“Rage, rage against the dying of the light.’ Welsh word-wiz Dylan Thomas’ angry _poem_ to his dying dad implied that the older man resisted passing. But for others, the end is welcome.

As palliative care staff know well, it’s the time when dignity becomes a mess of uncontrollable bodily functions and moods of despair.

For those who’ve lived lives of rugged independence, having to rely on others adds to the anguish. It doesn’t have to be.

Australia has cautiously become more considerate towards the seriously sick and their families. Patients demanding the right to make their own decisions now have voluntary assisted dying (VAD).

We’ve timidly resolved what to offer when the pain has become unbearable and recovery impossible – the Motherland hasn’t.

The Old Dart’s arcane political system includes the unelected elite able to stifle the will of the people through the House of Lords. Brits are looking to Australia for answers; the BBC is reportedly planning a documentary featuring the experiences of Ozzie friends and rellies of the terminally ill who’ve used VAD.

Three-quarters of respondents to a UK public poll reportedly said they’d “support making it lawful for someone to seek assisted dying,”. But when the proposal went to the House of Commons, the win wasn’t great – 314 MPs voted in favour and 291 against.

Even if it becomes law, implementation of VAD will take four years. An earlier clause in the bill had a wait of two years.

In Britain, assisted suicide has been illegal since 1961 and punishable by up to 14 years’ jail. Trying to kill yourself is not a criminal act, but having a helpmate breaks the law.

Euthanasia is regarded as either manslaughter or murder. The maximum penalty is life imprisonment.

In Australia, these issues are matters for state politicians, a frustration for those who think one nation should have one legal system. Like New Zealand.

The Northern Territory was a VAD pioneer with a law that didn’t survive. In March 1997, less than two years after it was introduced, Canberra used its power to forbid the Territories from handling VAD.

In its short life, the NT law was used by four people. Australian doctor Philip Nitschke, founder of the organisation Exit International and author of the Peaceful Pill Handbook, became the first doctor in the world to administer a legal, lethal, voluntary injection.

Before VAD came to Australia, those who wanted choice had to be well-off and buy a one-way ticket to Europe, usually Switzerland or the Netherlands.

This is where Nitschke has invented a 3D printed DIY "suicide machine", aka Sarco Pod (as in sarcophagus), using liquid nitrogen, allegedly delivering painless asphyxiation.

Although there are no public accounts of it being operated, that doesn’t mean it’s not being used privately.

Nine European nations now allow VAD. In the US, it’s known as MAID (medical aid in dying) and functions in 12 states, though not nationally.

Churches remain the main opponents, though less successfully as Australians turn away from formal faiths. Public opinion polls have consistently been in favour of VAD – about 70% since late last century.

However, MPs have been more influenced by organised submissions and forceful big-name advocates using the “slippery slope” argument.

They claim that if euthanasia is allowed, “then society will be inexorably led down the slippery slope to permitting other actions that are morally wrong”.

The major parties have refused to include VAD in their policies, so reform has been left to private members’ bills. Once again, public opinion has been ahead of the lawmakers worried about what bishops and newspaper editorials might say.

Many families have had deeply hurtful memories of relatives with terminal disease screaming in agony and demanding an end to the pain. They’ve been behind the demands for change.

Before VAD, helpers were sometimes hit hard by being turned from respecters of the law into street hoons because they exercised mercy.

The author recalls the distress of a progressive New Zealand Protestant congregation when police arrested a gentle elderly woman. She’d been privately advising a friend on ways and means, mainly from the published work of Dr Nitschke.

She was also seriously ill and later took her own life. New Zealand now has VAD.

Another fear invoked by the naysayers claims a legal right to die will be abused by svengali quacks employed by evil relatives seeking workarounds to hasten will settlements.

The sky still stays in place and, so far, law drafters have been expert enough to install watertight checks and balances.

Britain’s most notorious Doctor Death was the late Harold Shipman, who was convicted of 15 murders – mainly of the elderly during home visits. He may have killed 250 more over three decades, according to a later inquiry.

All this long before VAD laws were being considered, though still in the memory of older Brits, as he only perished in 2004.

Australia’s GP savage was William MacDonald; between 1961 and ‘62 he killed and mutilated five homeless homosexuals, though by then he was no longer employed as a doctor. He was caught because his knife work showed surgical skills.

He died a decade ago, his crimes seemingly forgotten by voters who were at last being heard.

Victoria passed the first VAD legislation in 2017, with all states following by late 2023. The NT and the ACT will start VAD next month.

The Catholics continue to refuse VAD:

“A consistent feature of our ethic of care is that we do not assist them to end their own lives or provide euthanasia. Our position is consistent with the Hippocratic ethic (do no harm), and is shared by the Australian Medical Association and the World Medical Association.”

This paragraph remains on the church website, although the AMA updated its “position statement” this year, basically allowing trained members to be involved in VAD procedures.

In 2019, the WMA pronounced that it remained “firmly opposed to euthanasia and physician-assisted suicide” even when the procedures are legal.

Some Australian private Catholic hospitals also have public facilities, yet qualified VAD doctors aren’t allowed to practise. So terminally ill patients wanting to use the law must transfer to a more willing facility.

This appears to contradict laws against discrimination, though the stand of the church has not been tested in court.

At the weekend, environmentalist and former Greens Senator Dr Bob Brown wrote of his encounter with a pulmonary embolism, aka blood clot:

“In recent years, nearly 3000 Australians have opted for voluntary assisted dying rather than enduring the more harrowing and expensive course of a terminal disease.

“That’s still a small percentage, but it’s good that the choice is now available and becoming more popular.

“Minimising the indignity of death helps maximise the dignity of life. A good life is one that optimised happiness and… leaves the planet better off.”

The views expressed in this article may or may not reflect those of Pearls and Irritations.