NORTHERN TERRITORY OF AUSTRALIA
RIGHTS OF THE TERMINALLY ILL ACT
As in force at 1 May 1997
Table of provisions
Part 1 Preliminary
1 Short title ......................................................................................... 1
2 Commencement .............................................................................. 1
3 Interpretation ................................................................................... 1
Part 2 Request for and giving of assistance
4 Request for assistance to voluntarily terminate life.......................... 2
5 Response of medical practitioner .................................................... 2
6 Response of medical practitioner, &c., not to be influenced by
extraneous considerations ............................................................... 3
7 Conditions under which medical practitioner may assist ................. 3
8 Palliative care .................................................................................. 6
9 Patient who is unable to sign certificate of request .......................... 6
10 Right to rescind request ................................................................... 7
11 Improper conduct............................................................................. 7
Part 3 Records and reporting of death
12 Medical records to be kept............................................................... 7
13 Certification as to death ................................................................... 8
14 Medical record to be sent to coroner ............................................... 8
15 Coroner may report on operation of act ........................................... 9
Part 4 Miscellaneous
16 Construction of Act .......................................................................... 9
17 Certificate of request is evidence..................................................... 9
18. Effect on construction of wills, contracts and statutes ..................... 9
19 Insurance or annuity policies ......................................................... 10
20 Immunities ..................................................................................... 10
21 Regulations.................................................................................... 11
Schedule
ENDNOTES
NORTHERN TERRITORY OF AUSTRALIA
As in force at 1 May 1997
RIGHTS OF THE TERMINALLY ILL ACT
An Act to confirm the right of a terminally ill person to request
assistance from a medically qualified person to voluntarily terminate his
or her life in a humane manner; to allow for such assistance to be given
in certain circumstances without legal impediment to the person
rendering the assistance; to provide procedural protection against the
possibility of abuse of the rights recognised by this Act; and for related
purposes
Part 1 Preliminary
1 Short title
This Act may be cited as the Rights of the Terminally Ill Act.
2 Commencement
This Act shall come into operation on a date to be fixed by the
Administrator by notice in the Gazette.
3 Interpretation
In this Act, unless the contrary intention appears:
assist, in relation to the death or proposed death of a patient,
includes the prescribing of a substance, the preparation of a
substance and the giving of a substance to the patient for self
administration, and the administration of a substance to the patient.
certificate of request means a certificate in or to the effect of the
form in the Schedule that has been completed, signed and
witnessed in accordance with this Act.
health care provider, in relation to a patient, includes a hospital,
nursing home or other institution (including those responsible for its
management) in which the patient is located for care or attention
and any nurse or other person whose duties include or directly or
indirectly relate to the care or medical treatment of the patient.
Part 2 Request for and giving of assistance
Rights of the Terminally Ill Act 2
illness includes injury or degeneration of mental or physical
faculties.
medical practitioner means a medical practitioner who has been
entitled to practise as a medical practitioner (however described) in
a State or a Territory of the Commonwealth for a continuous period
of not less than 5 years and who is resident in, and entitled under
the Medical Act to practise medicine in, the Territory.
qualified psychiatrist means:
(a) a person entitled under a law of a State or Territory of the
Commonwealth to practise as a specialist in the medical
specialty of psychiatry;
(b) a specialist whose qualifications are recognised by the Royal
Australian and New Zealand College of Psychiatrists as
entitling the person to fellowship of that College; or
(c) a person employed by the Commonwealth or a State or
Territory of the Commonwealth, or an Agency or authority of
the Commonwealth or a State or Territory, as a specialist or
consultant in the medical specialty of psychiatry.
terminal illness, in relation to a patient, means an illness which, in
reasonable medical judgment will, in the normal course, without the
application of extraordinary measures or of treatment unacceptable
to the patient, result in the death of the patient.
Part 2 Request for and giving of assistance
4 Request for assistance to voluntarily terminate life
A patient who, in the course of a terminal illness, is experiencing
pain, suffering and/or distress to an extent unacceptable to the
patient, may request the patient’s medical practitioner to assist the
patient to terminate the patient’s life.
5 Response of medical practitioner
A medical practitioner who receives a request referred to in
section 4, if satisfied that the conditions of section 7 have been met,
but subject to section 8, may assist the patient to terminate the
patient’s life in accordance with this Act or, for any reason and at
any time, refuse to give that assistance.
