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More practitioners needed as demand for assisted dying climbs in WA

To meet increased requests for voluntary assisted dying in Western Australia, the independent review board has called for a more sustainable service to avoid practitioner “burnout and fatigue”.

The WA Voluntary Assisted Dying Review Board has released its second annual report, covering the operations of the VAD Act between 1 July 2022 and 30 June 2023.

During 2022-23, there were 255 assisted deaths, up 33.5% from 190 the previous year. Twenty-seven practitioners completed the mandatory VAD training during the same period bringing the total number of VAD practitioners to 97.

The Board said it was pleased to see an increase in the number of health professionals completing the training but said there was more work to do. 

“Ongoing effort will be required to ensure that a sufficient practitioner pool is available to respond to the level of requests from the community and avoid practitioner burnout and fatigue,” the Board wrote.

The Board said nurse practitioners could play a greater role in the VAD process to bolster the pool of available practitioners and “improve the experience of practitioners and patients through the process”.

The Board also stressed the importance of adequately remunerating VAD practitioners for the time they spend assessing and supporting patients, as well as the administrative and reporting activities required. 

“Practitioner remuneration and ongoing support for voluntary assisted dying within the WA Health system should be addressed as a matter of priority,” the Board wrote.

Echoing the calls of other state VAD oversight bodies, the Board called for the Commonwealth Criminal Code to be amended as soon as possible to allow telehealth to be used for VAD appointments.

The Board also expressed disappointment that during 2022-23, several individuals or organisations had obstructed Western Australians who sought access to voluntary assisted dying. 

“The Board recommends that the Act is amended at the earliest opportunity to ensure patients and residents of health service facilities are not prevented from accessing voluntary assisted dying as a lawful end of life choice.”

The statistics

Between 1 July 2022 and 30 June 2023:

  • 757 West Australians made first requests, 66.6% of which were accepted. 
  • 474 first assessments were completed, with 89% deemed eligible.
  • The most common reason patients were found to be ineligible was they had not been diagnosed with at least one disease, illness or medical condition that would, on the balance of probabilities, cause death within 6-12 months.
  • Of the 422 patients assessed as eligible, a majority were male (58.8%), approximately 75% lived in metro Perth and surrounds, and the majority (73%) had a cancer-related primary diagnosis.
  • 347 patients submitted a final request, an increase of 22.2 percent from 2021–22
  • 275 patients, contact persons or administering practitioners were supplied a voluntary assisted dying substance
  • There were 255 VAD deaths recorded, a 33.5% increase from the previous year

Dr Linda Swan, Go Gentle Australia’s CEO, said: “West Australians are embracing voluntary assisted dying and the comfort and relief it provides to terminally ill people and their families. The greater uptake reflects the incredible trust in the dedicated health professionals who offer this compassionate end-of-life option.

"It is also important to note that these 255 assisted deaths represent a very small proportion of overall deaths in the state, just 1.4%.

“It is encouraging to see more practitioners stepping up to do the training to offer VAD services, but it is clear more need to be involved to ensure services remain sustainable.

“Easing workloads and proper payment for practitioners were identified as concerns at the recent VAD Conference in Sydney, and these are a priority in 2024.”

Read the full annual report here.

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