What is it like for doctors working under assisted dying laws?

My first case under Australia’s assisted dying law

Victoria was the first Australian state to enact a voluntary assisted dying (VAD) bill in 2017. Niroshe Amarasekera, a GP at the Carnegie Medical Centre in Melbourne, tells The BMJ what it was like as a working clinician at that time

“I was about seven years into working at my practice when Victoria’s bill came in in 2017. I don’t remember a lot of information communicated to doctors. I remember thinking, ‘It doesn’t affect us. If a patient asks, we refer them on. And we can’t bring it up as a care option.’ That’s it.

“It is against the law for us to bring VAD up. I still can’t start the conversation. You can get into trouble, get sanctioned.

“I’ve had three long term patients either accessing or exploring the option for accessing VAD. The first was about three years ago: she was elderly with diagnosed bowel cancer. The prognosis was poor, and the hospital had referred her. She asked me to be her second approving person—two doctors need to approve VAD under Victoria laws. One of them can be your GP but the other needs to be external [independent], and you both have to agree that VAD is in the best interest of the patient. But the doctor who prescribes or administers the drugs can be your GP if they are trained to do so.

“I hadn’t had any training in assisted dying, and the law was new at the time. Still, I said I’d support her and she put me in touch with her assisted dying navigator—that’s the patient’s primary contact throughout the process [separate from the two doctors who approve the process]. They’re …