for exactly that.

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It was actually one of the recommendations
that came up on recent review of the VAD

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legislation to see if that's something
that we may be able to change, and

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fingers crossed, we're still waiting for
the outcome of what those changes could.

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When that clause was put into
the law, it's called the gag

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clause to, for convenience.

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Just to explain, doctors cannot
initiate the conversation

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about voluntary assisted dying.

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It's seen as a protection for patients
because it's thought that us nefarious

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doctors were going to say, come on.

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You know, why don't you get on?

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Just bump yourself off.

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Why would we bother all this expensive
and complicated palliative care?

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It's so insulting.

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To the medical profession to think
that we would do that sort of thing.

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We want what's best for our patients
and I don't know a doctor in the world

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who's going to be saying to someone
that they should have this path,

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but turn it around the other way.

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There's no other area of medicine where we
are legally not allowed to tell people all

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their available options in any other area.

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Ofit, we would be negligent
from not giving people all their

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medically available options.

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And yet in this end of life space,
we, in Victoria and South Australia's

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the other state that has a gang
clause are legally not allowed.

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Bring that up.

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And it's really a, a
terrible disadvantage.

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Exactly.

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As you say, Kate, I see patients
who are old and failed and unwell

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and they simply don't know.

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And it disadvantages people
with lower levels of education

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maybe aren't aware of it.

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People, maybe it's English,
it's not their first language.

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And so they haven't come
across this in the news.

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Victoria and South Australia are
the only places that have it.

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00:12:30,855 --> 00:12:34,935
All the other states and the a CT do
not have a gag clause, and it's not

234
00:12:34,935 --> 00:12:39,015
as if they've been dragging people out
in those other states and, and taking

235
00:12:39,105 --> 00:12:42,075
'em through VAD against their well,
that simply isn't going to happen.

236
00:12:42,555 --> 00:12:44,565
So we really have to get
rid of this gag clause

237
00:12:46,035 --> 00:12:47,775
because it, it is legal option.

238
00:12:49,095 --> 00:12:54,375
And so I, I suppose for, for any other
legal options that are on the table,

239
00:12:54,705 --> 00:12:56,535
you, you're allowed to speak about them.

240
00:12:56,535 --> 00:13:02,265
So for me, who is someone on the outside
looking in, it's kind of crazy that you

241
00:13:02,265 --> 00:13:07,485
can't actually mention a legal option,
which is a valid option and choice

242
00:13:07,485 --> 00:13:09,400
for, for people in, in the community.

243
00:13:10,035 --> 00:13:13,455
You're probably aware that the
legislation in Victoria only passed

244
00:13:13,455 --> 00:13:17,625
by two votes, and a lot of these
restrictions and extra clauses were put

245
00:13:18,495 --> 00:13:19,150
in to make sure it got across the line.

246
00:13:19,860 --> 00:13:20,790
Uh, was wide.

247
00:13:20,790 --> 00:13:24,480
He described as being the most
restrictive, voluntary assisted dying

248
00:13:24,540 --> 00:13:26,250
legislation of any place in the world.

249
00:13:26,250 --> 00:13:29,760
With the 68 safeguards, it was
better to get it through than

250
00:13:29,760 --> 00:13:31,140
not get it through at all.

251
00:13:31,200 --> 00:13:34,800
But I think we're now recognizing exactly
as you're saying, Kate, having been at

252
00:13:34,800 --> 00:13:39,505
the Vanguard, we're now the lag arts and
really we now know that some of those

253
00:13:39,505 --> 00:13:41,670
protections are not actually protections.

254
00:13:41,670 --> 00:13:44,280
They're actually barriers for
people who need this care.

255
00:13:46,170 --> 00:13:48,060
And just on that, Kane, sorry.

256
00:13:48,150 --> 00:13:49,005
I'll let you let you go.

257
00:13:50,100 --> 00:13:53,760
I think that also ties into issues
we have around the telecommunications

258
00:13:53,760 --> 00:13:57,930
act at the moment, whereby, regardless
of whether the conversation's

259
00:13:57,930 --> 00:14:02,070
been started by the patient, we
can't continue it using telephone,

260
00:14:02,130 --> 00:14:03,930
email, or electronic communication.

261
00:14:04,770 --> 00:14:09,420
And so again, from a rural setting, I
have patients that are two hours away.

262
00:14:10,200 --> 00:14:13,380
We have to do this little song and
dance when we try to organize an

263
00:14:13,380 --> 00:14:15,960
appointment where I'll say, I'm calling
you up to say we need to catch up

264
00:14:15,960 --> 00:14:17,340
face to face to have a discussion.

265
00:14:17,340 --> 00:14:18,390
But I can't tell you why.

266
00:14:19,199 --> 00:14:22,230
And it's this ludicrous thing we have
to go through where we all know what

267
00:14:22,530 --> 00:14:25,349
we're planning, what we're talking about,
but we're restricted by the current

268
00:14:25,349 --> 00:14:27,540
legislation, current communication.

269
00:14:29,775 --> 00:14:33,885
For people who don't know quite why that
is, it's because there is a Commonwealth

270
00:14:33,885 --> 00:14:38,655
legislation called the Criminal Codes
Act minted in 2005, which bans any

271
00:14:38,655 --> 00:14:43,665
discussion or facilitation, suicide
by carriage service, text message,

272
00:14:43,665 --> 00:14:45,285
internet, telephone, that sort of thing.

273
00:14:45,645 --> 00:14:47,114
And it's a federal law.

274
00:14:47,354 --> 00:14:51,344
And so federal law trumps any
state or territory law, and.

275
00:14:51,810 --> 00:14:53,070
Dying with Dignity Victoria.

276
00:14:53,070 --> 00:14:57,630
We've been making strenuous efforts to
try and get this sorted out because the

277
00:14:57,630 --> 00:14:59,640
federal legislation talks about suicide.

278
00:15:00,060 --> 00:15:04,740
In the end, I end up in the federal
court with Mark DRS testing this in the

279
00:15:04,740 --> 00:15:08,760
federal court, and it was found that
the legislation does in fact apply to

280
00:15:08,760 --> 00:15:10,440
voluntary assisted dying legislation.

281
00:15:10,440 --> 00:15:11,820
So it's been clarified legally.

282
00:15:11,820 --> 00:15:12,660
You're quite right, Kate.

283
00:15:13,140 --> 00:15:15,750
In the legal sense, we're not
allowed to do any of this work.

284
00:15:16,125 --> 00:15:21,074
By telehealth, and of course that's an
immense imposition on frail older people,

285
00:15:21,074 --> 00:15:22,814
particularly our more regional areas.

286
00:15:22,875 --> 00:15:25,665
We then have to travel for
every aspect of this assessment.

287
00:15:25,964 --> 00:15:29,625
We do telehealth, but really
complicated medical problems.

288
00:15:29,625 --> 00:15:33,584
We, we become expert at that over
COVID and there's no reason why

289
00:15:33,584 --> 00:15:36,495
we shouldn't be able to do some
aspects of voluntary assisted.

290
00:15:36,555 --> 00:15:39,285
I don't need to do all of it,
but at least some of it, the

291
00:15:39,285 --> 00:15:41,204
patients will be no via telehealth.

292
00:15:42,839 --> 00:15:46,589
And, and that exactly what you were just
saying, Nick, about the advancements

293
00:15:46,589 --> 00:15:51,150
that we've seen during that COVID period,
how we have moved everything online.

294
00:15:51,150 --> 00:15:54,900
We have moved it to do just
about everything we possibly

295
00:15:54,900 --> 00:15:56,430
do remotely where possible.

296
00:15:56,699 --> 00:16:03,510
And, and it, it's a, seems to be a case
where, again, where life is more forward

297
00:16:03,510 --> 00:16:05,339
than the laws that actually govern it.

298
00:16:05,550 --> 00:16:08,400
So, so just talk me through Kane.

299
00:16:09,069 --> 00:16:13,090
The challenges that you were saying
that if you want to speak to a

300
00:16:13,090 --> 00:16:17,079
patient about voluntary assisted
dying, you have to do this in person.

301
00:16:17,590 --> 00:16:19,180
Talk me through what that looks like.

302
00:16:19,180 --> 00:16:21,010
Like you mentioned that you
may have to travel a few hours.

303
00:16:22,665 --> 00:16:23,025
Yes.

304
00:16:23,025 --> 00:16:25,875
I mean the, the first issue we
encounter is the patient needs to

305
00:16:25,875 --> 00:16:27,255
know we exist in the first place.

306
00:16:27,525 --> 00:16:32,115
And I actually do run a VAD clinic, but
we're not allowed to advertise it in case

307
00:16:32,115 --> 00:16:34,395
it's seen as initiating the discussion.

