voluntary and the patient must wait seven days between making the decision to end life and signing the certificate of request. The certificate of request must be signed by a second doctor who is satisfied that all requirements have been met; the second doctor must sign in the presence of the patient and the first doctor.
The Act further provides that the doctor who assists in the death must keep the prescribed records or face a $10 000 fine or 2 years imprisonment. The doctor must also send to the coroner the death certificate and the medical record relating to the patient's terminal illness and death. The coroner must inform the Attorney-General annually of the number of deaths resulting from assistance provided under the Act. The Attorney-General in turn is required to report the number to Parliament. The cause of death is to be recorded by the Registrar of Births, Deaths and Marriages as the underlying medical condition. The fact that the deceased was assisted to die will not appear on the register of deaths.
No other country has yet passed a law legalising voluntary euthanasia or assisted suicides. In the Netherlands, guidelines were approved by Parliament in 1993 to regulate active voluntary euthanasia and assisted suicide and do so by stipulating conditions which need to be met for doctors to avoid prosecution. In the United States, the courts have upheld the rights of mentally competent terminally ill adults to seek assistance from a doctor to hasten death.
In the United Kingdom, a rheumatologist was convicted in 1992 of attempted murder after he had used a lethal injection of potassium chloride to respond to a patient's request to have her life ended. He received a 12 months suspended term of imprisonment. The patient was 70 years of age and was in constant pain from rheumatoid arthritis, which disease was complicated by bed sores, bleeding ulcer and gangrene. A charge of murder was withdrawn because of the lack of evidence that the injection had actually caused her death, as an autopsy had not been performed and the body had been cremated. In a subsequent inquiry held by the General Medical Council (GMC) into the professional conduct of the doctor, it was reported that the patient's failure to respond to diamorphine was due to a rare paradoxical reaction whereby the narcotic aggravated the patient's pain. The GMC severely criticised the rheumatologist but did not impose a penalty.18
1 R v Bourne [ 1938] 3 All ER 619, per Macnaghten J.
2 R v Davidson [ 1969] VR 667, per Menhennit J.
3 Southwell J. R v Heath, 1972 (unreported County Court, Victoria). Reported in The Age, 19 February, 1972.