Bulletin 17: No Doctor Referral Required

21st July 2008

The question has been asked of the Physician Assisted Dying (PAD) Bill before Parliament:

Q10: Is a doctor declining to assist required to provide a referral to a doctor who is willing?

A: No.

It is important to understand what a doctor’s referral is. A referral is the deliberate, multi-step action of a doctor who is unable to assist the patient further (expert opinion usually required), to (a) identify a new, specific doctor to refer the patient to, (b) write an introduction for the patient to the new doctor, (c) explain to the patient the reason for the referral, and (d) recommend to the patient that they make an appointment to see the identified doctor.

None of these actions are required under the PAD Bill. A doctor declining to assist is required only to advise the sufferer that another doctor may be willing to assist. Notification of a right does not constitute approval. The declining doctor may even state their disapproval—this is not prohibited in the Bill. It is then up to the sufferer to identify another doctor and approach him or her without the assistance of the declining doctor.

Nor is it the case that a sufferer who finds another doctor would automatically qualify under the Bill. If the new doctor were willing, the sufferer then would undergo all the necessary assessment criteria and may or may not qualify for assistance to die peacefully. Therefore, the declining doctor’s advice that other doctors may be willing to assist does not mean the sufferer will automatically be assisted to die peacefully.

Finally, there are precedents in Victorian law for such ‘advice statements’. For example, in the Health Records Act 2001 S37, where a health care provider refuses to discuss a patient’s health records with the patient, the refusing provider is required to advise the patient that he or she may nominate another health care provider to discuss those records.

The declining doctor’s limited advice required in the PAD Bill provides the patient with information about their lawful rights given that they have expressed a desire to be assessed for an assisted, peaceful death; and not to be mislead about their rights either by deliberate misinformation or by omission.