308
00:16:34,785 --> 00:16:38,444
And so we are again, dependent on
the word of mouth of, of patients

309
00:16:38,535 --> 00:16:41,474
to kind of let it be known that
this is something that even exists.

310
00:16:42,255 --> 00:16:45,854
They will have to attend in
person to actually initiate and,

311
00:16:45,854 --> 00:16:49,755
and start that whole process,
assess for their eligibility.

312
00:16:50,655 --> 00:16:54,285
For the multiple assessments that are
involved, these all have to remain

313
00:16:54,285 --> 00:16:58,755
face to face, and again, these are
patients that are often suffering.

314
00:16:59,415 --> 00:17:02,055
They're frail and traveling.

315
00:17:02,055 --> 00:17:06,015
What can be hours and hours just to
see us in the first place, let alone

316
00:17:06,015 --> 00:17:10,005
the trip home again, after what can
be some really difficult discussions.

317
00:17:10,605 --> 00:17:14,050
It's incredibly taxing and
incredibly infuriating to be frank.

318
00:17:15,044 --> 00:17:18,764
We can't help these people in, in a way
that would actually benefit the most

319
00:17:19,034 --> 00:17:22,365
in this day and age when we have so
many other advances through healthcare,

320
00:17:22,365 --> 00:17:27,704
through telehealth and to feel like we
aren't actually servicing rural Victoria.

321
00:17:27,704 --> 00:17:32,085
And we know that the majority of
cases that are put through VAD come

322
00:17:32,085 --> 00:17:33,465
from more metropolitan settings.

323
00:17:33,915 --> 00:17:34,155
Uh.

324
00:17:34,710 --> 00:17:38,310
Then once we do get through their
initial assessments, trying to find

325
00:17:38,340 --> 00:17:43,230
additional doctors or specialists to
become involved, to agree with the

326
00:17:43,230 --> 00:17:46,020
assessments that are made, the, the
current Victorian requirements, so

327
00:17:46,020 --> 00:17:50,280
that two doctors be involved to come
to consensus around their eligibility.

328
00:17:52,170 --> 00:17:56,370
Again, if these are patients that
struggle to, to travel, and then

329
00:17:56,370 --> 00:17:59,010
sometimes we have to say, not only
have you had to travel two hours

330
00:17:59,010 --> 00:18:00,475
to get to this regional hospital.

331
00:18:01,485 --> 00:18:03,585
Now going to ask you to travel six hours.

332
00:18:03,855 --> 00:18:06,795
You get to a metropolitan hospital to
be assessed by another doctor again,

333
00:18:08,505 --> 00:18:12,765
and these are people who have been
diagnosed with a life limiting illness.

334
00:18:13,035 --> 00:18:17,145
So they're obviously trying to manage
their health at the same time that

335
00:18:17,145 --> 00:18:21,345
they're, or, you know, being involved in
these appointments and, and traveling.

336
00:18:21,435 --> 00:18:24,795
I'm, as I'm assuming that that's,
that's what the challenge some

337
00:18:24,795 --> 00:18:26,115
of the challenges are as well.

338
00:18:27,555 --> 00:18:31,395
And coordinating all of the, the
friends, family, carers that are

339
00:18:31,395 --> 00:18:35,205
around them as well, that also often
have to travel with them just to, to

340
00:18:35,205 --> 00:18:36,475
make it safe for them to travel as.

341
00:18:37,649 --> 00:18:39,929
Even if someone doesn't live
a long distance away in city

342
00:18:39,929 --> 00:18:44,310
environments, these people remember
these people are often very infirm.

343
00:18:44,699 --> 00:18:48,810
Some of them are bit bound, and just
getting someone out of the bed and

344
00:18:48,810 --> 00:18:53,459
into a car can be a major struggle
and it doesn't matter if sometimes if

345
00:18:53,459 --> 00:18:55,185
the travel is only 10, 20, 30 minutes.

346
00:18:55,835 --> 00:19:01,325
The whole process can be painful,
exhausting, and a massive imposition.

347
00:19:01,325 --> 00:19:05,675
So it's, it has a very big
impact on people, rural,

348
00:19:05,705 --> 00:19:07,895
regional, and also metropolitan.

349
00:19:09,495 --> 00:19:13,005
Look, I, I, when you're, when
you're both talking, it reminds me

350
00:19:13,005 --> 00:19:18,045
of just the appointments I used to
have at the Vic Rehab Center after

351
00:19:18,045 --> 00:19:23,210
my car accident and, and you know,
they were an ordeal and, and I was.

352
00:19:23,940 --> 00:19:27,300
In recovery, you know, and, and
going through rehabilitation.

353
00:19:27,300 --> 00:19:33,360
So I was improving my health and wellbeing
and, but they were really hard and I

354
00:19:33,360 --> 00:19:37,920
was having to catch a taxi and, but
just to coordinate each, those two days

355
00:19:37,920 --> 00:19:42,390
that I was doing each week for the 16
weeks, that was a huge toll that it

356
00:19:42,390 --> 00:19:45,240
not only took on me, but all my family.

357
00:19:45,270 --> 00:19:48,240
'cause it it is, it's a, it's
a family commitment, isn't it?

358
00:19:50,520 --> 00:19:50,730
Yeah.

359
00:19:50,735 --> 00:19:50,925
Yes.

360
00:19:50,925 --> 00:19:52,525
Agreement very much.

361
00:19:54,480 --> 00:19:59,940
So tell me when you have referred to
the, the differences between, obviously

362
00:19:59,940 --> 00:20:03,840
Victoria being the first state to
introduce voluntary assisted dying, and

363
00:20:03,840 --> 00:20:08,820
then we have, I think the last state
that will introduce it currently is as.

364
00:20:09,210 --> 00:20:10,680
Canberra, is that correct?

365
00:20:10,740 --> 00:20:16,260
This year and yet we've still to
have it passed in Northern Territory.

366
00:20:16,740 --> 00:20:22,440
So what are the difference you is between,
for someone who is unfamiliar between,

367
00:20:22,440 --> 00:20:27,450
you know, Victorian laws and, and what's,
you know, being introduced into Canberra.

368
00:20:27,720 --> 00:20:31,620
You've mentioned that the gag
clause is obviously one, one issue.

369
00:20:31,980 --> 00:20:35,310
Then, you know, you've gotta love
Australia with all of our different

370
00:20:35,310 --> 00:20:36,810
laws in each states, don't you?

371
00:20:36,810 --> 00:20:37,015
And then the.

372
00:20:37,360 --> 00:20:42,010
The federal overarching law makes, makes
death and, and health so much fun to

373
00:20:42,010 --> 00:20:44,949
navigate and, and you are qualified.

374
00:20:46,419 --> 00:20:51,699
So, so what are the other, other
things that is, is sort of have, I

375
00:20:51,699 --> 00:20:54,909
suppose you could say, say we're a bit
more progressive than what we have in

376
00:20:54,909 --> 00:20:58,810
Victoria that we're, we find that's
challenging in our lovely little state.

377
00:20:59,889 --> 00:21:04,300
Katie, are you across the details of
the differences in a CT versus Victoria?

378
00:21:05,235 --> 00:21:09,105
Not particularly, but Mildura
is a, a border a town.

379
00:21:09,105 --> 00:21:13,215
We border a New South Wales and South
Australia is just a stone's throwaway.

380
00:21:13,695 --> 00:21:17,085
But I'm acutely aware that the one of
the Victorian restrictions that you

381
00:21:17,235 --> 00:21:20,835
is, that you need to be a Victorian
resident for the preceding 12 months.

382
00:21:21,525 --> 00:21:25,320
And so when our health service
catchment includes other states.

383
00:21:26,205 --> 00:21:29,235
We have residents of other states
that attend our health service

384
00:21:29,235 --> 00:21:31,514
and try to seek VAD as an option.

385
00:21:31,935 --> 00:21:35,175
We unfortunately have to turn them
away or redirect them rather to their

386
00:21:35,175 --> 00:21:37,095
home state for for assessment there.

387
00:21:38,264 --> 00:21:38,745
Oh wow.

388
00:21:38,835 --> 00:21:40,064
That's super challenging

389
00:21:41,085 --> 00:21:45,375
and I think I'm right in saying that
in a CT, they don't have the prognosis

390
00:21:45,375 --> 00:21:49,425
requirement of six months or 12 months
from neurodegenerative disorders.

391
00:21:49,875 --> 00:21:53,625
You just have to have a illness
that is going to end your life.

