Assisted dying to begin in ACT, but regional government plan to include patients without capacity sparks concern

Regional government plan underway to expand assisted dying rights to those without rational capacity in Australian Capital Territory, “slippery slope” says Canberra Declaration community of Christians
Rachel Stephen-Smith, Minister for Health for the Australian Capital Territory, called the issue both "complex" and "nuanced" Screenshot from ACT Government ministerial statements video

Assisted dying will become legal in Australia’s Capital Territory from Nov. 3, 2025—but the territory’s government is already exploring controversial plans to expand the law to include patients who can no longer consent, raising alarm among Christian advocates and bioethicists.

On social media platform X, the Canberra Declaration, a wide community of Christians espousing biblical values, posted a message expressing consternation about the plan.

“The ACT is considering assisted suicide (euthanasia) for those who can’t consent—raising serious ethical concerns. It IS [sic] a slippery slope. Life is sacred from beginning to end. We can improve care for the suffering, without requiring their removal.”

On May 7, Rachel Stephen-Smith, Minister for Health for the Australian Capital Territory and ACT Labor member for Kurrajong, made a ministerial statement to the Legislative Assembly in Civic Square, Canberra, giving feedback on the government’s investigation into the issue of assisted dying for those with or without rational capacity for such choices.

The Voluntary Assisted Dying Act 2024 was passed by the assembly on June 5 last year, allowing assisted deaths for those with capacity to choose. The next day, the assembly passed a resolution asking the ACT Government to probe the issue of allowing voluntary assisted dying (VAD) for patients who have lost the capacity for making such decisions. The resolution called for exploring how other jurisdictions have handled the issue, engaging with stakeholders, and reviewing models that consider individuals who no longer have decision-making capacity.

Stephen-Smith spoke of the ACT Government’s response to the resolution, terming it a “highly complex issue” in regard to those without such capacity, which she described as both “complex” and “nuanced.”

The government consultation sought the views of 102 people, including palliative care experts. These included 23 clinicians—seven of whom are VAD practitioners—four international VAD jurisdictions, 12 law and policy experts, and 16 bioethicists.

Stephen-Smith said she recognized “broad support across the community” for considering access to VAD for people who have lost their capacity.

Later, the health minister conceded “there is limited data available from Australian jurisdictions on loss of capacity after final approval. But it is nevertheless clear that this is one of the reasons why some approved VAD individuals do not end up receiving voluntary assisted dying.”

Stephen-Smith said the government remained committed to ensuring assisted dying was available from November, but that both clinicians and the wider community needed to “clearly understand and have confidence in the current scheme as it will be implemented.” She acknowledged that both the public and stakeholders “broadly” speaking, have not yet had their say on the topic.

The minister admitted the idea of someone administering the medication enabling death to a patient had both “serious and profound implications,” and she reiterated that the “ethical and human rights implications are profound.” In particular, she noted that medical experts in the consultation reported the loss of capacity was a “common occurrence” for patients close to natural death, and even earlier in certain medical conditions and diseases.

“In considering this issue as legislators, we must ultimately consider some core principles,” Stephen-Smith said. “First, inherent in the name ‘voluntary assisted dying’ is the name ‘voluntary.’ To be voluntary an individual must be able to understand the decision they are making and communicate that.”

“This concept is an essential safeguard for voluntary assisted dying in the ACT, across Australia and around the world. However, we must also balance this against the principles of autonomy and dignity on which voluntary assisted dying legislation is founded.

“We accept that people’s choices about how they want to live, and how they want to end their life when they’re suffering must be respected and we seek to minimise their pain and suffering. It is hard to see how it is equitable if this choice in control is then removed if a person is at risk of losing capacity at the final step of voluntary assisted dying.”

The health minister’s statement was noted by the assembly, and the debate adjourned for a future sitting of the legislative body.

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