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Matt Woodley

07 Aug 2019
News

WA Parliament to vote on voluntary assisted dying

Matt Woodley

7/08/2019 2:18:13 PM

The bill includes 102 safeguards and follows the largest community consultation ever undertaken by WA Health.

WA Premier Mark McGowan with Belinda Teh
WA Premier Mark McGowan with voluntary assisted dying campaigner Belinda Teh outside WA Parliament House in Perth. Image: AAP

The proposed legislation is similar to the Victorian model, which began in June and has already been accessed by at least one patient.
 
In order to access voluntary assisted dying in WA, a person would need to be: 

  • aged over 18
  • an Australian citizen or permanent resident
  • a resident of the state for at least 12 months. 
Patients would need to have a disease, illness or medical condition that is advanced, progressive and likely to cause death within six months, or 12 months if it is a neurodegenerative condition. The condition would also need to be causing suffering that cannot be relieved in a manner that the person considers tolerable.
 
The bill’s introduction was announced on the same day voluntary assisted dying campaigner Belinda Teh arrived on the steps of WA Parliament following a 4500 km walk from Victoria in honour of her mother, who passed away ‘in agony’ in 2016.
 
WA Premier Mark McGowan will allow a conscience vote on the issue. He said the Voluntary Assisted Dying Bill is the culmination of a ‘comprehensive’ consultation process that represents practical policy and ensures the specific needs of the WA community are addressed.
 
‘Many people across the community who have had their parents or loved one pass away in agony want something done, and that’s what this is about,’ he said.
 
‘We have been looking at this issue in its entirety … voluntary assisted dying is a significant issue for WA and every member of parliament deserves the right to speak and vote on the legislation.
 
‘I would urge for a respectful, factual and dignified debate.’
 
The WA Government commissioned two major reports into voluntary assisted dying that have been tabled in the past year – the Joint Select Committee report on End of Life Choices and the Final Report of the Ministerial Expert Panel on Voluntary Assisted Dying.
 
However, the final bill calls for a more conservative version than the process recommended by the ministerial expert panel, which comprised a number of palliative and aged care experts, including RACGP life member Dr Scott Blackwell.
 
The proposed process requires three requests by the patient; two verbal with a written declaration in between, witnessed by two independent people.
 
A minimum of two independent medical assessments would need to be undertaken by two doctors, and a final review done by the co-ordinating doctor. Palliative care and treatment options available to the patient, and the likely outcomes of that care and treatment, are among a list of assessment measures and information included in the medical assessment phase.
 
A Voluntary Assisted Dying Board would be formed as a measure to ensure proper adherence, while it would also have a monitoring and advisory role on matters related to voluntary assisted dying.
 
The RACGP made a formal submission to the Joint Select Committee’s report in 2017. It acknowledges the desire for change from many in the community, but emphasises GP involvement will be determined by personal, cultural and religious beliefs, and the profession’s guiding ethical principles.
 
‘While the RACGP neither supports or opposes the introduction of laws to legalise voluntary assisted dying, we believe both patients and GPs must be appropriately supported if any legislation for voluntary assisted dying comes into the clinical setting,’ the submission states.
 
‘Doctors willing to participate in voluntary assisted dying should opt into the process and receive the necessary training.
 
‘GPs who choose not to participate should not be placed in the difficult position of responding to pressure from patients and their families to engage, nor should those GPs impede access to voluntary assisted dying for their patients if that is their wish.’
 
Debate on the bill is slated to begin in three weeks.

legislation voluntary assisted dying Western Australia

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Peter Coleman   8/08/2019 8:30:39 AM

There are no safeguards , people do not need to die in agony with good palliative care. Australia and doctors beware. Listen to palliative care doctors who have had so much experience. Patients will not trust doctors involved in killing another human being and neither would I We doctors treat symptoms and can help with emotional pain. Do not pass this law WA politicians , Peter Coleman

Dr Janice Sheringham   8/08/2019 1:15:48 PM

Peter, you are SADLY mistaken! Even the best palliative care fails many, and even if pain can be generally controlled, there are many other aspects of terminal decline which, for so many people, are indeed intolerable and unacceptable. My 50+ years #justaGP gives me the necessary perspective on this issue, and one I totally support as do the majority of Australians.