Part 2 Request for and giving of assistance
Rights of the Terminally Ill Act 3
6 Response of medical practitioner, &c., not to be influenced by
extraneous considerations
(1) A person shall not give or promise any reward or advantage (other
than a reasonable payment for medical services), or by any means
cause or threaten to cause any disadvantage, to a medical
practitioner or other person for refusing to assist, or for the purpose
of compelling or persuading the medical practitioner or other person
to assist or refuse to assist, in the termination of a patient’s life
under this Act.
Penalty: $10,000.
(2) A person to whom a reward or advantage is promised or given, as
referred to in subsection (1), does not have the legal right or
capacity to receive or retain the reward or accept or exercise the
advantage, whether or not, at the relevant time, he or she was
aware of the promise or the intention to give the reward or
advantage.
7 Conditions under which medical practitioner may assist
(1) A medical practitioner may assist a patient to end his or her life only
if all of the following conditions are met:
(a) the patient has attained the age of 18 years;
(b) the medical practitioner is satisfied, on reasonable grounds,
that:
(i) the patient is suffering from an illness that will, in the
normal course and without the application of
extraordinary measures, result in the death of the
patient;
(ii) in reasonable medical judgment, there is no medical
measure acceptable to the patient that can reasonably
be undertaken in the hope of effecting a cure; and
(iii) any medical treatment reasonably available to the
patient is confined to the relief of pain, suffering and/or
distress with the object of allowing the patient to die a
comfortable death;
Part 2 Request for and giving of assistance
Rights of the Terminally Ill Act 4
(c) two other persons, neither of whom is a relative or employee
of, or a member of the same medical practice as, the first
medical practitioner or each other:
(i) one of whom is a medical practitioner who holds
prescribed qualifications, or has prescribed experience,
in the treatment of the terminal illness from which the
patient is suffering; and
(ii) the other who is a qualified psychiatrist,
have examined the patient and have:
(iii) in the case of the medical practitioner referred to in
subparagraph (i), confirmed:
(A) the first medical practitioner’s opinion as to the
existence and seriousness of the illness;
(B) that the patient is likely to die as a result of the
illness; and
(C) the first medical practitioner’s prognosis; and
(iv) in the case of the qualified psychiatrist referred to in
subparagraph (ii), confirmed that the patient is not
suffering from a treatable clinical depression in respect
of the illness;
(d) the illness is causing the patient severe pain or suffering;
(e) the medical practitioner has informed the patient of the nature
of the illness and its likely course, and the medical treatment,
including palliative care, counselling and psychiatric support
and extraordinary measures for keeping the patient alive, that
might be available to the patient;
(f) after being informed as referred to in paragraph (e), the
patient indicates to the medical practitioner that the patient
has decided to end his or her life;
(g) the medical practitioner is satisfied that the patient has
considered the possible implications of the patient’s decision
to his or her family;
(h) the medical practitioner is satisfied, on reasonable grounds,
that the patient is of sound mind and that the patient’s decision
to end his or her life has been made freely, voluntarily and
after due consideration;
Part 2 Request for and giving of assistance
Rights of the Terminally Ill Act 5
(i) the patient, or a person acting on the patient’s behalf in
accordance with section 9, has, not earlier than 7 days after
the patient has indicated to his or her medical practitioner as
referred to in paragraph (f), signed that part of the certificate of
request required to be completed by or on behalf of the
patient;
(j) the medical practitioner has witnessed the patient’s signature
on the certificate of request or that of the person who signed
on behalf of the patient, and has completed and signed the
relevant declaration on the certificate;
(k) the certificate of request has been signed in the presence of
the patient and the first medical practitioner by another
medical practitioner (who may be the medical practitioner
referred to in paragraph (c)(i) or any other medical
practitioner) after that medical practitioner has discussed the
case with the first medical practitioner and the patient and is
satisfied, on reasonable grounds, that the certificate is in
order, that the patient is of sound mind and the patient’s
decision to end his or her life has been made freely, voluntarily
and after due consideration, and that the above conditions
have been complied with;
(l) where, in accordance with subsection (4), an interpreter is
required to be present at the signing of the certificate of
request, the certificate of request has been signed by the
interpreter confirming the patient’s understanding of the
request for assistance;
(m) the medical practitioner has no reason to believe that he or
she, the countersigning medical practitioner or a close relative
or associate of either of them, will gain a financial or other
advantage (other than a reasonable payment for medical
services) directly or indirectly as a result of the death of the
patient;
(n) not less than 48 hours has elapsed since the signing of the
completed certificate of request;
(o) at no time before assisting the patient to end his or her life had
the patient given to the medical practitioner an indication that it
was no longer the patient’s wish to end his or her life;
(p) the medical practitioner himself or herself provides the
assistance and/or is and remains present while the assistance
is given and until the death of the patient.
