Personal stories from patients, family members and health practitioners continue to enhance the VAD Board’s annual report, assisting the Board’s understanding of voluntary assisted dying in Western Australia (pp 8 – 15). 

While most of the feedback received by the Board was positive, some of the reflections continue to highlight areas where the process could be improved. The reflections published in the 2024-2025 Report can be found via the WA Health Department website here - Voluntary Assisted Dying Board Western Australia Annual Report 2024-2025.

Here are just some of the reflections under the key themes: 

Gratitude for the option to choose voluntary assisted dying and experience a peaceful death

‘…Having watched and cared for my husband for so many years in and out of hospital and so many operations and close calls, to see him at peace with his decision was a beautiful experience. … The procedure was so very respectful and a very moving experience. The doctors were lovely and explained it all to us before and during. [My husband] had the most beautiful smile on his face just before he passed which left us all feeling so sad but happy for him.’ Family member

‘…Thank you. What a wonderful gift VAD is, making it possible for us all to be by my dad’s side laughing, talking and singing with him till his last moment. … VAD is a gift, an important part of patient care and a valuable option for anyone facing end of life.’ Family member

‘…Dad was especially grateful and it gave him the gift of going out “on a high”.. the change in dad in the last 24 hours is something we never expected and for glimpses he was just our dad.. not our sick and dying dad.. I will never forget being able to spend those last few hours with him at home, in his shed and drinking one last glass of [champagne] around the kitchen bench with him. While I wish he didn’t have to leave us, the way he did leave was the best possible way that could ever be imagined…’ Family member

‘…The final process was dignified and simple, with [my wife] in total control of proceedings. As difficult as it was to watch my wife die, I know that she was more than ready. We were able to hug, kiss, lay in each other’s arms one last time. Hold hands and look into each other’s eyes with one final statement to each other. It was moving and surreal, I doubt I could have handled her going on as she was….’ Family member

Care navigators, practitioners, pharmacists and HSP Coordinators are highly valued for guiding patients and families through the voluntary assisted dying process with the utmost care and compassion

‘…The work that you do is so vital – I cannot even let myself imagine what dad’s last days would have been like if not for VAD. I remember how quickly everyone worked together to get the expedited process in place. Without this dad would have suffered so much and instead of looking back at his last 2 days as special, happy memories filled with love, I am quite sure the alternative would have been traumatic for everyone and that would have been our last memory...’ Family member

‘…It’s 90 hours before I pass. I feel at peace with the world in large part due to the caring, sensitive help my wife and family have (and friends) been shown by [practitioner], [Care Navigator], others we have spoken to. I know what is ahead and only wish for the courage and strength shown by those we know from VAD. They are so committed in bringing peace to those in real need – like me. Vocation is not a word used much these days and before my need for their care, I reserved it for ‘angels’ who rendered humanity to others in need…’ Patient

Poor communication and lack of understanding of the voluntary assisted dying process in the community and amongst practitioners causes delays to accessing voluntary assisted dying as an end of life choice

‘…Despite my dad’s request repeated to his [practitioner] to “wind things up”, [my dad] did not receive any written information about the VAD process. .... My dad’s GPs also seemed unaware they have a requirement to provide VAD approved information once their patient makes an enquiry about VAD… At a deeply distressing period for my dad with loneliness, extreme nausea and frightening episodes of breathlessness, even a few days would have made a real difference to my dad’s sense of comfort about progressing towards his goal. … so much suffering and uncertainty could be alleviated if this information is easily and readily available as soon as they raise this query with their health practitioner. I hope in the near future, VAD information is made freely available to those facing end of life...’ Family member

‘…[I understand that] the medical team … sometimes give a “cooling off/ thinking” time with the patient before putting in the First Request paperwork – it would be good to do more education, so they realise that is already built into the VAD process and that the sooner we get involved the better.…’ Health practitioner

Patients and family members seek amendments of eligibility criteria and processes for accessing voluntary assisted dying

‘…The requirement for a prognosis of death within 12 months is a nonsense given the nature of degenerative neurological conditions. Surely having a terminal illness and poor quality of life should be a sufficient threshold to meet? … Waiting to die of natural causes is mentally exhausting and distressing not only for [my wife], but her family too. The current legislation should be amended to remove the required prognosis of death within the currently stated 12 months for degenerative neurological conditions. A person suffering a terminal illness should be allowed to die with dignity at a time of their choosing, not in accordance with an arbitrary timeframe. We would be rightly criticised for denying our pets a compassionate death, yet the current VAD legislation denies our loved ones the same kindness…’ Family member

‘…My Dad was diagnosed with un-treatable B Cell Lymphoma while in the hospital. He was not able to access VAD because he did not have enough time from diagnosis to death… Dad had always been an advocate of voluntary dying and he made it no secret to his family that he wanted to be in control of his own death when there was nothing else that could be done… We began the VAD process but did not manage to make it through as from diagnosis to death was only 3 weeks. Being with him in his last 3 weeks was traumatic and painful and we wished he had access to VAD as we believe it would have been much more humane than what he went through. …I feel that the process needs to be quicker or that you can begin the process prior to receiving notice that you are dying. Why can the first steps not be undertaken whilst a person is well and then the substance be given as soon as diagnosis has been received. Much like we write an advanced health directive, or choose to donate our organs and have this witnessed and signed well in advance of a life and death event. …Please don’t stop trying to make it more accessible to those who want it....’ Family member

The low number of trained voluntary assisted dying practitioners has put pressure on and exposed vulnerabilities in the system

…We have unrelenting demand. We have generous doctors who go above and beyond but cannot ever seem to get on top of the workload and requests. … chronic under-resourcing and inability to access doctors is causing widespread problems and patient distress. …we need to grow a more sustainable system, or we will be facing critical levels of concern very soon. …Staff are exhausted and can no longer just push harder... For most of us involved in this work, the alleviation of suffering is core to what motivates us. I feel that much of my work these last months is supporting patients to manage the emotional distress that the system and delays are causing.’ Health practitioner

Patients who are eligible to access voluntary assisted dying expressed alleviation of their distress and suicidal ideation

‘It is a great relief to me to have VAD in place. Up to this point I [was] thinking I would have to take matters into my own hands, despite the impact on my family. I came very close on at least 2 occasions. The only thing that stopped me was concern for the unlucky person who would have to discover my body. I spent too much time on my back, in pain ruminating on this. Thank you for relieving me of that burden. …’ Patient

Individual and institutional obstructions to accessing voluntary assisted dying has caused distress and delays to patients in private facilities which has impacted their ability to exercise their lawful end of life choice and human right to have their health choices respected

‘I have been distressed today by witnessing the effects of the unnecessary obstacles [private] Hospice impose on their patients who want to pursue a legitimate end of life option. The patient was admitted to [private] Hospice last week. [His son] was going to wheel him over to the [public] outpatient clinic in a wheelchair [for his final assessment, as the private hospital would not permit this on their premises], but when today came, [the patient was] very weak, has an NG tube and continuous oxygen, and spends almost all his time in bed. And it is raining. Getting to the outpatient department was too far, so [we] compromised by seeing him in the shelter of a cafe that was closer to the hospice. It actually wasn’t that sheltered, and certainly not private. What part of this is OK?…’ Health practitioner

If you have a personal story to tell, please let us know by sending an email to:

President, Stephen Walker at [email protected]