Dying Paramedic’s Final Plea: End 'Cruel' Federal Laws Restricting Telehealth for Assisted Dying

A terminally ill Adelaide woman preparing to end her life under voluntary assisted dying (VAD) laws has issued a final plea to the Prime Minister to reform federal legislation restricting telehealth access.

Sandra Sarantou, 58, was diagnosed nine weeks ago with the same aggressive lung cancer that took her father's life. With medication no longer relieving her intense nerve pain, nausea, and dizziness, she is preparing to die on her own terms. Ms Sarantou watched her father experience a prolonged and painful death before VAD was legalised across the country, making her "grateful" to have this option. However, she was shocked to discover that some Australians are blocked from accessing VAD because of geographic barriers.

"It's even a struggle just to move from one end from the house to another … for those people to travel hours to possibly see a doctor and not get the chance for VAD is just horrific," Ms Sarantou said.

VAD is currently legal across all Australian states and is expected to be legislated in the Northern Territory this month. While state laws allow telehealth for early-stage end-of-life consultations, a provision in the Commonwealth Criminal Code, originally designed to prevent the use of carriage services to incite suicide, has been interpreted as prohibiting doctors from using online tools, phone, or email to discuss VAD. Consequently, dying patients in rural and remote areas, already facing severe doctor shortages, must travel long distances for face-to-face appointments. For some, physical deterioration makes this travel impossible, forcing them to miss out entirely.

The Fight for Legislative Reform

There is mounting political pressure to change the law. Federal Independent MP Kate Chaney has introduced a private member's bill to amend the Commonwealth Criminal Code, while Greens Senator Sarah Hanson-Young plans to introduce a similar bill to the Senate this month. Labor's own rank-and-file delegates also recently voted to alter the party platform to support telehealth for end-of-life care, establishing a conscience vote for MPs.

However, Prime Minister Anthony Albanese reportedly remains personally opposed to the change. While he supports VAD, he has argued that in-person consultations protect vulnerable patients from exploitation. Attorney-General Michelle Rowland has also expressed reservations regarding the risk of elder abuse.

Ms Sarantou, who spent 13 years working as a paramedic in rural South Australia, said she felt "guilty" that her location granted her access while others are excluded. "Their time is ticking and they have to suffer. It's cruel, it's not fair," she said. She has appealed directly to the Albanese government: "Please change these laws, make it fair and available for everyone despite where they are living."

An Issue of Equity

Advocacy group Go Gentle reported in its latest State of VAD report that 39 per cent of VAD applicants in 2024-25 were from rural, regional, and remote areas. Dr Scott Lewis, a South Australian general practitioner who flies his own plane to reach regional patients, sees approximately two new VAD patients per week. He highlighted that doctor shortages and a lack of Medicare funding prevent many regional doctors from offering the service.

"[Rural and remote] doctors are so busy as it is, that they simply haven't had the time or thought to extend their practice into voluntary assisted dying," Dr Lewis said. He added, "I don't make much money from it, to be blunt."

Dr Lewis stated he felt "a sense of failure" when remote patients missed out on VAD. "To see the hurt in family members who've had to see their loved ones suffer and … come so close to being approved for voluntary assisted dying but not quite get there … it's hard at times."

Ensuring Safeguards Remain Intact

University of Sydney health law expert Dr Christopher Rudge argued that telehealth could be integrated without weakening patient protections. "Across the country the states have very rigorous and documented process for permitting someone to undergo a VAD procedure, and all of those would apply whether it's by telehealth or any other circumstance," he said.

He explained that while early-stage discussions could occur remotely, other parts of the process, such as witnessing, would still need to occur in person. State guidelines require VAD applicants to have a terminal diagnosis with death expected within a year, and they must undergo assessments by two independent practitioners.

"My understanding is that the telehealth communications would occur at an early stage of the process but that at some stage, the witnessing and some other processes, would presumably need to occur in an environment where doctors are present," Dr Rudge said. While he is "sympathetic" to concerns regarding elder abuse, he believes the risk is managed. "In circumstances where informed consent is not clear, the in-person consultation is the best place for those questions to be answered. And so, I can understand why people could be concerned," he added.

A Final Farewell

Preparing for her death, Ms Sarantou has maintained openness and humour with her son. "We had the idea to put my ashes into a big party cracker … and then everybody has got a bit of my ashes," she shared. "But it is hard. It is emotional at times. But we just try to make the best out of it."