Part 2 Request for and giving of assistance
Rights of the Terminally Ill Act 6
(2) In assisting a patient under this Act a medical practitioner shall be
guided by appropriate medical standards and such guidelines, if
any, as are prescribed, and shall consider the appropriate
pharmaceutical information about any substance reasonably
available for use in the circumstances.
(3) Where a patient’s medical practitioner has no special qualifications
in the field of palliative care, the information to be provided to the
patient on the availability of palliative care shall be given by a
medical practitioner (who may be the medical practitioner referred
to in subsection (1)(c)(i) or any other medical practitioner) who has
such special qualifications in the field of palliative care as are
prescribed.
(4) A medical practitioner shall not assist a patient under this Act where
the medical practitioner or any other medical practitioner or
qualified psychiatrist who is required under subsection (1) or (3) to
communicate with the patient does not share the same first
language as the patient, unless there is present at the time of that
communication and at the time the certificate of request is signed
by or on behalf of the patient, an interpreter who holds a prescribed
professional qualification for interpreters in the first language of the
patient.
8 Palliative care
(1) A medical practitioner shall not assist a patient under this Act if, in
his or her opinion and after considering the advice of the medical
practitioner referred to in section 7(1)(c)(i), there are palliative care
options reasonably available to the patient to alleviate the patient’s
pain and suffering to levels acceptable to the patient.
(2) Where a patient has requested assistance under this Act and has
subsequently been provided with palliative care that brings about
the remission of the patient’s pain or suffering, the medical
practitioner shall not, in pursuance of the patient’s original request
for assistance, assist the patient under this Act. If subsequently the
palliative care ceases to alleviate the patient’s pain and suffering to
levels acceptable to the patient, the medical practitioner may
continue to assist the patient under this Act only if the patient
indicates to the medical practitioner the patient’s wish to proceed in
pursuance of the request.
9 Patient who is unable to sign certificate of request
(1) If a patient who has requested his or her medical practitioner to
assist the patient to end the patient’s life is physically unable to sign
the certificate of request, any person who has attained the age of
18 years, other than the medical practitioner or a medical
Part 3 Records and reporting of death
Rights of the Terminally Ill Act 7
practitioner or qualified psychiatrist referred to in section 7(1)(c), or
a person who is likely to receive a financial benefit directly or
indirectly as a result of the death of the patient, may, at the patient’s
request and in the presence of the patient and both the medical
practitioner witnesses (and where, in accordance with section 7(4)
an interpreter has been used, also in the presence of the
interpreter), sign the certificate on behalf of the patient.
(2) A person who signs a certificate of request on behalf of a patient
forfeits any financial or other benefit the person would otherwise
obtain, directly or indirectly, as a result of the death of the patient.
10 Right to rescind request
(1) Notwithstanding anything in this Act, a patient may rescind a
request for assistance under this Act at any time and in any
manner.
(2) Where a patient rescinds a request, the patient’s medical
practitioner shall, as soon as practicable, destroy the certificate of
request and note that fact on the patient’s medical record.
11 Improper conduct
(1) A person shall not, by deception or improper influence, procure the
signing or witnessing of a certificate of request.
Penalty: $20,000 or imprisonment for 4 years.
(2) A person found guilty of an offence against subsection (1) forfeits
any financial or other benefit the person would otherwise obtain,
directly or indirectly, as a result of the death of the patient, whether
or not the death results from assistance given under this Act.
Part 3 Records and reporting of death
12 Medical records to be kept
A medical practitioner who, under this Act, assists a patient to
terminate the patient’s life shall file and, subject to this Act, keep the
following as part of the medical record of the patient:
(a) a note of any oral request of the patient for such assistance;
(b) the certificate of request;
(c) a record of the opinion of the patient’s medical practitioner as
to the patient’s state of mind at the time of signing the
certificate of request and certification of the medical
Part 3 Records and reporting of death
Rights of the Terminally Ill Act 8
practitioner’s opinion that the patient’s decision to end his or
her life was made freely, voluntarily and after due
consideration;
(d) the reports of the medical practitioner and qualified
psychiatrist referred to in section 7(1)(c);
(e) a note by the patient’s medical practitioner:
(i) certifying as to the independence of the medical
practitioner and qualified psychiatrist referred to in
section 7(1)(c) and the residential and period of practice
qualifications of the patient’s medical practitioner;
(ii) indicating that all requirements under this Act have been
met;
(iii) indicating the steps taken to carry out the request for
assistance; and
(iv) including a notation of the substance prescribed,
and such other information, if any, as is prescribed.