392
00:21:54,030 --> 00:21:58,980
So one of the concerns we have
is that we're asking in Victoria

393
00:21:58,980 --> 00:22:03,390
to give a prognosis and has to
be six months or less, unless

394
00:22:03,390 --> 00:22:06,720
it's a neuro neurodegenerative
disorder when it's 12 months.

395
00:22:07,020 --> 00:22:12,390
And this sometimes is a very significant
impediment because I frankly, we

396
00:22:12,390 --> 00:22:16,500
doctors a hopeless at prognosis and
it's often said that doctors won't

397
00:22:16,500 --> 00:22:20,580
give you six months as a timeline
until you've only got six weeks.

398
00:22:20,625 --> 00:22:25,305
And this sometimes does mean people
come to the process too late.

399
00:22:25,455 --> 00:22:29,055
'cause the specialists are doing
best job in the world that they can

400
00:22:29,055 --> 00:22:32,055
do and they say, no, we could try
this and let's there's hope here.

401
00:22:32,055 --> 00:22:34,365
And, and they don't want to say
to someone, you know what, I

402
00:22:34,365 --> 00:22:36,105
think we're not doing too badly.

403
00:22:36,105 --> 00:22:39,105
However, I think in's six months
time, this is not gonna work.

404
00:22:39,135 --> 00:22:43,065
They, they keep trying and keep
putting it off and then say, oh,

405
00:22:43,065 --> 00:22:44,265
things are not looking so good.

406
00:22:44,295 --> 00:22:45,915
And then the timelines get a bit short.

407
00:22:46,605 --> 00:22:49,875
And I believe in a CT, that
prognosis requirement isn't there.

408
00:22:49,875 --> 00:22:53,715
And I think that will free
the process to, to make it

409
00:22:54,255 --> 00:22:55,845
possible to start a bit earlier.

410
00:22:55,995 --> 00:22:58,905
Ideally, what we like to see, when
people ask me about it and they

411
00:22:58,905 --> 00:23:00,165
say, well, when should I start?

412
00:23:00,555 --> 00:23:02,115
I say, as soon as possible.

413
00:23:02,145 --> 00:23:06,135
'cause the best possible thing you can
do is go through this process, get it

414
00:23:06,135 --> 00:23:10,905
done, get your medication permit in
place, and then don't need to use it.

415
00:23:11,685 --> 00:23:14,625
Nothing I love more than someone
getting their little black box, stick

416
00:23:14,625 --> 00:23:16,514
it on the shelf and it gathers dust.

417
00:23:16,875 --> 00:23:18,435
'cause they get on with life.

418
00:23:18,975 --> 00:23:22,185
And I think there's a concern
that people will get this stuff

419
00:23:22,185 --> 00:23:23,955
and then take it too soon.

420
00:23:23,955 --> 00:23:28,334
I dunno, anyone who's ever done that,
what It's really the other way round.

421
00:23:28,364 --> 00:23:33,524
And I remember perfect phrase from
someone who said, once that little

422
00:23:33,524 --> 00:23:35,294
black pop, black pops arrived.

423
00:23:35,294 --> 00:23:37,784
And he said, now I've
got the dying sorted out.

424
00:23:37,935 --> 00:23:39,254
I can get on with living.

425
00:23:40,770 --> 00:23:42,149
But that's so true, isn't it?

426
00:23:42,149 --> 00:23:47,189
That it, it seems to be a common story
that I've heard is when people are

427
00:23:47,189 --> 00:23:51,629
diagnosed with a life limiting illness,
they, they don't get in contact with the

428
00:23:51,629 --> 00:23:55,560
services for that support, whether it
be palliative care support or whether

429
00:23:55,560 --> 00:23:59,909
it actually be, you know, looking at,
into voluntary assisted dying because.

430
00:24:00,060 --> 00:24:05,070
You know, the words that you were using
then Nick were the, the author, Leah

431
00:24:05,070 --> 00:24:09,930
Kaminsky refers to it as militarizing,
you know, the Battle of Cancer.

432
00:24:09,930 --> 00:24:12,360
And, you know, we've gotta wage the war.

433
00:24:12,360 --> 00:24:18,210
And, and, and the whole way in which
we talk about death and dying is like,

434
00:24:18,210 --> 00:24:22,710
it's, it's something that we, you know,
we don't want to lose the fight and all

435
00:24:22,710 --> 00:24:25,650
of this, this rhetoric around it, but.

436
00:24:26,110 --> 00:24:31,480
It really does come down to the end of
the day about choices and making informed

437
00:24:31,480 --> 00:24:38,050
choices about what's available and, and
it sounds like that there's an added layer

438
00:24:38,050 --> 00:24:42,550
upon those conversations that you have
because it's not just palliative care.

439
00:24:42,550 --> 00:24:45,370
There's another layer that you need
to take into consideration because.

440
00:24:45,935 --> 00:24:50,135
Of the, the, the real process
that you seem to have to go to

441
00:24:50,465 --> 00:24:54,905
once you, you actually decide to
go with voluntary assisted dying.

442
00:24:55,445 --> 00:25:00,155
Can perhaps, Kane, would you like to just
give us an indication of, I think it was

443
00:25:00,155 --> 00:25:06,425
68 sort of guidelines or checklists that
are associated with the, the process?

444
00:25:06,425 --> 00:25:11,014
Can you just give us people a snapshot
of what is involved and what, what

445
00:25:11,014 --> 00:25:14,105
are the checks and balances in
place for those that are unaware?

446
00:25:16,065 --> 00:25:16,515
Definitely.

447
00:25:16,515 --> 00:25:20,505
So probably focusing a little bit
more on the the patient perspective.

448
00:25:21,585 --> 00:25:25,515
The first point is where the
patient first voices that request,

449
00:25:25,635 --> 00:25:29,175
the first request say, I would
like you to help me in my life.

450
00:25:29,865 --> 00:25:33,765
From there, an initial assessment
can be made by that doctor

451
00:25:33,765 --> 00:25:35,235
if they are VAD trained.

452
00:25:35,235 --> 00:25:39,015
Or more often than not, I think
referrals have to be made through

453
00:25:39,015 --> 00:25:40,430
to doctors who are VAD trained.

454
00:25:41,835 --> 00:25:46,635
From that first assessment, there's a
a very thorough assessment of not only

455
00:25:46,635 --> 00:25:52,695
their medical history, their current
diagnosis, the quality of life, as well

456
00:25:52,695 --> 00:25:56,595
as their other eligibility requirement,
which again, speaking from Victoria, they

457
00:25:56,595 --> 00:26:02,025
need to be 18 years of age, a Australian
citizen, or holding permanent residency.

458
00:26:02,535 --> 00:26:08,145
They need to have resided in Victoria
for the preceding 12 months, and they

459
00:26:08,175 --> 00:26:09,855
need to, oh, there's one more there.

460
00:26:09,860 --> 00:26:10,210
I'm forgetting.

461
00:26:11,715 --> 00:26:12,615
Can you help me out there?

462
00:26:13,005 --> 00:26:13,125
Yes.

463
00:26:13,335 --> 00:26:15,945
Well, they need to have
decision making capacity.

464
00:26:15,945 --> 00:26:16,335
Thank you.

465
00:26:16,665 --> 00:26:17,025
Yes.

466
00:26:17,475 --> 00:26:19,365
And that's actually a
massive part of that.

467
00:26:19,425 --> 00:26:22,245
That first, first assessment
is to find out what is the

468
00:26:22,245 --> 00:26:24,465
intent behind their request.

469
00:26:24,945 --> 00:26:27,075
I've had a lot of people that
come in and say, look, I actually

470
00:26:27,075 --> 00:26:28,065
just want the information.

471
00:26:28,065 --> 00:26:30,075
I just want to know what
all the options are.

472
00:26:30,075 --> 00:26:32,865
And they don't necessarily want
to proceed with, um, actually

473
00:26:32,865 --> 00:26:34,785
obtaining VAD medication.

474
00:26:35,895 --> 00:26:37,665
Sometimes I think they just
want to know that it's there.

475
00:26:38,879 --> 00:26:39,990
Tied into that as well.

476
00:26:40,050 --> 00:26:43,740
We do get a lot of people that actually
don't qualify and I, I would say

477
00:26:43,740 --> 00:26:48,899
I've had ballpark 25% of people that
have actually said, look, I'm not

478
00:26:48,899 --> 00:26:50,580
entirely sure you, you do want this.

479
00:26:50,580 --> 00:26:53,340
I think you have symptoms that
we can actually get on top of.

480
00:26:53,340 --> 00:26:56,699
Or, you know, there may be an
understandable depression in

481
00:26:56,729 --> 00:26:59,550
this situation or a mental health
condition that may be contributing.

482
00:26:59,550 --> 00:27:01,104
Let's address that first.