Dr Peter j Strickland   8/08/2019 2:03:58 PM

No Janice --you are mistaken here. As a GP of 50+ years myself there is the Hippocratic oath to consider here. One can support voluntary assisted death, but as a medical practitioner you are ethically responsible to not be part of it. Those who administer drugs for VAD or recommend VAD must unfortunately NOT be a medical practitioner at all, but the patient alone. The test for VAD in the general community is to ask patients to self-administer the fatal drugs in the presence of relatives, or get the relative who agrees with VAD to administer to their child, mother, father etc. these fatal drugs-- not a pharmacist. In all cases of VAD there should be an obligation legally for a post-mortem signed off by a pathologist, medical referee for the coroner, and a judge of the Supreme Court -- in that case it could be beneficial and prove the diagnosis absolutely. Palliative care CAN treat intractable pain, but its dilemma is the patient is not cognisant to be able to sign off on VAD then.

Margaret Sing   8/08/2019 4:28:43 PM

Dr Coleman's view about the universal efficacy of palliative care is not supported by the data from 135 palliative care services reported through the Palliative Care Outcomes Collaboration (https://ahsri.uow.edu.au/pcoc/index.html) which has the aim of evidence-based improvement, evidence and testimonials to the Victorian and WA inquiries into end of life choices, and the views of top palliative care experts. As Professor of Palliative Care, Michael Ashby, told a Tasmanian Parliamentary Inquiry in 2016: "There isn't a single area of medicine that has a 100 per cent score, so why would palliative care be any different? Any claims by us that we can relieve all pain are patently nonsense. I think it is very foolish of certain people in our specialty around the world to convey the impression that they can. I don't think anybody these days would make that claim."

Margaret Sing   8/08/2019 5:48:43 PM

Yes there is the Hippocratic Oath to consider including the bits about swearing "by Apollo Physician and Asclepius and Hygieia and Panaceia and all the gods and goddesses", promise not to do surgery or abortions, the promise to "hold him who has taught me this art as equal to my parents and to live my life in partnership with him, and if he is in need of money to give him a share of mine", and and there's more - "to regard his offspring as equal to my brothers in male lineage and to teach them this art — if they desire to learn it — without fee and covenant". Doctors who use the "Hippocratic Oath" to try to dictate to their colleagues are remarkably quiet about these bits.

Barry Fatovich   8/08/2019 7:22:49 PM

As a palliative care GP I do not support the proposed legislation. There are many reasons, including, how many patients who have been told they only have 6 months to live and the Doctor has got it wrong, if the legislation is introduced, how many people will die who would have otherwise lived. It is easy to frighten people about end of life issues. An important part of our role is to help people who are suffering, not because they have uncontrollable pain, but because they cant do what they want to do? One of the common reasons palliative care patients have pain, is their reluctance to take pain relieving medication. Death anxiety is inversely proportional to life satisfaction according to Irvin Yalom who has worked with many dying people.

Barry Fatovich   8/08/2019 7:28:06 PM

I have looked at the website Margaret Coleman cites and cannot find her assertion, what I did find was the following , quote "For people receiving palliative care, severe pain or other distressing symptoms are rare in the final stages of life."

James Brown   9/08/2019 9:35:56 AM

Without a voluntary euthanasia law, lots of cancer patients and people with ALS would have joined Al Qaeda.

One of my cousins joined Al Qaeda. I tried to talk her out of it, but she wouldn't listen.

By the time the police arrested her, she had given 50 million dollars to Al Qaeda.

Margaret Sing   11/08/2019 2:40:38 PM

Dr Barry Fatovich: I can only assume your look at the PCOC website and reports was a very cursory one and you were satisfied with cherry-picking one sentence which itself refers only to the last few days of life. In relation to those last few days, "around 5% of people experience severe distress from some, not all, of these problems". There is significantly more information in reports about the difficulties for all services in reducing moderate or severe symptoms to mild or absent. In fact, the benchmark to do this is only 60% and even that is not met by many services. And statistics don't show the suffering and distress for the patients with those symptoms.

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