Penalty: $10,000 or imprisonment for 2 years.
13 Certification as to death
(1) A medical practitioner who, under this Act, assists a patient to end
the patient’s life shall be taken, for the purposes of section 34 of the
Births, Deaths and Marriages Registration Act, to have been
responsible for the patient's medical care immediately before death.
(2) A death as the result of assistance given under this Act shall not,
for that reason only, be taken to be unexpected, unnatural or violent
for the purposes of the definition of reportable death in the
application of Part 4 of the Coroner’s Act, or be a reportable death
by reason only of having occurred during an anaesthetic.
14 Medical record to be sent to coroner
(1) As soon as practicable after the death of a patient as the result of
assistance given under this Act, the medical practitioner who gave
the assistance shall report the death to a Coroner by sending to the
Coroner a copy of the notice given to the Registrar under section 34
of the Births, Deaths and Marriages Registration Act and so much
of the medical record of the patient (including that required by
section 12 to be kept) as relates to the terminal illness and death of
the patient.
Part 4 Miscellaneous
Rights of the Terminally Ill Act 9
(2) As soon as practicable after the end of each financial year the
Coroner shall advise the Attorney-General of the number of patients
who died as a result of assistance given under this Act and the
Attorney-General, in such manner or report as he or she thinks
appropriate, shall report the number to the Legislative Assembly.
15 Coroner may report on operation of act
The Coroner may, at any time and in his or her absolute discretion,
report to the Attorney-General on the operation, or any matter
affecting the operation, of this Act and the Attorney-General shall,
within 3 sitting days of the Legislative Assembly after receiving the
report, table a copy of the report in the Assembly.
Part 4 Miscellaneous
16 Construction of Act
(1) Notwithstanding section 26(3) of the Criminal Code, an action taken
in accordance with this Act by a medical practitioner or by a health
care provider on the instructions of a medical practitioner does not
constitute an offence against Part VI of the Criminal Code or an
attempt to commit such an offence, a conspiracy to commit such an
offence, or an offence of aiding, abetting, counselling or procuring
the commission of such an offence.
(2) Assistance given in accordance with this Act by a medical
practitioner or by a health care provider on the instructions of a
medical practitioner is taken to be medical treatment for the
purposes of the law.
17 Certificate of request is evidence
A document purporting to be a certificate of request is, in any
proceedings before a court, admissible in evidence and is prima
facie evidence of the request by the person who purported to sign it
or on whose behalf it is purported to have been signed, for
assistance under this Act.
18. Effect on construction of wills, contracts and statutes
(1) Any will, contract or other agreement, whether or not in writing or
executed or made before or after the commencement of this Act, to
the extent that it affects whether a person may make or rescind a
request for assistance under this Act, or the giving of such
assistance, is not valid.
(2) An obligation owing under a contract, whether made before or after
the commencement of this Act, shall not be conditioned or affected
Part 4 Miscellaneous
Rights of the Terminally Ill Act 10
by the making or rescinding of a request for assistance under this
Act or the giving of that assistance.
19 Insurance or annuity policies
The sale, procurement or issuing of any life, health or accident
insurance or annuity policy or the rate charged for such a policy
shall not be conditioned on or affected by the making or rescinding
of a request for assistance under this Act or the giving of that
assistance.
20 Immunities
(1) A person shall not be subject to civil or criminal action or
professional disciplinary action for anything done in good faith and
without negligence in compliance with this Act, including being
present when a patient takes a substance prescribed for or supplied
to the patient as the result of assistance under this Act to end the
patient’s life.
(2) A professional organisation or association or health care provider
shall not subject a person to censure, discipline, suspension, loss of
licence, certificate or other authority to practise, loss of privilege,
loss of membership or other penalty for anything that, in good faith
and without negligence, was done or refused to be done by the
person and which may under this Act lawfully be done or refused to
be done.
(3) A request by a patient for assistance under this Act, or giving of
such assistance in good faith by a medical practitioner in
compliance with this Act, shall not constitute neglect for any
purpose of law or alone constitute or indicate a disability for the
purposes of an application under section 8 of the Adult
Guardianship Act.
(4) A health care provider is not under any duty, whether by contract,
statute or other legal requirement, to participate in the provision to a
patient of assistance under this Act, and if a health care provider is
unable or unwilling to carry out a direction of a medical practitioner
for the purpose of the medical practitioner assisting a patient under
this Act and the patient transfers his or her care to another health
care provider, the former health care provider shall, on request,
transfer a copy of the patient’s relevant medical records to the new
health care provider.