483
00:27:02,625 --> 00:27:06,315
And the, the majority of those kinds
of cases I actually choose in the end

484
00:27:06,525 --> 00:27:10,155
not to proceed with VAD because we can
actually improve their quality of life.

485
00:27:10,155 --> 00:27:13,005
And again, that's really what we're
trying to achieve here is maximizing

486
00:27:13,005 --> 00:27:16,635
quality of life, acknowledging that
we, we often can't change the outcome,

487
00:27:16,635 --> 00:27:17,715
but we can change the journey.

488
00:27:18,835 --> 00:27:21,600
For those that do decide,
actually no, this, this is an

489
00:27:21,600 --> 00:27:22,770
option I would like to pursue.

490
00:27:23,010 --> 00:27:25,740
We then, then to need to
link into a second doctor.

491
00:27:26,220 --> 00:27:29,639
We have one doctor that acts as
a coordinating practitioner who

492
00:27:29,970 --> 00:27:33,000
essentially holds the hand through
the journey, makes sure all the

493
00:27:33,000 --> 00:27:36,300
proper boxes are ticked, the forms are
filled, all the requirements are met.

494
00:27:36,780 --> 00:27:39,960
And another doctor that acts as
a consulting doctor, their job

495
00:27:39,960 --> 00:27:43,860
is to make sure that yes they
agree, diagnosis, prognosis,

496
00:27:43,860 --> 00:27:45,360
and that all those same kind of.

497
00:27:45,750 --> 00:27:47,970
Important safeguards are being met.

498
00:27:49,110 --> 00:27:52,800
Um, important to point out again
in Victoria that at least one of

499
00:27:52,800 --> 00:27:57,150
these doctors has to beed in their
specialty for at least five years,

500
00:27:57,930 --> 00:28:01,200
and they have, there has to be at
least one person who is a specialist

501
00:28:01,290 --> 00:28:03,030
in that specific condition as well.

502
00:28:03,210 --> 00:28:07,290
Making sure there is that expertise
behind the, the diagnosis, the prognosis,

503
00:28:07,980 --> 00:28:11,430
acknowledging that the prognosis is
incredibly difficult to determine, and

504
00:28:11,430 --> 00:28:14,415
it's often that, you know, how long is
a piece of string kind of guesstimation.

505
00:28:15,510 --> 00:28:16,470
In the best of our ability.

506
00:28:17,850 --> 00:28:21,960
Once that second assessment's been
submitted, we can then actually go through

507
00:28:21,960 --> 00:28:27,030
and there's a compulsory kind of pause
between that second assessment through

508
00:28:27,030 --> 00:28:31,290
to, or the first assessment, second
assessment, and then a, uh, written

509
00:28:31,290 --> 00:28:36,149
declaration, a written request, which is
that formal request, then to say, this

510
00:28:36,149 --> 00:28:41,550
is an ongoing request from the patient,
made freely without coercion, and this

511
00:28:41,550 --> 00:28:43,590
isn't just a spur of the moment decision.

512
00:28:44,310 --> 00:28:46,290
One opportunity to get this right.

513
00:28:46,710 --> 00:28:49,860
And so it's that kind of forced
benchmark to make sure that the time

514
00:28:49,860 --> 00:28:51,450
is taken to consider all options.

515
00:28:52,470 --> 00:28:56,370
Yes, there are ways to speed things
up if we do think that the prognosis

516
00:28:56,370 --> 00:29:00,900
is within the, the nine day compulsory
kind of pause there, but I would say

517
00:29:00,900 --> 00:29:05,940
the vast majority of cases, taking
that nine days is achievable, is done.

518
00:29:05,940 --> 00:29:08,035
And I think the really
important part of the process.

519
00:29:09,585 --> 00:29:13,725
Once that's gone through, we can
finally put in an application for

520
00:29:13,725 --> 00:29:15,945
the permit to have the medication.

521
00:29:15,945 --> 00:29:20,625
There's an appointment of a contact
person Out of their role is to also act

522
00:29:20,625 --> 00:29:24,855
as a safeguard around the, the storage
and return of medications as well.

523
00:29:25,304 --> 00:29:29,774
And depending on what form of medication
that patient's actually going to receive,

524
00:29:30,225 --> 00:29:34,575
we tend to prefer generally speaking that
the patient's able to self-administer

525
00:29:34,575 --> 00:29:35,925
the medication to themselves.

526
00:29:36,314 --> 00:29:37,754
That can be orally.

527
00:29:37,905 --> 00:29:39,675
It does have quite a bitter taste.

528
00:29:39,675 --> 00:29:40,064
I hear.

529
00:29:40,064 --> 00:29:43,574
I've never tried it myself,
but an incredibly bitter taste.

530
00:29:43,965 --> 00:29:44,594
I've tried it.

531
00:29:44,985 --> 00:29:46,485
You, you have and lift a tail.

532
00:29:46,485 --> 00:29:46,604
The

533
00:29:46,604 --> 00:29:47,415
tail, yes.

534
00:29:47,415 --> 00:29:51,344
I, I decided I needed to taste this stuff
to see what it is that people are having

535
00:29:51,344 --> 00:29:55,814
as the very last thing they tasted and oh
my goodness, it is outrageously bitter.

536
00:29:57,195 --> 00:29:58,844
I did only have a very small dose.

537
00:29:59,715 --> 00:30:00,074
Good

538
00:30:00,074 --> 00:30:00,284
to hear.

539
00:30:02,715 --> 00:30:04,515
I might just stick to
coffee if it's all the same.

540
00:30:05,775 --> 00:30:06,255
Yeah.

541
00:30:06,285 --> 00:30:07,275
Yep, definitely.

542
00:30:08,175 --> 00:30:12,045
And, and so I'm just trying to
mentally, as you are, you are going

543
00:30:12,045 --> 00:30:13,695
through all of these steps to Kane.

544
00:30:14,055 --> 00:30:19,275
I'm mentally trying to think from
just a, from my perspective, it.

545
00:30:19,625 --> 00:30:23,375
It took me months to get
in to see a specialist.

546
00:30:23,825 --> 00:30:28,805
Is, is that the case in some of these
scenarios, like especially like it doesn't

547
00:30:28,805 --> 00:30:31,985
matter whether you're in a rural area or
whether you're in a metropolitan area.

548
00:30:32,225 --> 00:30:36,995
Sometimes the waiting lists for these
specialists are extensively long.

549
00:30:37,745 --> 00:30:40,325
Is that also part of that
timeline and process?

550
00:30:40,325 --> 00:30:41,225
How does that work?

551
00:30:42,575 --> 00:30:45,605
Well, yes, there can be extensive weights.

552
00:30:46,920 --> 00:30:51,300
But that's even if there is a specialist
in that condition who is VD trained?

553
00:30:52,350 --> 00:30:52,530
Yeah.

554
00:30:52,710 --> 00:30:52,830
Do you

555
00:30:52,830 --> 00:30:54,690
believe we have specialties
where that is not?

556
00:30:54,690 --> 00:30:54,870
That was

557
00:30:54,870 --> 00:30:56,100
gonna be my next question.

558
00:30:57,314 --> 00:31:02,235
Yeah, so there are some understanding,
some agreements with the secretariat

559
00:31:02,294 --> 00:31:04,425
around where that is the case.

560
00:31:04,425 --> 00:31:06,405
What other things might we be able to do?

561
00:31:06,405 --> 00:31:10,304
What other specialties may be able to
weigh in acknowledging that it's, it's

562
00:31:10,304 --> 00:31:14,504
not as ideal, but it certainly does
add that extra complexity, that extra

563
00:31:14,504 --> 00:31:18,929
delay more often than not, as well as
I think making it more difficult and

564
00:31:19,169 --> 00:31:20,745
frustrating for the patients involved.

565
00:31:21,419 --> 00:31:26,370
To hear that there aren't doctors
available or, or trained in VAD for

566
00:31:26,370 --> 00:31:30,270
something that's obviously going to
have such a big impact on their life and

567
00:31:30,270 --> 00:31:34,020
ultimately their death is a source of
great frustration and, and particularly

568
00:31:34,020 --> 00:31:37,230
from a rural setting where we struggle
to have specialists at the best of times.

569
00:31:37,649 --> 00:31:40,919
Then trying to say, you know, Hey,
we also need you to travel to see

570
00:31:40,919 --> 00:31:44,399
a specialist who may not even be
a specialist of their condition.

571
00:31:44,850 --> 00:31:46,169
This bit of insult to injury, I think.

