Western Australian MPs will debate a voluntary assisted dying (VAD) bill later this month which will enable nurse practitioners to give the medication, does not require doctors to have a VAD permit, and allows health practitioners to raise VAD with the patient.
These are all key differences from Victoria’s VAD legislation, enacted in June, say Professor Ben White and Professor Lindy Willmott, from QUT’s Australian Health Law Research Centre, whose almost 20 years of research in the field has informed Australian end-of-life law reform.
“While the criteria remain very similar for VAD eligibility, the administration of the VAD medication and the setting in which it can be discussed differs in the WA bill,” Professor White said.
“The eligibility criteria requires that the person requests VAD three times, is capable of making their own decisions and has lived in the state for at least a year.
“In Victoria health practitioners are forbidden to raise the subject of VAD – it must be the patient who raises the topic.
“To be eligible, a person has to have an advanced and progressive condition that is expected to cause death within six months or 12 months for a neurodegenerative condition whose suffering cannot be tolerably relieved.
“In both states, a Voluntary Assisted Dying Review Board will oversee the system.”
Professor Willmott said a WA ministerial expert panel had determined that nurse practitioners could administer the VAD medication to ensure equitable access for everyone wherever they are in WA.
“While doctors must conduct eligibility assessments, the WA bill allows nurse practitioners who have at least two years’ experience to give the medication,” Professor Willmott said.
“Another difference is that a doctor or nurse practitioner can administer the medication in wider circumstances.
“The Victorian law requires self-administration of the VAD medication and practitioner administration only where a person is physically incapable of administering it.
“In WA, self-administration is the preferred option but if the doctor advises this would be inappropriate, a person can choose practitioner administration if, for example, they have concerns about taking the medication themselves.”
The WA bill further differs from Victoria’s law in that WA doctors are not required to apply for a VAD permit from the government, and the WA bill allows for health practitioners to raise the subject of VAD with patients.
Professor White and Professor Willmott said conscientious objection provisions in Victoria exempted health practitioners from having to provide any information about VAD if they did not wish to and gave them up to seven days to respond to a first request from the patient for VAD.
“In the WA bill, doctors can decline to be involved in the process but they must inform the patient immediately about their conscientious objection and give them standardised information.”