Part 4 Miscellaneous
Rights of the Terminally Ill Act 11
21 Regulations
The Administrator may make regulations, not inconsistent with this
Act, prescribing all matters:
(a) required or permitted by this Act to be prescribed; or
(b) necessary or convenient to be prescribed for carrying out or
giving effect to this Act.
Schedule
Rights of the Terminally Ill Act 12
Schedule
section 7
REQUEST FOR ASSISTANCE TO END MY LIFE IN A HUMANE AND
DIGNIFIED MANNER
I,
have been advised by my medical practitioner that I am suffering
from an
illness which will ultimately result in my death and this has been confirmed by
a second medical practitioner.
I have been fully informed of the nature of my illness and its likely course and
the medical treatment, including palliative care, counselling and psychiatric
support and extraordinary measures that may keep me alive, that is available
to me and I am satisfied that there is no medical treatment reasonably
available that is acceptable to me in my circumstances.
I request my medical practitioner to assist me to terminate my life in a humane
and dignified manner.
I understand that I have the right to rescind this request at any time.
Signed:
Dated:
Schedule
Rights of the Terminally Ill Act 13
DECLARATION OF WITNESSES
I declare that:
(a) the person signing this request is personally known to me;
(b) he/she is a patient under my care;
(c) he /she signed the request in my presence and in the presence of the
second witness to this request;
(d) I am satisfied that he/she is of sound mind and that his/her decision to
end his/her life has been made freely, voluntarily and after due
consideration.
Signed: Patient’s Medical Practitioner
I declare that:
(a) the person signing this request is known to me;
(b) I have discussed his/her case with him/her and his/her medical
practitioner;
(c) he/she signed the request in my presence and in the presence of
his/her medical practitioner;
(d) I am satisfied that he/she is of sound mind and that his/her decision to
end his/her life has been made freely, voluntarily and after due
consideration;
(e) I am satisfied that the conditions of section 7 of the Act have been or
will be complied with.
Signed: Second Medical Practitioner
Schedule
Rights of the Terminally Ill Act 14
[Where under section 7(4) an interpreter is required to be present]
DECLARATION OF INTERPRETER
I declare that:
(a) the person signing this request or on whose behalf it is signed is
known to me;
(b) I am an interpreter qualified to interpret in the first language of the
patient as required by section 7(4);
(c) I have interpreted for the patient in connection with the completion
and signing of this certificate;
(d) in my opinion, the patient understands the meaning and nature of this
certificate.
Signed: Qualified Interpreter.
ENDNOTES
Rights of the Terminally Ill Act 15
ENDNOTES
1 KEY
Key to abbreviations
amd = amended od = order
app = appendix om = omitted
bl = by-law pt = Part
ch = Chapter r = regulation/rule
cl = clause rem = remainder
div = Division renum = renumbered
exp = expires/expired rep = repealed
f = forms s = section
Gaz = Gazette sch = Schedule
hdg = heading sdiv = Subdivision
ins = inserted SL = Subordinate Legislation
lt = long title sub = substituted
nc = not commenced
2 LIST OF LEGISLATION
Rights of the Terminally Ill Act 1995 (Act No. 12, 1995)
Assent date 16 June 1995
Commenced 1 July 1996 (Gaz S15, 13 June 1996)
Rights of the Terminally Ill Amendment Act 1996 (Act No. 5, 1996)
Assent date 20 March 1996
Commenced 20 March 1996
Statue Law Revision Act 1996 (Act No. 42, 1996)
Assent date 17 September 1996
Commenced 17 September 1996
Births, Deaths and Marriages Registration (Consequential Amendments) Act 1996 (Act
No. 27, 1996)
Assent date 28 June 1996
Commenced 1 January 1997 (s 2, s 2 Births, Deaths and Marriages
Registration Act 1996 (Act No. 26, 1996) and Gaz G49,
4 December 1996, p 5)
Statue Law Revision Act 1997 (Act No. 17, 1997)
Assent date 11 April 1997
Commenced s 16: 10 December 1997; rem: 1 May 1997 (s 2(2) and Gaz
G17, 30 April 1997, p 2)
3 LIST OF AMENDMENTS
s 3 amd No. 5, 1996, s 3; No. 42, 1996, s 6
s 7 amd No. 5, 1996, s 4; No. 17, 1997, s 15
s 9 amd No. 5, 1996, s 6
s 12 amd No. 5, 1996, s 7
ss 13 – 14 amd No. 27, 1996, s 5