572
00:31:46,500 --> 00:31:46,560
I

573
00:31:47,040 --> 00:31:51,000
do have to say that many specialists
who work in this field of voluntary

574
00:31:51,000 --> 00:31:56,070
assisted dying, bend over backwards
to accommodate these patients.

575
00:31:56,070 --> 00:32:00,120
They know that they can't reasonably ask
someone with a prognosis of six months

576
00:32:00,330 --> 00:32:02,100
to come and see 'em in seven months time.

577
00:32:02,100 --> 00:32:06,390
So I have found that people
are extraordinarily kind.

578
00:32:06,420 --> 00:32:08,730
They go out their way and.

579
00:32:09,149 --> 00:32:12,210
I mean, I have the privilege of working
in the city environment where we have

580
00:32:12,210 --> 00:32:17,550
more options, but the devotion of some
of the people working in this area, their

581
00:32:17,550 --> 00:32:22,710
preparedness to do, do the extras, to
see people when they simply do not have

582
00:32:22,710 --> 00:32:26,294
appointments to do so, but they get people
in and they go and see them at home.

583
00:32:26,294 --> 00:32:31,169
They, they really go to extraordinary
lengths to make this possible for people.

584
00:32:32,295 --> 00:32:33,885
I will highlight up here.

585
00:32:33,885 --> 00:32:37,815
Obviously we've had many occasions where
we've actually flown a specialist in

586
00:32:37,815 --> 00:32:42,075
to be able to see that patient, that's
someone who's not only taken the time

587
00:32:42,075 --> 00:32:45,315
to come up, but that's essentially
a full day list of other patients

588
00:32:45,315 --> 00:32:46,665
they could have seen in that time.

589
00:32:47,145 --> 00:32:50,965
And to their absolute credit, I'm unaware
of any of the specialists I've worked with

590
00:32:51,105 --> 00:32:54,045
that have actually charged the patient
anything for any of these assessments

591
00:32:54,045 --> 00:32:55,395
or, or any of their time involved.

592
00:32:56,580 --> 00:32:57,780
Wow, that's amazing.

593
00:32:57,810 --> 00:33:01,500
And Nick, do you mind talking me
through what is the process for

594
00:33:01,500 --> 00:33:06,065
someone to a doctor to become
A-A-V-A-D, you know, trained doctor?

595
00:33:07,334 --> 00:33:09,675
First thing is to want to do it.

596
00:33:09,675 --> 00:33:11,475
So please adopt this out there.

597
00:33:11,834 --> 00:33:13,725
Don't just be interested, be passionate.

598
00:33:13,754 --> 00:33:14,655
Let's get involved.

599
00:33:14,655 --> 00:33:17,745
You'll find if you do do it,
it's possibly some of the most

600
00:33:17,745 --> 00:33:19,844
rewarding work I have ever done.

601
00:33:20,175 --> 00:33:23,324
Not something I would've
expected, but it's so true.

602
00:33:24,135 --> 00:33:28,935
So it's, it's people being prepared
to do it is the number one huge hurdle

603
00:33:29,145 --> 00:33:30,764
then It's actually, it's not that hard.

604
00:33:30,854 --> 00:33:33,104
It's a, it's an online training.

605
00:33:33,195 --> 00:33:35,475
It takes most of the day and.

606
00:33:36,139 --> 00:33:40,910
Another areas of this work is, there's
very little incentive for this because

607
00:33:40,910 --> 00:33:42,860
it's, it's a day away from your work.

608
00:33:42,860 --> 00:33:46,790
There's, there's really no reward
for doing that work other than being

609
00:33:46,790 --> 00:33:49,070
able to become a VAD practitioner.

610
00:33:49,820 --> 00:33:52,010
But that's, but that
trendy is very thorough.

611
00:33:52,010 --> 00:33:54,800
It's actually very interesting,
and we've had people who do it

612
00:33:54,800 --> 00:33:57,560
because they want to find out more
about voluntary assisted dying.

613
00:33:57,560 --> 00:33:59,840
They don't necessarily want to
become the ad practitioners.

614
00:34:00,225 --> 00:34:03,135
But they think this is an important
area of healthcare I should know about.

615
00:34:03,524 --> 00:34:04,905
So the training is the number one.

616
00:34:04,905 --> 00:34:05,445
It's very easy.

617
00:34:05,445 --> 00:34:07,725
You sign up online and get that done.

618
00:34:07,725 --> 00:34:11,715
And once you've done that, you
are then a VAD trained pop up.

619
00:34:11,985 --> 00:34:15,375
And like most training, you do
that and you have absolutely no

620
00:34:15,375 --> 00:34:16,755
idea how to do the real work.

621
00:34:16,904 --> 00:34:20,210
So the real training comes with you
actually see a patient for the first time.

622
00:34:21,105 --> 00:34:26,385
I did the training in April of 2019 before
the law had even been implemented in

623
00:34:26,385 --> 00:34:28,125
the first group that did the training.

624
00:34:28,574 --> 00:34:33,824
And then the law began in June, 2019, and
eight days later, a patient rang up who

625
00:34:33,824 --> 00:34:38,925
had seen me in the news and said, oh, VAD
had pancreatic cancer, and came along.

626
00:34:38,985 --> 00:34:40,310
And that's when I really started learning.

627
00:34:41,000 --> 00:34:41,990
How this works.

628
00:34:42,350 --> 00:34:45,050
He actually was a very good example
of one things you were saying,

629
00:34:45,050 --> 00:34:49,610
Kane, about the criteria because the
Victorian legislation said he must be an

630
00:34:49,610 --> 00:34:52,040
Australian citizen or permanent resident.

631
00:34:52,820 --> 00:34:57,650
This man, Julian, was his name here to
lived in Australia for over 40 years,

632
00:34:58,520 --> 00:35:00,440
and I was doing his first assessment.

633
00:35:00,440 --> 00:35:03,170
The very first patient I'd ever
done, done it for, he brought in

634
00:35:03,170 --> 00:35:05,390
his passport and it was British.

635
00:35:06,375 --> 00:35:10,275
He had never taken out citizenship,
so he'd lived here 42 years.

636
00:35:10,275 --> 00:35:11,384
He paid his taxes.

637
00:35:11,384 --> 00:35:12,555
He was registered to vote.

638
00:35:12,765 --> 00:35:16,154
He was now on an Australian
pension, but because he didn't

639
00:35:16,154 --> 00:35:20,865
have Australian citizenship, he
did not qualify for royals to die.

640
00:35:21,015 --> 00:35:22,125
My very first patient.

641
00:35:22,335 --> 00:35:22,395
Oh,

642
00:35:23,175 --> 00:35:23,835
wow.

643
00:35:24,435 --> 00:35:24,885
That's it.

644
00:35:24,885 --> 00:35:27,225
That's sort of going
sidetracking from how you track.

645
00:35:27,825 --> 00:35:30,885
But Nick, how did, how
did that make you feel?

646
00:35:31,305 --> 00:35:32,235
Oh, it was devastating.

647
00:35:32,235 --> 00:35:32,385
You had

648
00:35:32,385 --> 00:35:32,610
to tell him,

649
00:35:33,410 --> 00:35:34,210
absolutely devastating.

650
00:35:34,210 --> 00:35:36,135
This, this, he was a lonely man.

651
00:35:36,225 --> 00:35:37,815
He had pancreatic cancer.

652
00:35:38,115 --> 00:35:39,525
He was going to die from this.

653
00:35:39,525 --> 00:35:41,475
It was a horrendous disease and.

654
00:35:43,170 --> 00:35:45,180
He, and of course I'd
never met him before this.

655
00:35:45,180 --> 00:35:47,610
I met him twice the second time I met him.

656
00:35:47,700 --> 00:35:49,620
And we just, it was all brand new.

657
00:35:49,620 --> 00:35:51,270
We thought there must
be a way around this.

658
00:35:51,270 --> 00:35:54,779
And we talked to lawyers and the
navigators and Peter McCallum

659
00:35:54,990 --> 00:35:58,800
lawyers, but I said, no, I now
realize it's very clear if you're

660
00:35:58,800 --> 00:36:00,960
not a citizen, you're not eligible.

661
00:36:01,500 --> 00:36:04,770
And Julian was absolutely devastated
'cause he'd hung his hopes,

662
00:36:04,770 --> 00:36:06,180
he'd followed the legislation.

663
00:36:06,180 --> 00:36:09,660
He had this disease, and that's
why as soon as it passed, he got in

664
00:36:09,660 --> 00:36:11,970
touch with me and Julian suicide.

665
00:36:11,970 --> 00:36:12,150
It.

666
00:36:13,319 --> 00:36:14,580
It was devastating.

667
00:36:14,819 --> 00:36:18,450
It was one of the most distressing
days of my life when I heard that.

