Message from the Voluntary Assisted Dying Board Chair
As voluntary assisted dying approaches the fourth anniversary of operation in Western Australia we see a continued increase in activity as more West Australians seek to access VAD as their end of life choice. It is evident that practitioners, care navigators, pharmacists and coordinators are working extremely hard to meet the growing demand for these services and we thank you for your ongoing commitment to providing exemplary care for your patients.
The Board recently met with practitioners, community organisations, the Southwest Aboriginal Medical Service and members of the public in the Southwest region to hear more about how voluntary assisted dying is operating in that region. Our regional engagement activities assist us in fulfilling our function under the Act to monitor the operation of voluntary assisted dying in WA, and to hear from local patients and practitioners about the successes and challenges of VAD in the region. The Board is currently planning meetings in the Kimberley region for winter 2025, including meeting with peak Aboriginal bodies to explore delivery of culturally safe care.
As always, we encourage you to reach out and share your experiences with us. You can do this through the submission of a personal reflection (that can be found here) or by emailing the VAD Board Secretariat Unit (VADBoard@health.wa.gov.au)
Dr Scott Blackwell Chair - Voluntary Assisted Dying Board
Recording Diagnoses on Assessment Forms
As mentioned in Quality Practice Series #11, the primary diagnosis field on the First and Consulting Assessment Forms in VAD-IMS should be used for the condition that satisfies the eligibility criteria for voluntary assisted dying, i.e. is the
The primary diagnosis in the First and Consulting Assessments should also be the diagnosis that will ultimately be included on the Medical Certificate of Cause of Death.
Voluntary Assisted Dying Workforce Survey
The Department of Health End Of Life Care Program are investigating opportunities to improve the sustainability and wellbeing of the Voluntary Assisted Dying (VAD) workforce.
They are seeking to understand the factors that influence eligible medical and nurse practitioners to undertake VAD Approved Training and roles under the Act. This feedback will help them identify enablers, barriers and additional resources needed to ensure that equity of access to VAD is upheld alongside other end of life care choices.
They are looking to hear from medical and nurse practitioners that meet the eligibility requirements to provide VAD services in Western Australia, including those who have not completed VAD Approved Training. Please feel free to forward the survey link onto any interested colleagues.
The survey is available on Citizen Space and closes on 22 April 2025.
VAD Guidelines
An updated version of the WA Voluntary Assisted Dying Guidelines has been published and can be found here. We will be highlighting updates to the guidelines over the next few editions of the Quality Practice Series to assist practitioners to stay up to date.
Decision-making capacity
The Guidelines include new information on assessing decision-making capacity of a patient where they are subject to Guardianship, Administrative or Mental Health order. A person subject to such an order is not automatically precluded from requesting voluntary assisted dying. However, the person may not meet the eligibility criteria regarding decision-making capacity for voluntary assisted dying.
The content of the order(s) should be taken into consideration by the Coordinating and Consulting Practitioners while completing the assessment regarding a person’s decision-making capacity to access voluntary assisted dying, as it could provide some understanding as to the person’s decision-making capacity.
A person who is subject to an order is able to request that the order be reviewed by the appropriate authority (e.g. the SAT, the Mental Health Review Board, the Mentally Impaired Accused Review Board etc) to assist in their ability to be found eligible for voluntary assisted dying.
Complications
The Practitioner Administration Form provides for practitioners to record any complications experienced related to the administration of the substance.
The recording of complications is intended to capture things that might occur during the administration of the substance that are not part of the normal process of dying, which might include laboured and rattly breathing, gurgling, twitching and restlessness among other symptoms commonly observed when someone dies.
Complications recorded on the Practitioner Administration Form are aggregated and reported in the Board's Annual Report each year as part of the Board's role to monitor the operation of the Voluntary Assisted Dying Act 2019 (WA).
Planning for Holidays
If you are planning a holiday, please remember to consider options for any patients who may require further voluntary assisted dying steps to be completed while you are away. This might include transferring roles before you leave or ensuring you have access to VAD-IMS and the ability to submit approved forms while away. It might also be advisable to take some blank forms with you, which can be completed and faxed or emailed to us. Please feel free to contact the Secretariat Unit on 0487 447 920 or VADBoard@health.wa.gov.au if you require assistance with the transfer process.
Feedback to the Board
The Board has recently received our 100th Personal Reflection. Personal reflections are a valuable tool to give the Board insight into the barriers and problems that might be experienced by patients, families and practitioners in accessing and delivering VAD services.
We would welcome further submissions of personal reflections from practitioners to share your experience. The Personal Reflection form can be found here and can be emailed to the VAD Board Secretariat Unit (VADBoard@health.wa.gov.au).
VAD-IMS reminders
The Secretariat Unit continues to monitor and support practitioners with submitting the required notifications to the Board through VAD-IMS. Some common issues to look out for include:
Where a substance has already been supplied and the Administering Practitioner role is transferred to a new practitioner, VAD-IMS provides a mechanism to record that the substance has been transferred to the new Administering Practitioner. From the substance tab of the episode, click "Record transfer of substance" and enter the date and method of transfer. The new practitioner is then able to confirm the date of receipt in the episode.
Archives of previous editions
Previous editions of the Quality Practice Series can be downloaded from the Resource Hub in VAD-IMS.
This document can be made available in alternative formats on request for a person with disability.
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