Voluntary assisted dying advocates urge expanded access as WA laws are reviewed

Helen George’s mother, Olive, lived an active and independent life, regularly visiting her daughter in Perth from her home in the UK, until she was in her 90s, when she began to deteriorate physically.

“From the moment she lost her mobility, she said, ‘I’ve had a good life. I’d be very happy to leave now,'” she said.

Eventually, Olive’s care needs became so great that she had to enter an aged care facility, causing her great distress.

“To the very end, she was mentally astute. She knew exactly what was going on, she knew exactly what was going on in the world,” George said.

He said his mother repeatedly expressed her wish to be able to access voluntary assisted dying (VAD), before eventually passing away at the age of 99 following a stroke.

“She couldn’t swallow anymore and it was really heartbreaking because she couldn’t eat,” he said.

Olive died in the UK, where no VAD exists.

Back home in Perth, Ms George is a passionate advocate for changing Western Australia’s VAD laws, which are only accessible to patients with a terminal diagnosis.

He wants laws to be passed that allow elderly people who feel they have reached the end of their lives to access voluntary euthanasia.

“What happened to my mother was cruel,” she said.

“It is a human right to be able to choose, without a doubt. I don’t want anyone to experience what I experienced, seeing my mother die in that way.”

WA laws under review

Voluntary assisted dying became legal in Western Australia in July 2021 and is available to people with a medical condition or illness that is expected to cause their death within six months, or 12 months for neurodegenerative diseases.

Three years after the introduction of VAD in WA, the state government has set up an independent panel to investigate how well the laws are working.

Charging…

But the review is unlikely to provide the access to VAD that Helen George and other advocates would like to see, with Health Minister Amber-Jade Sanderson making clear that it is “not about changing the scope of the VAD Act” but rather about seeing whether the laws are working as intended.

Speaking at an ABC Radio Perth Spotlight forum on VAD this week, Dr Clare Fellingham, clinical director for VAD at East Metro Health Service, said VAD had proven more popular than anticipated when the laws were introduced.

“During the first two years of operation, 200 to 300 percent more people (than projected) are seeking access,” Dr. Fellingham said.

“In the second year of operations, it accessed 33 percent more than in the first year of operations.”

Figures show that in the first two years, 446 people died by voluntary assisted dying in Western Australia.

The median age was 75 years and 73 percent had cancer, while 86 percent were in palliative care.

Community feedback on VAD

Associate Professor Eyal Gringart from Edith Cowan University in Perth recently conducted a national survey of 796 people to investigate community attitudes towards VAD.

The results have not yet been published, but he said preliminary findings showed broad support.

“The majority of those 796 people basically said they consider it a basic human right,” Dr. Gringart said.

“They also said there should be more discussion in general about death and dying in general.

“The majority also said that, in their opinion, VAD should be legal.”

However, the majority of respondents also said that “palliative care should be improved to the point where voluntary assisted dying should not even be considered,” he said.

The survey also indicated a lack of support for VAD in cases where people did not have a terminal illness or overwhelming suffering, but had simply reached an advanced age.

“But when we asked people about the possibility of voluntary assisted dying being made available to those who are fed up with living, they strongly disagreed,” he said.

“When we asked them about the possibility of offering voluntary assisted dying regardless of people’s age, they also totally disagreed with that.”

Their survey also showed strong disagreement with allowing VAD for people who were not in poor health or who suffered from mental illness.

“But at the same time, they are concerned that a dangerous situation is developing that could lead to people using this service when they could otherwise have received help.”

Call for a code of conduct

Labor MP Sally Talbot, a member of the independent panel currently reviewing the laws, said that when VAD was first introduced in WA, adequate safeguards were a key concern.

“We knew that if we were going to produce a law that would be supported by the majority of Western Australians, it would have to have very strong safeguards for vulnerable people,” he said.

“For me, that is one of the fundamental provisions of the law. It is one of the reasons why the law has been so widely accepted.”

One aspect of the legislation being closely scrutinized is whether it provides sufficient support for people who want to access VAD but are in a hospital or religious nursing home that prohibits its staff from facilitating their wishes.

Stephen Walker, chair of Dying with Dignity WA, said this had proven to be a serious obstacle in some cases.

“We very much want a code of conduct, amended legislation to say what people’s rights are and to force aged care providers, hospitals and the like to advertise where they stand,” he said.

Mr Walker said that although the review panel said it was not considering expanding eligibility for VAD, his organisation would continue to push for it to include people like Helen George’s mother.

Regional access is more difficult

Dr Fellingham said the other issue was providing access to the VAD to patients in regional areas, as only 100 doctors across WA are able to offer it, with most of them in Perth.

This problem is compounded by the fact that some of the conversations that need to take place between doctors and patients cannot take place over the telephone, due to a provision in the Commonwealth Criminal Code.

The code makes it a crime to use a transportation service to publish or distribute material that advises or incites committing or attempting suicide.

Ms Talbot said recent court rulings had confirmed that VAD was included in this legislation.