668
00:36:19,080 --> 00:36:24,180
And instead of being able to go
through a, a medical process where

669
00:36:24,180 --> 00:36:27,629
it was all legitimate, he could do
it with whoever he wanted there.

670
00:36:27,930 --> 00:36:29,430
He had to do it on his own.

671
00:36:29,580 --> 00:36:32,279
Leaving a note from his, for
his neighbor who had the keys

672
00:36:32,279 --> 00:36:33,899
said, do not come into my house.

673
00:36:34,200 --> 00:36:35,580
Just call the ambos.

674
00:36:36,000 --> 00:36:39,569
And of course then those first
responders had to find a man

675
00:36:39,569 --> 00:36:40,935
who had suicided on his own.

676
00:36:41,820 --> 00:36:42,720
Horrible for them.

677
00:36:42,930 --> 00:36:44,160
Devastating for Julian.

678
00:36:44,580 --> 00:36:46,860
And what was a technicality in the law?

679
00:36:49,500 --> 00:36:51,930
Oh, I'm so sorry to to hear that.

680
00:36:52,290 --> 00:36:53,310
Thank you for sharing.

681
00:36:53,310 --> 00:36:53,910
It's not uncommon.

682
00:36:53,910 --> 00:36:57,540
We've got, we've got a lot of Kiwis
and, and Brits in this country.

683
00:36:57,540 --> 00:36:59,759
You've lived here a long time,
haven't taken out citizenship.

684
00:36:59,759 --> 00:37:00,840
You've probably come across that, Kate.

685
00:37:02,279 --> 00:37:05,520
Yeah, I was just going to say, having
been a paramedic myself and walked

686
00:37:05,520 --> 00:37:08,940
into exactly that kind of house,
you know, it, it devastates everyone

687
00:37:08,940 --> 00:37:10,950
around and that impact is ongoing.

688
00:37:11,970 --> 00:37:16,410
Ultimately, at the end of the day, for
a lot of people, and again, farming

689
00:37:16,410 --> 00:37:19,890
communities, if they're going to do
something, they're going to do it proper.

690
00:37:21,270 --> 00:37:25,049
A lot of people will suicide
if this isn't a, a seen to be a

691
00:37:25,049 --> 00:37:27,089
valid, accessible option for them.

692
00:37:27,720 --> 00:37:29,670
And again, at the end of the
day, we're not changing the

693
00:37:29,700 --> 00:37:30,960
outcome for these patients.

694
00:37:31,080 --> 00:37:32,220
We're changing that journey.

695
00:37:32,220 --> 00:37:34,470
We're giving them that
sense of control back again.

696
00:37:34,740 --> 00:37:38,339
Often in times where they don't feel
like they have control over their

697
00:37:38,339 --> 00:37:40,740
symptoms, their disease or their death.

698
00:37:41,805 --> 00:37:45,555
I think you can't emphasize that too much,
Kane, because one of the things often

699
00:37:45,555 --> 00:37:48,945
to say when people start the voluntary
assisted dying process mean know only

700
00:37:48,945 --> 00:37:51,825
around about 30 or 40% go through to end.

701
00:37:51,915 --> 00:37:53,235
End up taking the medication.

702
00:37:53,265 --> 00:37:54,165
They get sick, they die.

703
00:37:54,750 --> 00:38:00,870
Almost all never changes their mind, but
100% of the people who take part in the

704
00:38:00,870 --> 00:38:05,730
process get the comfort of getting back
some of that control and use that word

705
00:38:05,730 --> 00:38:07,380
ca. And I think it's so, so important.

706
00:38:07,650 --> 00:38:11,280
'cause these hideous diseases
rob us of our control.

707
00:38:11,280 --> 00:38:13,140
They take over ravage our bodies.

708
00:38:13,365 --> 00:38:19,095
Do terrible things to our minds and to
snatch back some little morsel of control

709
00:38:19,095 --> 00:38:21,524
towards the end is such a huge comfort.

710
00:38:21,944 --> 00:38:25,725
And the VAD process gives people that
comfort, even if they never end up using.

711
00:38:25,725 --> 00:38:26,984
It's so, so important.

712
00:38:26,984 --> 00:38:29,234
I think it's one of the most
important things about it.

713
00:38:30,750 --> 00:38:35,400
There was a, a beautiful exhibition and
I, I think that you were, were there Nick

714
00:38:35,759 --> 00:38:41,520
by Julian Kinga earlier this this year,
and beautiful black and white photography.

715
00:38:41,520 --> 00:38:46,109
And he had followed the families
of people who had chosen to go down

716
00:38:46,109 --> 00:38:47,970
the voluntary assisted dying path.

717
00:38:48,660 --> 00:38:52,410
And there was this amazing
photo of this woman, and I can't

718
00:38:52,410 --> 00:38:53,940
recall her name right now, but.

719
00:38:54,620 --> 00:38:56,270
She had, she was still alive.

720
00:38:56,270 --> 00:39:01,790
She had not chosen to go down voluntary
assisted dying and, and take the open,

721
00:39:01,790 --> 00:39:05,899
the black box, as you say, at, at
that point when we had the exhibition.

722
00:39:06,319 --> 00:39:09,259
But what really clearly
showed to me is that.

723
00:39:09,685 --> 00:39:14,575
The, the people that were being
highlighted, they're all people who have

724
00:39:14,665 --> 00:39:20,095
their own individual stories and their
families and the impact that, and the,

725
00:39:20,214 --> 00:39:26,605
the, the flow on effect that the option
and the choice has given those people.

726
00:39:26,845 --> 00:39:31,435
And, you know, the, the Julian, the
name of the book and the exhibition was

727
00:39:31,795 --> 00:39:37,404
the Power of Choice and, and it just
highlights that so beautifully and.

728
00:39:38,160 --> 00:39:42,720
It brings me to, to ask you about, you
know, we, we have in our healthcare

729
00:39:42,720 --> 00:39:47,190
system in Australia, the, a lot of
religious organizations that are

730
00:39:47,190 --> 00:39:52,770
actually, you know, either patrons or
they're actually involved in healthcare.

731
00:39:52,950 --> 00:39:56,215
And what sort of things do people
need to consider when they're thinking

732
00:39:56,430 --> 00:40:00,210
about voluntary assisted dying and the
care facility that they're actually

733
00:40:00,210 --> 00:40:02,010
choosing or that is nearby them?

734
00:40:02,400 --> 00:40:06,360
Because I'm, I'm assuming that that would,
there would be some tension there as well.

735
00:40:08,085 --> 00:40:12,195
The majority of palliative care in this
country is provided by the Catholic sector

736
00:40:12,645 --> 00:40:15,255
and quite a lot of residential care also.

737
00:40:15,690 --> 00:40:19,920
And some of those places are
more inclined to look favorably

738
00:40:19,920 --> 00:40:22,920
at voluntary assisted dying, and
some of them are very vehemently

739
00:40:22,980 --> 00:40:24,660
against voluntary assisted dying.

740
00:40:25,410 --> 00:40:29,430
And we encourage our older patients
who are looking at aged care who might

741
00:40:29,520 --> 00:40:33,120
think about this for the future, to
take that in mind and die with Dignity.

742
00:40:33,299 --> 00:40:36,990
Victoria, we've actually set up a.
Which will show you which aged care

743
00:40:36,990 --> 00:40:41,370
facilities are on board with voluntary
assisted dying, which are a bit equivocal

744
00:40:41,370 --> 00:40:45,630
and which are against, and it's not
comprehensive 'cause we haven't managed

745
00:40:45,630 --> 00:40:47,460
to get that information from some of them.

746
00:40:48,060 --> 00:40:49,259
And it's a very important thing.

747
00:40:49,259 --> 00:40:53,700
If it, if you're considering aged care
and voluntary assisted dying is something

748
00:40:53,700 --> 00:40:58,380
which you might want to have as an option
for yourself, then that's a question

749
00:40:58,380 --> 00:40:59,910
that needs to be asked at The Aged Care.

750
00:41:00,025 --> 00:41:02,910
I, I dunno, you may not have
so many options as in the

751
00:41:02,910 --> 00:41:03,865
community where you work, Kate.

752
00:41:05,340 --> 00:41:09,870
No, and we have had, uh, several cases
now of VAD in the aged care setting.

753
00:41:10,230 --> 00:41:13,560
I'm a little bit grateful that the,
the first question we kind of get

754
00:41:13,560 --> 00:41:15,900
is, oh, well, tell me more about it.

755
00:41:16,080 --> 00:41:19,830
It's often that lack of information
or lack of knowing about the process.

756
00:41:20,295 --> 00:41:24,195
Once we sit down with the people that
run the facilities, explain it through.

