FACT: The End of Life Choices cross-party Parliamentary Committee’s ‘My Life, My Choice’ report, which recommends legalising voluntary assisted dying with appropriate safeguards also acknowledges and recommends more funding and resourcing for the palliative care sector across WA.
Here are some direct quotes from the report about palliative care:
“The Committee found that too many Western Australians are experiencing profound suffering as they die. This is, in part, due to inequitable access to palliative care. Palliative care aims to provide treatment to alleviate symptoms from diseases and illnesses that cannot be cured. However, it is clear from the evidence that even with access to the best quality palliative care, not all suffering can be alleviated. Palliative care physicians themselves acknowledge this.”
“A competent individual’s absolute right to refuse food and water, and to refuse medical treatment is clear in the law. At the end of life, those refusals are not suicide. Health professionals providing palliation for those who choose this difficult path are not aiding a suicide – they are providing good palliative care. There is, however, uncertainty among some health professionals about both these absolute rights for individuals and the protections afforded to health professionals under the law.”
“Western Australia has the lowest number of publicly funded in‐patient beds per capita and access to specialist palliative care is limited across the state. Access is even further limited in rural areas and almost non‐existent in remote regions. In an extraordinary admission, the WA Country Health Service told us ‘there is limited oversight, coordination and governance of medical palliative care services across WA Country Health Services’. This, together with the barriers to access across the state generally, must be urgently addressed by the State Government.”
There were 12 recommendations relating to palliative care:
- The Minister for Health should facilitate the establishment of an inpatient specialist palliative care hospice providing publicly funded beds in the northern suburbs of Perth.
- The Minister for Health should ensure that community palliative care providers, such as Silver Chain, are adequately funded to provide for growing demand.
- WA Health should conduct an independent review, from a patient’s perspective, of the three models of palliative care in Western Australia: inpatient, consultative and community. The review should examine the benefits and risks of each model and the accessibility of each across the state as well as the admission criteria for hospice care.
- WA Health should implement a process to determine the unmet demand for palliative care and establish an ongoing process to measure the delivery of palliative care services with the aim of making those services available to more Western Australians.
To improve understanding of palliative care in Western Australia, WA Health should:
- Establish a consistent definition of palliative care to be adopted by all health professionals;
- Provide comprehensive, accessible and practical information and education services about palliative care to health professionals and the community;
- Encourage knowledge sharing by palliative care specialists with their generalist colleagues; and
- Establish a palliative care information and community hotline.
- The Minister for Health should prioritise policy development and improved governance structures for the delivery of palliative care by WA Country Health Services.
- The Minister for Health should ensure regional palliative care be adequately funded to meet demand.
Once a consistent definition of palliative care has been established by WA Health, the Minister for Heath should appoint an independent reviewer to audit:
- The level of palliative care activity actually provided in Western Australia’s hospitals and compare it against the level of recorded palliative care activity.
- The actual spend by WA Health on palliative care on a year-by-year and like-for-like basis, across all aspects of palliative care provision, including community service providers, area health services (including WA Country Health Services) and delineating between inpatient, consultancy and community care.
- WA Health should provide ongoing professional development for all health professionals – beyond undergraduate training – about the right of a patient to refuse medical treatment. WA Health should also specifically amend the Consent to Treatment Policy to provide comprehensive information in relation to a competent patient’s absolute right to refuse medical treatment.
- WA Health should provide ongoing professional development – beyond undergraduate training – for all health professionals regarding the absolute right of a competent patient to refuse food and water. Training should also include those working in aged care.
- WA Health should provide ongoing professional development – beyond undergraduate training – for health professionals about the transition from curative to non-curative end of life care and effective discussions with patients and families about futile treatments WA Health should consider how it might effectively educate the community about end of life decision-making, and implement appropriate health promotion in this area.
- WA Health should provide specific guidelines on the use of terminal sedation by health professionals for patients at the end of life. These guidelines should include an agreed name and definition of the treatment. As per any other medical treatment, the requirement for informed consent must be clear. The treatment must be specifically noted in the medical record as ‘terminal sedation’.
The full report can be found here.