Elder abuse concerns raised as Labor backs VAD telehealth

A Labor push to lift the ban on accessing voluntary assisted dying through telehealth has triggered a warning about unintended consequences for both young and elderly vulnerable Australians.One advocacy group has welcomed the move at the ALP National Conference to reduce the barriers to end-of-life care, particularly for people in regional and remote areas, but the country's highest law officer has raised concerns about the risk of elder abuse.Delegates voted to amend the party's draft platform to include support for a conscience vote on expanding the accessibility of end-of-life care during a sensitive debate at the conference in Adelaide on Friday.Australia currently bans people from using telehealth for voluntary assisted dying (VAD) consultations, with doctors facing fines of up to $300,000 for discussing the matter via phone or video.An amendment endorsed at the conference said Labor would "remove barriers that exist in federal law to the provision of end-of-life care (including via telehealth) as part of lawful access to voluntary assisted dying in the states and territories, while maintaining appropriate clinical safeguards".Delegates also inserted a guarantee into Labor's constitution to always grant a conscience vote on the issue of VAD.VAD amendment welcomed by advocatesThe chief executive of advocacy group Go Gentle Australia, Dr Linda Swan, said the vote at the Labor conference was a "positive first step" toward equity of access to "compassionate and timely care"."The current Commonwealth Criminal Code restrictions impose unnecessary barriers, particularly for terminally ill people living in rural and regional Australia who may need to travel long distances to attend in-person VAD assessments," she said."Removing these barriers also supports dying people wherever they live who are too sick, frail or physically unable to travel to in-person appointments."Speaking at the conference, Victorian Labor MP Ryan Bachelor said the amendments were targeted at the removal of a Howard government-era provision in the criminal code effectively banning the use of electronic communication for the provision of VAD information."These laws hinder care and cause unnecessary delays. It's inequitable. It's distressing, and it must change,'' he said.Sally Quinnell warned against slowly removing guardrails around VAD. (ABC News: Matt Roberts)NSW state MP Sally Quinnell spoke against the amendment, saying when VAD was debated and adopted those with concerns about it being passed were "told there were going to be strong guardrails"."Now we need to be careful that we don't pull those guardrails down bit by bit," she said."I think we all agree this is complex, nuanced and shouldn't be done over a Zoom call. It happens in person with empathy, careful listening, and human interaction."Rowland 'not convinced' by VAD telehealthAttorney-General Michelle Rowland spoke in favour of a conscience vote on VAD, though pushed back on any blanket change to the law around telehealth."I am personally not convinced that a person confronting an end-of-life decision shouldn't be afforded the dignity of a personal face-to-face consultation with a medical practitioner '' she said."I acknowledge the well-intentioned advocacy in this area, particularly with respect to the needs of remote and regional patients. I expect that any further work on this will be accompanied by rigorous evidence and safeguards."Ms Rowland said she also needed to consider the "wider implications" of a change across her portfolio, including the "effective operation of the criminal code"."There are currently provisions in the criminal code that make it an offence to use a carriage service, either over the phone or online, to counsel or incite suicide," she said."These provisions are there for a good reason: they were enacted to deter ill- intentioned individuals from encouraging vulnerable people to self-harm or commit suicide."Michelle Rowland was among those who expressed personal reservations about changing the voluntary assisted dying laws. (ABC News: Matt Roberts)Ms Rowland said the number of cases of incitement were "trending upwards" including "many cases" of young people being encouraged online to self-harm."AI is already exacerbating risks in this area, where chatbots, or those with malicious intent potentially masquerading behind convincing AI-generated avatars, seek to cause serious harm, again particularly to children and young people," she said.Ms Rowland also raised concerns about the removal of any safeguards resulting in more elder abuse where vulnerable older people might be inappropriately influenced about their end-of-life decisions."This is an issue that I take extremely seriously, and I'm discussing it with states and territories," she said."My view is that this is fundamentally a health policy issue, and any movement in this area needs to be supported by strong evidence and rigorous safeguards to prevent abuse."Labor deals on gambling and dental in MedicareThe VAD debate was the most contentious issue of the second day of the conference, with other amendments to the draft platform agreed on the sidelines of the debate.A resolution passed pledging Labor would "endeavour to strengthen the powers of the relevant national regulators" to support the "effectiveness and impact" of efforts to reduce harms.The ABC revealed earlier this week a push to toughen Labor's stance on gambling was focused on beefing up the enforcement of rules on the industry.The Albanese government did not move to establish a national gambling regulator in its bill to crack down on wagering advertising currently before the parliament despite it being a key recommendation of the You Win Some, You Lose More report.Delegates also supported an amendment committing Labor to developing a "road map" to including dental health services in Medicare.The final day of the conference is scheduled to cover a range of international and defence issues, with talks ongoing about the language in the platform related to Israel and Palestine.Party figures were not expecting any debate on the AUKUS pact despite calls from critics like Labor MP Ed Husic to revisit the issue.