757
00:41:24,495 --> 00:41:27,525
Fortunately, we've, we've actually had
a lot of success and a lot of people

758
00:41:27,525 --> 00:41:29,775
being on board with the, the process.

759
00:41:30,195 --> 00:41:33,315
You know, we appreciate that people
are going to object to VAD on

760
00:41:33,315 --> 00:41:37,125
moral, religious, or philosophical
grounds, and we respect that.

761
00:41:38,055 --> 00:41:42,315
But the hope is that they also
respect patient's ability to be able

762
00:41:42,315 --> 00:41:45,225
to choose and, and be involved and
make that choice for themselves.

763
00:41:46,725 --> 00:41:50,085
And just anecdotally, I was
doing a, a teaching session for

764
00:41:50,384 --> 00:41:52,935
GP registrars just last week.

765
00:41:53,174 --> 00:41:56,295
It was about 40 registrars and one
of the first questions I asked,

766
00:41:56,295 --> 00:41:57,525
this was about voluntary system.

767
00:41:57,674 --> 00:42:01,214
One of the first questions I asked
anonymously was a did little poll and

768
00:42:01,214 --> 00:42:03,045
I dropped people to rate where they.

769
00:42:03,470 --> 00:42:06,740
Felt about voluntary assisted dying from
fully supportive through to objecting.

770
00:42:06,800 --> 00:42:11,780
And one of my options was I object
on the grounds of my faith, and

771
00:42:11,780 --> 00:42:17,210
15% of the registrars at that
meeting ticked that particular box.

772
00:42:17,600 --> 00:42:21,110
So we must remember that
objection on the grounds of.

773
00:42:21,690 --> 00:42:25,890
Philosophical or faith-based
beliefs is very common.

774
00:42:26,010 --> 00:42:30,240
And I've often said that there
is only one really true, strong

775
00:42:30,240 --> 00:42:32,160
argument against voluntary cys dying.

776
00:42:32,160 --> 00:42:36,810
And that's the one of of moral
philosophical belief or faith.

777
00:42:37,320 --> 00:42:39,960
Because when you look at data, when
you look at the science, when you look

778
00:42:39,960 --> 00:42:44,730
at research around the world, there's
almost no other reason why you would be

779
00:42:44,760 --> 00:42:49,500
opposed to it because it works well at
every jurisdiction where it's studied.

780
00:42:49,590 --> 00:42:50,040
But if you.

781
00:42:50,270 --> 00:42:53,330
Don't believe that it's right
for you or it's not right for

782
00:42:53,330 --> 00:42:55,460
your religion, then absolutely.

783
00:42:55,460 --> 00:42:57,290
Of course you should
have the right to say no.

784
00:42:57,440 --> 00:43:02,420
I would just say exactly like you did
Kane earlier, just now that, that's fine.

785
00:43:02,420 --> 00:43:05,300
You can have that decision for
yourself, but please don't, don't

786
00:43:05,300 --> 00:43:07,310
try and impose it on others.

787
00:43:09,080 --> 00:43:14,060
And so for someone who is interested
in voluntary assisted dying, where can

788
00:43:14,060 --> 00:43:19,100
they go to receive information and, and
sort of navigate, you know, this space?

789
00:43:23,070 --> 00:43:26,460
Hopefully there's already a bit
of knowledge amongst the general

790
00:43:26,460 --> 00:43:30,720
practitioners in the area or the, the
health practitioners, and I think at

791
00:43:30,720 --> 00:43:34,170
the moment at least the, the majority of
referrals that I get are actually from

792
00:43:34,170 --> 00:43:38,430
colleagues where I've let them know that
I, I do participate in practice VAD, and

793
00:43:38,460 --> 00:43:41,040
so I get referrals from that in Victoria.

794
00:43:41,040 --> 00:43:46,380
Thankfully we have, and most states do,
a incredible team of care navigators.

795
00:43:46,740 --> 00:43:50,790
That if you are not sure where to
go or who to contact, a quick little

796
00:43:50,790 --> 00:43:52,140
Google search can find them out.

797
00:43:52,170 --> 00:43:56,190
But they're based out of the
Peter Mac cancer center and are

798
00:43:56,190 --> 00:43:58,140
available via phone, hypothetically.

799
00:43:58,140 --> 00:44:03,090
It might be 0385595823, but
to, to give people a way to at

800
00:44:03,090 --> 00:44:04,560
least link into the service.

801
00:44:04,770 --> 00:44:09,555
While lists of BAD doctors aren't
publicized anywhere, they do have a, a

802
00:44:09,560 --> 00:44:11,550
list behind the scenes where they can say.

803
00:44:11,890 --> 00:44:13,810
You are in this area,
you have this condition.

804
00:44:13,810 --> 00:44:16,990
Hey, let's try and link you in with these
people to get your assessment started.

805
00:44:19,544 --> 00:44:22,125
And it is something that we'll
definitely include in the show notes.

806
00:44:22,125 --> 00:44:26,115
And you, you've also, we've also mentioned
the resources that are available on

807
00:44:26,475 --> 00:44:31,335
Dying, dying With Dignity Victoria's
website, which is, is exceptionally good.

808
00:44:31,785 --> 00:44:35,725
One thing that I find that a lot
of people ask about is, you know.

809
00:44:36,720 --> 00:44:41,340
The advanced care directives, how
do, how do they fill those out when

810
00:44:41,340 --> 00:44:43,800
it's about voluntary assisted dying?

811
00:44:43,800 --> 00:44:45,360
How do they cover off on that?

812
00:44:45,810 --> 00:44:48,570
How do they even start that process?

813
00:44:48,570 --> 00:44:51,300
So do you have any, any thoughts on that?

814
00:44:52,080 --> 00:44:54,570
Very simply, you cannot put
voluntary assisted dying

815
00:44:54,570 --> 00:44:56,130
into advance care directive.

816
00:44:56,410 --> 00:44:58,990
So you could state that that
would be your preference, but

817
00:44:58,990 --> 00:45:01,330
it has no legal weight at all.

818
00:45:01,870 --> 00:45:07,029
Advanced care directive is a very useful
document to help doctors know how you

819
00:45:07,029 --> 00:45:08,439
want to be treated towards you, your life.

820
00:45:08,734 --> 00:45:10,674
But it can't include
voluntary assisted diet.

821
00:45:12,845 --> 00:45:16,600
Uh, and so for, for those
people, they, they have to go

822
00:45:16,600 --> 00:45:17,830
through that formal process.

823
00:45:17,830 --> 00:45:20,859
It's not something that they
can just pop on that form.

824
00:45:20,859 --> 00:45:21,310
Is it?

825
00:45:22,600 --> 00:45:25,810
I think one of the most common
questions I get about that is.

826
00:45:26,565 --> 00:45:31,815
Everything's going okay now, but
if I develop a dementia or I'm in

827
00:45:31,815 --> 00:45:34,605
that position where I can't make
these decisions, why can't I do it?

828
00:45:35,565 --> 00:45:38,925
And again, it kind of highlights at the
moment the, the importance of those safety

829
00:45:38,925 --> 00:45:42,735
checks to make sure, and, and one of those
criteria is you need to be of sound mind.

830
00:45:43,215 --> 00:45:47,145
The whole point of voluntary assisted
dying is that it's voluntary.

831
00:45:48,345 --> 00:45:51,795
And so if you're not in the position to
be able to make that decision, the rest

832
00:45:51,795 --> 00:45:52,820
of the framework kind of falls apart.

833
00:45:54,105 --> 00:45:54,315
So

834
00:45:54,315 --> 00:45:54,645
change's

835
00:45:54,645 --> 00:45:59,655
raised the funny question of dementia
and the commonest reason my patients

836
00:45:59,655 --> 00:46:03,134
come to me saying that they may want
to consider bone assisted dying in

837
00:46:03,134 --> 00:46:08,655
the future is if I develop dementia
and I've yet to meet anyone who sits.

838
00:46:08,655 --> 00:46:11,445
If I develop dementia, look
after me, keep me going at all

839
00:46:11,445 --> 00:46:13,634
costs, and don't worry about how.

840
00:46:13,855 --> 00:46:14,185
Bad.

841
00:46:14,185 --> 00:46:15,625
I am on how much I've lost.

842
00:46:15,625 --> 00:46:17,425
My marbles just keep me alive.

843
00:46:17,815 --> 00:46:19,165
I've yet to meet that person.

844
00:46:19,165 --> 00:46:21,565
They probably do exist, but they
haven't spoken to me about it.

845
00:46:21,685 --> 00:46:25,585
Nearly everybody says if I'm in
that situation, I would like to

846
00:46:25,585 --> 00:46:26,695
have voluntary assisted dying.

