‘I’m running out of time’: Steve begged his doctors for a single piece of paper

A shortage of practitioners, stonewalling religious medical services and a law barring telehealth are preventing some terminally ill patients from accessing voluntary assisted dying (VAD).

The latest national report found people in NSW accounted for almost one-third of Australia’s 6621 VAD applications in 2024-25, despite NSW being the last state to legalise the practice, in November 2023.

Dr Linda Swan, the chief executive of Go Gentle, which compiled the report, said its main message was overwhelmingly positive: VAD laws were working safely and compassionately, with almost universal compliance.

But the increasing demand was left to a small, highly concentrated group of practitioners, leaving some patients fearing they may not find a doctor to help them.

Other terminally ill patients reported that religious healthcare institutions were actively blocking their applications and, in some cases, treating them “quite badly, like they’d done something wrong”, Swan said.

Practitioners have the right not to participate in VAD, but by law must not hinder a patient’s access.

Sydneysider Steve Lowe’s final months were marred by stress and frustration under the treatment of doctors at a faith-based hospital.

The 60-year-old had terminal oesophageal cancer and was adamant he would not spend the little time he had left undergoing gruelling treatments or being tube-fed.

“I need to go knowing everybody is OK and that everything has been done [and] there are going to be wonderful memories of me rather than the tubed-up guy in the ward,” Lowe said in footage recorded by Go Gentle.

He did not want his doctors to be involved in VAD. But he needed a letter confirming what they had told him: he had three to six months to live.

“[I was] stonewalled at every corner that I took with the doctors,” he said.

His sister, Allison Mueller, said Lowe had cared for their mother as she underwent chemotherapy for ovarian cancer before she died.

“He saw the distress and trauma she went through, and he said: ‘I will never do that’.”

Lowe’s anxiety rose with every rebuff.

“I’m running out of time. I want that letter. Please,” Lowe said. “Then finally, when I got it, I burst into tears.”

Lowe died at Concord Hospital on July 24, 2025, surrounded by his family and friends.

“He was very calm and ready to go,” Mueller said. “It just looked like he was drifting off to sleep. Then he made a ‘whee!’ sound, as if he was going down a slippery dip, and we all smiled because we knew he wasn’t in pain.”

A spokesperson for Catholic Health Australia, which represents the largest faith-based health and aged care provider, said its members’ commitment to compassionate end-of-life care does not change when a patient or resident is considering VAD.

“Our hospitals do not impede people from making choices that are available to them under the law, and we comply with all relevant provisions under state legislation,” the spokesperson said.

VAD accounted for about 2 per cent of deaths nationally in 2024-25, and a growing proportion of cancer deaths (one in 20) and motor neurone disease deaths (about one in three).

The report found that difficulties in finding VAD practitioners were particularly pronounced outside major cities.

Exacerbating the problem was a section in the Commonwealth Criminal Code enacted in response to internet suicide chat rooms, which prohibits telehealth for VAD assessments by making it an offence to use a carriage service to incite, encourage or provide instructions on suicide.

Swan said people were often too sick to travel for the multiple in-person consultations necessary to apply for VAD.

“Getting in a car and driving hours away when you might only have two good hours a day is really quite cruel.”

Swan said a simple, one-line fix to the code would exempt people lawfully abiding by state or territory VAD acts, “and the stalling from the federal government on this is becoming frustratingly inhumane”.

A spokesperson for the Albanese government said it was considering a range of complex issues arising from Commonwealth legislation and VAD schemes in consultation with the states and territories.

The report found NSW had 188 registered VAD practitioners, but Swan said many opt in to help one of their own patients, then stop. Fewer than half of Australia’s roughly 1600 VAD practitioners provided the service in 2024-25.

“If you look at how NSW is growing, Blind Freddy can see we need more health practitioners,” Swan said.

Swan hoped the current legislative review of NSW’s VAD laws would lead to financial penalties for institutions that obstruct access, and broaden the application time frame from six to 12 months for all conditions, to allow more people to undertake the complex process while they are still able.

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