Voluntary Assisted Dying: “We wish to provide the best care possible,” says Archbishop Costelloe

08 Jul 2021

By Contributor

In this April 19, 2011, file photo, patient Warren Saunders smiles as Dominican Sister Agnes Mary plays the piano at Rosary Hill Home in Hawthorne, New York, where the nursing home staff provides palliative care to people with incurable cancer. Photo: CNS/Gregory A. Shemitz.

WA is now the second state after Victoria to activate voluntary assisted dying, which was recently also legalised in South Australia and Tasmania.

After an 18-month implementation period, Western Australia’s voluntary assisted dying laws come into effect last Thursday 1 July.

More than 180 hours were spent debating the legislation in parliament, mostly in the upper house where it was heavily amended before passing in December 2019.

Under the WA scheme, terminally ill adults in pain and likely to have less than six months to live – or one year if they have a neurodegenerative condition – will be able to take a drug to end their lives if approved by two medical practitioners.

Premier Mark McGowan has been reported as saying some 60 people were expected to be approved to end their lives in the first 12 months.

In a Pastoral Letter released Wednesday 23 June, Perth Archbishop Timothy Costelloe SDB said that Catholic hospitals and aged care facilities will not support, and will not provide or facilitate, Voluntary Assisted Dying.

A woman in Vienna is seen in a home for seniors in this 2005 photo. Photo: CNS/Harald Schneider, EPA.

“VAD is not regarded in any of our institutions as “medical care or treatment” and cannot from part of the “provision of care” which is the fundamental obligation our institutions have to all their patients, residents or clients,” Archbishop Costelloe wrote.

“Precisely because we wish to provide the best care possible according to our Catholic values, our various institutions will make their policies around VAD clear and unambiguous.

“This is important, both to provide certainty to those who choose to come to one of our facilities and to provide clarity to those who choose to work in our facilities,” he said.

Click Here to Read the Pastoral Letter

The legislation

In reality, very few people will be eligible, with strict criteria governing the VAD process.

The legislation is such that a person must be suffering from a medical condition that is advanced, progressive and is expected to cause death within six months, or within 12 months in the case of a neurodegenerative disease.

Patients must be 18 years of age and they need to make three requests for a voluntary assisted death and two doctors who have completed the relevant training must independently assess the patient’s eligibility.

Patients must also be an Australian citizen and a resident in WA for at least 12 months.

The legislation presents some practical challenges for the doctors tasked with administering the lethal injection that will end a person’s life as well as with some important ethical questions for the broader community.

In order to offer consultation and prescriptions to patients interested in accessing VAD, doctors need to undergo additional comprehensive training.

As at July 1, just eight medical practitioners had completed the necessary training to administer voluntary assisted dying.

A further 37 GPs and nurse practitioners are currently undergoing the training among a total of 95 who have expressed interest.

The legislation also states that all persons, including health practitioners, have the right to be shown respect for their culture, religion, beliefs, values and personal characteristics.

It also establishes a body called the Voluntary Assisted Dying Board, consisting of five (5) members, which will monitor operation of the legislation, in addition to the provision of advice and information to the Minister.

Increased focus needed on Palliative Care

Palliative Care WA Chief Executive Lana Glogowski said palliative care hasn’t had anywhere near the profile needed.

“Voluntary assisted dying is accessed ultimately by less than 2 per cent of the population.

“What about the 98 per cent of the population who won’t be accessing voluntary assisted dying?

“What are we doing to share with the vast majority of our community about how they plan for the last stage of their life?”

But she welcomes the public debate that the new laws have prompted around end of life care, saying people need to take more proactive steps to prepare for the final stage of their life.

An unidentified man suffering from Alzheimer’s disease and who refused to eat sleeps peacefully the day before passing away in a nursing home in Utrecht, Netherlands. Photo: CNS /Michael Kooren, Reuters.

“We need to encourage people not to be death phobic … to realise that at some stage they are going to die,” she said.

“Everybody wants the best death possible.”

Ms Glogowski is hopeful more fit and healthy people will seek out information about advanced care planning, well before they need to access it.

With acknowledgement to The West Australian