847
00:46:26,725 --> 00:46:29,125
That's not an option in
this country anywhere.

848
00:46:29,395 --> 00:46:33,685
It's not likely to be anytime soon, but
so the area which we are dealing with

849
00:46:33,685 --> 00:46:36,295
dignity Victoria, are talking about a lot.

850
00:46:36,580 --> 00:46:38,605
We plan to try and address it.

851
00:46:38,605 --> 00:46:42,339
It is an option In some countries
it's very hard to make it work.

852
00:46:42,730 --> 00:46:46,990
It's done on very few occasions, but
I'm gonna work at it furiously hard.

853
00:46:46,990 --> 00:46:48,730
'cause I want it for when I need it.

854
00:46:52,180 --> 00:47:00,250
And so tell me as the sort of final sort
of thoughts on the topic Ni and Kane.

855
00:47:00,250 --> 00:47:04,779
What can I, what can I ask you that
you've, you've learned through your.

856
00:47:05,520 --> 00:47:09,089
Patients and taking them
through this process, what

857
00:47:09,089 --> 00:47:10,319
have, what have they taught you?

858
00:47:16,140 --> 00:47:17,100
Happy I'll, I'll start.

859
00:47:17,339 --> 00:47:17,640
Sure.

860
00:47:17,819 --> 00:47:18,210
EAD.

861
00:47:18,629 --> 00:47:20,910
I've been a relatively
recent practitioner.

862
00:47:20,910 --> 00:47:24,210
I only started at the beginning
of last year and already it has

863
00:47:24,210 --> 00:47:30,450
profoundly changed the way I practice
day-to-day through my roles with

864
00:47:30,450 --> 00:47:33,960
ambulance, through my roles as an ed
doctor, then through general practice.

865
00:47:34,694 --> 00:47:35,835
Death is a bit of an old friend.

866
00:47:36,345 --> 00:47:40,005
I've seen good deaths, seen
some not so good deaths.

867
00:47:40,214 --> 00:47:41,234
Seen some terrible deaths.

868
00:47:43,065 --> 00:47:45,975
Having seen now numerous VAD deaths.

869
00:47:46,875 --> 00:47:48,225
I can tell you how I wanna go.

870
00:47:48,915 --> 00:47:51,105
It's peaceful, it's lovely.

871
00:47:51,105 --> 00:47:52,605
It's a celebration of life.

872
00:47:52,785 --> 00:47:55,875
You choose the time,
the location, the music.

873
00:47:55,875 --> 00:47:59,595
We had one family that was
blasting highway to hell in the

874
00:47:59,595 --> 00:48:01,395
background for the entire afternoon.

875
00:48:02,085 --> 00:48:02,895
For that person.

876
00:48:02,895 --> 00:48:06,195
That was their sendoff, that was the
celebration of, of who they were,

877
00:48:06,195 --> 00:48:12,315
such as, there's tears, there's often
laughter and joy and, and just people

878
00:48:12,495 --> 00:48:14,325
with love surrounding that person.

879
00:48:15,375 --> 00:48:17,055
Uh, you put that so beautifully, Cain.

880
00:48:17,055 --> 00:48:18,465
I could not agree more.

881
00:48:18,465 --> 00:48:22,815
It's, it's one of the astonishing things
I found about this work is I meet someone

882
00:48:23,025 --> 00:48:24,675
maybe only two or three times, but.

883
00:48:25,890 --> 00:48:29,400
Almost at the end of the first assessment,
we're hugging and crying, breaking all

884
00:48:29,400 --> 00:48:32,670
the kind of boundaries you're supposed
to have about doctor patient interaction.

885
00:48:32,700 --> 00:48:36,960
'cause it's such an intimate,
profound experience and it

886
00:48:36,960 --> 00:48:38,460
matters so much to these people.

887
00:48:38,460 --> 00:48:39,660
They're so grateful.

888
00:48:40,080 --> 00:48:44,280
And it sounds weird to talk about
death as beautiful, but like you

889
00:48:44,280 --> 00:48:47,610
K and I've seen, I've never been a
paramedic, so I haven't seen it the way

890
00:48:47,610 --> 00:48:49,650
you have, but I've seen lousy deaths.

891
00:48:49,650 --> 00:48:50,940
I've seen okay deaths.

892
00:48:51,090 --> 00:48:52,290
But every single.

893
00:48:52,620 --> 00:48:53,190
VAD.

894
00:48:53,190 --> 00:48:56,730
Death has been beautiful and I
actually had the experience from the

895
00:48:56,790 --> 00:48:58,500
other side just a few months ago.

896
00:48:58,500 --> 00:49:01,860
'cause my own beloved sister-in-law
died through voluntary assisted

897
00:49:01,860 --> 00:49:04,470
dying, developed a hideous cancer.

898
00:49:05,279 --> 00:49:06,630
She knew she was going to die.

899
00:49:06,630 --> 00:49:07,799
A very practical person.

900
00:49:07,799 --> 00:49:09,660
She'd been an ICU nurse herself.

901
00:49:10,410 --> 00:49:13,740
She also knew that this cancer
could erode something nasty.

902
00:49:13,740 --> 00:49:16,950
She could die by ex San grating
at two in the morning or something

903
00:49:17,279 --> 00:49:18,779
really hideous like that.

904
00:49:18,779 --> 00:49:20,100
And she wasn't prepared to.

905
00:49:20,520 --> 00:49:22,140
To, to have that happen.

906
00:49:22,470 --> 00:49:25,529
And instead she died, had to
be intravenous administration.

907
00:49:25,529 --> 00:49:31,080
The lovely VAD came along, team came
along and we had this beautiful day and

908
00:49:31,080 --> 00:49:36,569
we all remember it as, as you say, came
very sad, lots of tears, but with this

909
00:49:36,569 --> 00:49:38,790
fond memory of this gorgeous last day.

910
00:49:38,819 --> 00:49:41,730
And her last words were, she
looked at me and she said, I

911
00:49:41,730 --> 00:49:43,560
cannot wait for this sleep.

912
00:49:44,310 --> 00:49:46,680
And then she had her sleep
and it was beautiful.

913
00:49:46,859 --> 00:49:47,250
So.

914
00:49:47,985 --> 00:49:49,305
Immensely moving.

915
00:49:49,335 --> 00:49:50,235
Very powerful.

916
00:49:50,235 --> 00:49:54,495
And like you Kane, I think it's completely
changed how I feel about being a doctor

917
00:49:54,855 --> 00:49:59,415
and the work and given me a, an area
that I now absolutely love working

918
00:49:59,415 --> 00:50:01,154
in, which I would never have expected.

919
00:50:04,485 --> 00:50:05,384
And I think that.

920
00:50:06,540 --> 00:50:10,650
Those beautiful photos that we saw
at that Julian King and, and what's

921
00:50:10,650 --> 00:50:15,210
in that book, the Power of Choice
are a real testament to that, that

922
00:50:15,720 --> 00:50:20,069
it shows beautifully and has captured
beautifully, those stories and that.

923
00:50:20,535 --> 00:50:24,615
Those final moments where they've
had the choice and they've made it

924
00:50:24,645 --> 00:50:26,385
and they're supported by family.

925
00:50:26,565 --> 00:50:31,785
I can't thank you enough, both
you, Nick and Kane, for sharing

926
00:50:31,785 --> 00:50:33,465
your stories with us today.

927
00:50:33,495 --> 00:50:37,245
And yeah, and just letting us
know some of the challenge that

928
00:50:37,455 --> 00:50:40,875
that still exists when it comes to
voluntary assisted dying in Victoria.

929
00:50:41,270 --> 00:50:43,700
Thank you, Catherine, and thank you
for your great work with your podcast.

930
00:50:44,730 --> 00:50:45,855
Thank you so much.

931
00:50:46,425 --> 00:50:47,175
Thank you, Catherine.

932
00:50:47,175 --> 00:50:47,475
Um.

933
00:50:47,850 --> 00:50:51,390
Absolutely massive fan of your work
and hope to hear more in the future.

934
00:50:52,470 --> 00:50:52,950
Thank you.

935
00:50:57,404 --> 00:51:00,825
We hope you enjoyed today's
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936
00:51:01,125 --> 00:51:02,895
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937
00:51:03,645 --> 00:51:07,904
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938
00:51:07,904 --> 00:51:09,855
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939
00:51:09,975 --> 00:51:13,605
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940
00:51:13,605 --> 00:51:15,345
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941
00:51:15,524 --> 00:51:17,145
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00:51:17,405 --> 00:51:21,395
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00:51:21,695 --> 00:51:23,015
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