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Australia: Western Australia Legalizes Voluntary Assisted Dying

(Dec. 20, 2019) On December 10, 2019, the Parliament of Western Australia passed the Voluntary Assisted Dying Bill 2019 (WA), when the Legislative Assembly (lower house) voted in favor of amendments that had been passed in the Legislative Council (upper house) the previous week. Western Australia will therefore be the second Australian state to legalize voluntary assisted dying, following Victoria, which enacted relevant legislation in November 2017.

The passage of the Bill “followed a lengthy debate, with more than 180 hours in State Parliament spent debating the Bill – more than 76 in the Legislative Assembly and 105 in the Legislative Council.” Following royal assent, the provisions in the Bill will take effect at the end of an eighteen-month implementation period. An implementation panel will be established to “oversee development of clinical guidance, medication protocols and training for participating health practitioners, as well as information for the community and health professionals.”

Under the Bill, to be eligible for voluntary assisted dying, a person will be required to meet all of the eligibility criteria, which includes that they

  • are aged 18 years or over
  • are an Australian citizen or permanent resident who has been ordinarily resident in Western Australia for at least 12 months
  • have been diagnosed with at least 1 disease, illness or medical condition that is advanced, progressive and will cause death; and, will, on the balance of probabilities cause death within a period of 6 months (or 12 months for neurodegenerative); and, is causing suffering that cannot be relieved in a manner that the person considers tolerable
  • must have decision-making capacity in relation to voluntary assisted dying
  • must be acting voluntarily and without coercion
  • must have an enduring request for access to voluntary assisted dying

Other processes and protections in the Bill include the following:

  • A person must be independently assessed as eligible by two medical practitioners, who must meet certain requirements and have undergone mandatory training.
  • The person must “make three separate requests for voluntary assisted dying: a first request, a written declaration and a final request. The written declaration must be witnessed by two people (who meet specific requirements).”
  • Voluntary assisted dying may be “through self-administration or practitioner administration of the voluntary assisted dying substance – this is a decision made in consultation with the co-ordinating medical practitioner.”  Where it is through self-administration, “the person must appoint a Contact Person who has specific responsibilities, including return of any unused substance.”
  • The death certificate “must not include any reference to voluntary assisted dying.”
  • The person “must be informed of many different aspects relating to voluntary assisted dying, as well as their treatment and palliative care options.”
  • The person “can withdraw or revoke their involvement at any stage.”
  • Health practitioners “are also able to refuse to participate in voluntary assisted dying for any reason (including conscientious objection).”
  • Health care workers “must not initiate discussion about, or suggest, voluntary assisted dying to a person to whom they are providing health or professional care services. The exception to this is for medical practitioners or nurse practitioners if, at the same time, they also inform the person about treatment and palliative care options available to them and the likely outcomes of that care and treatment.”

The introduction of the Bill in August 2019 followed the 2017 establishment of the Joint Select Committee on End of Life Choices. The Committee’s report was completed in August 2018. The Western Australian government responded to its recommendations in December 2018 and instructed the Department of Health and Department of Justice to develop legislation. A Ministerial Expert Panel “was established to provide expert advice on the development of voluntary assisted dying legislation.”

Two other Australian states, South Australia and Queensland, are currently carrying out parliamentary inquiries on end-of-life choices that include consideration of legalizing voluntary assisted dying.