The Voluntary Assisted Dying Legislation is due to come into effect in Western Australia on 1 July 2021.
The Government has been very active of late in ensuring everything is in place before the start date, including releasing a number of Guidelines, an Overview of the process and information sheets and conducting training for practitioners.
In summary, the following process applies for those wishing to access voluntary assisted dying (VAD):
- The person makes a request to a medical practitioner, who, if they accept, becomes the coordinating practitioner;
- The coordinating practitioner then assesses that person’s eligibility to participate. Relevantly, you need to be over 18 years of age, have full decision making capacity, on the balance of probabilities death will occur within a period of 6 months, or 12 months for a neurodegenerative disease, and the disease is causing suffering that cannot be relieved in a manner that the person considers tolerable;
- The coordinating practitioner then makes a referral to a second practitioner (consulting practitioner) for independent assessment;
- Once the eligibility has been confirmed by both the coordinating practitioner and the consulting practitioner, the person then makes a written declaration in the presence of 2 authorised witnesses. The written declaration is the formal request for access to voluntary assisted dying and must be made in the approved form. By completing the declaration the person confirms that their decision to access VAD is being made voluntarily and without coercion and that they understand the nature and effect of their decision. Once the form has been completed the coordinating practitioner submits it to the Voluntary Assisted Dying Board;
- After the declaration has been completed, the person then makes a further final request to the coordinating practitioner. The final request can only be made 9 days after the first request (but in some cases it can be sooner than this);
- The coordinating practitioner then does a final review to ensure the person still has decision making capacity, is acting voluntarily and without coercion, and still wants to access VAD.
The government is currently rolling out consultation and training for practitioners in anticipation of the legislation becoming operative.
The key criterion will be decision making capacity and that on the balance of probabilities, death will occur in 6 months (or 12 months for a neurodegenerative disease). There is however a further requirement that disease is causing suffering that cannot be relieved in a manner that the person considers tolerable.
Once the final review has been completed the Administration Process begins.
The person may choose to self-administer the voluntary assisted dying substance or have it administered by an Administrating Practitioner. If the voluntary assisted dying substance is to be self-administered, a Contact Person must be appointed before the coordinating Practitioner can write the subscription. The Contact Person is responsible for returning any unused or remaining substance to an Authorised Disposer to dispose of correctly. This may occur where for example the subscription is filled but the person changes their mind, or passes away before the substance is administered.
The prescription is filled by the Statewide Pharmacy Service, who is legally allowed to supply the voluntary assisted dying substance to the person, a Contact Person or the Administering Practitioner.
The practical matter is finding a medical practitioner, as not all medical practitioners will participate, either because they object or do not meet the qualification requirements. To meet the qualification requirements the practitioner must:
- Hold a specialist registration (and have practised for at least one year);
- Hold a general registration (and have practised for at least 10 years); or
- Be an overseas specialist with limited or provisional registration; and
- In each case meet the requirements of the CEO set out here. In essence, they include clinical practice minimum hours, no notations, conditions, undertakings or reprimands, and two referees.
The Department of Health website has a lot of information about Voluntary Assisted Dying.
It is expected that initially at least there will be a lot of interest in accessing voluntary assisted dying, the question will be how that translates into subscriptions for a voluntary assisted dying substance actually being filled.
Victoria implemented a voluntary assisted dying scheme on 1 July 2019. The Voluntary Assisted Dying report of operations July to December 2020 showed that since the commencement:
- 581 people were assessed as being eligible;
- 465 permit applications were made;
- 405 permits were issued; and
- 224 people died from taking the prescribed medications.
The legislation is a very big change for West Australians and will no doubt bring comfort to a great number of people who now have a choice about how to proceed.
If you would like to find out more, or have a confidential discussion regarding any matters raised in this article, don’t hesitate to contact our Darren Miller or Michaela Speering on 9488 1300 or at firstname.lastname@example.org.