Voluntary Assisted Dying Board Annual Reports

In the 2022 annual report, the Board identified key areas for improvement to VAD, including:

• the need for more practitioners to participate in and complete the Western Australian Voluntary Assisted Dying Approved Training and to be properly remunerated;
• amendments to the Commonwealth Criminal Code Act 1995 relating to the use of a carriage service that has limited the use of Telehealth for voluntary assisted dying in Western Australia; and
• Adequate and ongoing funding to support the operation of the Voluntary Assisted Dying Act 2019 and access to voluntary assisted dying for eligible Western Australians including regional residents.

The Board also identified areas for review under the Act, including self-administration.

About this issue the report stated that section 58 of the VAD Act requires a person who has elected to self- administer the VAD substance to prepare and ingest the substance independently, and recommends that the Contact Person be authorised by the Act to assist the person if necessary.                                                                                                                                                                                                                                                                                                                                                                                   DWDWA does not agree with this interpretation of section 58, which states that the person may receive, possess, prepare and self-administer the substance. It is silent on the issue of assistance, in that it neither authorises nor prohibits assistance for these actions. It is the Department of Health’s Guidelines for Practitioners that articulates a prohibition on assistance and is inconsistent with the Act in this regard.

DWDWA agrees that the Act should be amended but would recommend that the Contact person, a family member or doctor should be specifically authorised to help the person to self-administer if requested to do so. In addition, we recommend that a medical or nurse practitioner who is qualified to provide VAD services should be authorised to intervene in a process of self-administration if he or she considers it clinically advisable, and to provide practitioner administration in the place of self-administration.

Second VAD Board Annual Report for the year ended 30^th June  2023

In the Annual Report for 2023, the Board identified additional areas for improvement to VAD to those identified in the 2022 Report.  At the time of writing (January 2025), the Federal Government has remained immovably recalcitrant on the issue of Telehealth, but the number of VAD practitioners has increased to 114 and some progress had been made in relation to remuneration and equity of access for regional Western Australians.

Of the other areas for improvement and review identified in the 2023 Report, DWDWA regards the following as the most significant:

Institutional conscientious objection

Concerns by VAD stakeholders were brought to the attention of the Board about institutional conscientious objection restricting the ability of residents in old age homes, palliative care hospices and other health service facilities from accessing VAD. This is an important and ongoing issue. There are no protections for a person seeking VAD in such facilities, which in many cases are the person’s only home. Even the simplest of the Board’s recommendations – namely that there should be full disclosure of an institution’s policy on VAD to enable people to make an informed choice before moving in - has not been implemented.

Citizenship and Residency requirements

The Board recognised the hardship caused by these criteria for those who have lived in Western Australia for many years but are not citizens or permanent residents; those who have a substantial connection to WA but have not been ‘ordinarily resident’ in the state for the requisite 12 month period before making a first request for VAD; and for those who have been assessed as eligible for VAD in another Australian state but (for family or other reasons) want to come to WA to die. Since all Australian states now have VAD laws, such a restriction is no longer needed. The Board has made various recommendations about the amendments to the Act that are necessary to ameliorate the harshness and inequity of these requirements.

Nurse practitioners

Given the number of people who seek VAD in Western Australia, there is considerable pressure on the doctors who satisfy the qualification requirements in the Act and who have completed the mandatory training.

The Board recommended that nurse practitioners ‘be utilised more effectively’ in the VAD process, and specifically that the Review ‘should include consideration of nurse practitioners participating as Coordinating or Consulting Practitioners in the voluntary assisted dying process’.

DWDWA endorses these recommendations, which would require amendments to the VAD Act.  As observed elsewhere on this website, It is a travesty that the Review panel was obliged by the Minister to disregard even recommendations made by a statutory body in carrying out its specified functions under the Act.

Third VAD Board Annual Report for the year ended 30^th June  2024

Personal Reflections

There was a notable increase in the number of stakeholders who wrote to the Board of their experiences of VAD in WA’s third year of having this as an end of life choice. These (de-identified) stories have become an increasingly important part of the Board’s annual report (pp 7 – 12).

Much of the feedback received by the Board was positive, but there was also frustration and grief about the barriers to access, in particular the time taken to move through the process and the restrictive eligibility criteria.

These stories can be found on this website under Stories here.

Recommendations

The Board’s recommendations in the third annual report – including those in its submission to the Review - can be found on pages 52 – 55 of the Report.

In essence they repeat the recommendations of the previous two reports and raise a number of additional concerns. In particular there is focus on:

• Barriers to access and delays within the WA health system, “including public and private hospitals providing public health services as contracted health entities”;
• The anomaly that although nurse practitioners can be authorised practitioner administrators they are not authorised to complete a patient’s death certificate;
• The “inadequate access to practitioners presents a risk to the sustainability and operation of voluntary assisted dying in Western Australia”;
• The lack of public awareness and the Board’s concern that “many patients are beginning the voluntary assisted dying process late in the course of their illness…”; and reported cases where “health practitioners provided inaccurate or delayed responses to requests for information on voluntary assisted dying to patients and family members”; and
• The recalcitrant Telehealth issue.

Note: The above is just a summary: to see the recommendations in full please read pages 52 – 55 of the Report.

Important Note re WA State Election on 8 March 2025:

We all know that there is a state election in WA in March 2025. We need to use this opportunity to make the Voluntary Assisted Dying Act 2019 the best legislation it can be.

For more information, see ABOUT/State Election 2025 on this website.