“He didn’t die with his family around him as he wanted,” said Dr Carr, who sits on the board of Dying With Dignity Victoria.
“He died exactly as he was frightened of doing: alone in a nursing home facility. We really let him down.”
Victoria has the most conservative euthanasia laws in the world, with 68 safeguards in place.
Patients are required to meet strict criteria to be eligible, including having a terminal illness with no more than six months left to live, or 12 months if they have a degenerative neurological condition.
Two doctors must conduct favourable assessments of a person’s eligibility and a person has to make three separate requests to end their life, after initiating the process themselves.
They must also provide documentation proving they are an Australian citizen or permanent resident and have lived in Victoria for at least a year, including a birth certificate, driver’s licence, passport or utility bills.
Dr Carr said another two women in the final stages of cancer were denied access to the laws after being unable to provide paperwork proving they had lived in Victoria for the past year.
One of the women was born in the UK but has lived as a permanent resident in Australia since 1961. She is an Australian pensioner and registered to vote but has been unable to get approval because she cannot find her visa documentation.
“She’s lived in Victoria for 55 years,” Dr Carr said. “This is someone who is eligible in every sense except a demographic technicality.”
Dr Carr said the woman, who is close to death, felt “demoralised” by the process.
“She’s too tired and too unwell to overcome these bureaucratic barriers,” Dr Carr said.
“To take out citizenship now just seems too overwhelming. She’s resigned to the fact that she’s not going to be able to access voluntary assisted dying.
“That’s a terrible and tragic outcome because these very laws were put in place to help people like her.”
The other, an elderly women living in a nursing home, has misplaced her birth certificate and does not have a current driver’s licence or passport.
Dr Carr said while safeguards were paramount, the legislation surrounding the scheme was too rigid.
“There needs to be some capacity to recognise that very old and very sick people may not be good at paperwork and it’s not at the forefront of their minds when they are dying,” he said.
“There has to be flexibility where people who are eligible for the service are not denied it because of paperwork.
“The strict interpretation of the legislation means people who were never meant to be excluded from the scheme are being effectively locked out.”
Dr Carr called for the provision of a legal binding document, such as a statutory declaration, which could be signed by witnesses to prove a terminally ill person has lived in Victoria for more than a year when they are missing identity documents.
In July, mother-of-three Kerry Robertson, 61, died in a Bendigo nursing home after being the first Victorian to be granted a permit under the new voluntary assisted dying laws.
Late last month, the government confirmed 11 terminally ill Victorians have received approval to end their lives through Australia’s only voluntary euthanasia scheme.
A spokesman for Victorian Health Minister Jenny Mikakos said the voluntary assisted dying laws were working and there are no immediate plans to change them.
“People are accessing the system and progressing through it appropriately so they can have the compassionate choice that they deserve at the end of their lives,” he said.
“Victoria’s voluntary assisted dying model is the most conservative of its kind in the world and it’s entirely appropriate that it has a significant number of safeguards.”
He said the legislation was in its early stages and its operation will be guided by the Voluntary Assisted Dying Review Board, which is reviewing every application and death through the scheme.
To date, 327 doctors have registered for mandatory training required to be allowed to assist terminally ill patients who need medical help to die, about one third of whom are based in regional and rural areas.
The government expects up to 150 people a year will eventually use the scheme.
More information on voluntary assisted dying is available here.
Melissa Cunningham is The Age’s health reporter.