Western Australia is set to become the 18th jurisdiction in the world to legalise some form of assisted suicide or euthanasia. Last week its state upper house voted resoundingly in favour of the Voluntary Assisted Dying Bill 24 to 11. A special sitting of the lower house on Tuesday is expected to consider some amendments and then pass it into law.
Labor Premier Mark McGowan has dismissed concerns about the government-sponsored law as “ridiculous”, and has accused opponents of “scaremongering”. He is being unduly sanguine. The Western Australian assisted dying bill is significantly more permissive than the one passed by Victoria in 2017.
Western Australian adults will be eligible for assisted suicide or euthanasia if they have been diagnosed with a terminal illness, have six months or less to live (12 months in the case of neurodegenerative illness), and are suffering in a manner that they deem to be intolerable. A patient must make three requests – two verbal and one in writing – and must be assessed by two medical practitioners.
Unlike Victoria, WA will not require a patient to be assessed by a specialist. Two GPs, for example, could approve a request for euthanasia from a patient with pancreatic cancer or motor neurone disease even if they have never treated patients with these conditions before. Critics warn that non-specialists may provide inaccurate diagnoses and prognoses for terminally ill patients, leading to wrongful deaths. “[If] we get it wrong in relation to a diagnosis, what number [of wrongful deaths] is acceptable?”says former Labor MP Tim Hammond, a vocal opponent of the bill.
Critics also claim that people with mental illness will be at risk. Doctors in Victoria are advised by the state’s legislation to refer patients to a psychiatrist if they have a mental illness that affects their decision-making capacity. The WA bill contains no such provision. Suicide prevention advocate and former SANE Australia director Michael Perrott slammed this oversight, arguing that “we need specially trained people to deal with those who are mentally unwell”.
One hotly debated issue was that the bill will allow doctors to initiate conversations about euthanasia. This is problematic. Doctors may be tempted to suggest the easiest (and cheapest) solution. What if a neurologist proposes euthanasia as “the best option” for a patient diagnosed with an inoperable brain tumour?
This bill exposes patients to undue influence from doctors. In addition, Indigenous groups, culturally and linguistically diverse populations and patients with disabilities may misinterpret a doctor’s words. But it also leaves doctors exposed to pressure from families who want them to recommend euthanasia.
The upper house accepted amendments to an earlier draft, including a clause that ensures that witnesses and practitioners involved in a patient’s application for euthanasia are not beneficiaries of the patient’s will. Yet other amendments were rejected, including provisions for equitable access to palliative care in rural areas and adequate oversight for patients with mental illness.
The method of assisted dying in WA will be either the self-administration of a lethal dose of medication (assisted suicide), or administration of the drug by a medical practitioner (euthanasia). In Victoria, a doctor can only administer the drug if a patient is physically incapable.
This is important. Rates of euthanasia are higher in Canada, for instance, where patients can choose either euthanasia or assisted suicide. There may be a far higher rate of patients in WA choosing to end their lives than most politicians have anticipated.
Victoria’s legislation was described by Premier Daniel Andrews as “the most conservative euthanasia law in the world”. Perhaps the Western Australian bill should be described as the most liberal euthanasia law in Australia. It leaves sick and elderly Australians open to coercion at the most vulnerable moments of their lives.
Xavier Symons is a research associate in the Institute for Ethics and Society at the University of Notre Dame.
Labor Premier Mark McGowan has dismissed concerns about the government-sponsored law as “ridiculous”, and has accused opponents of “scaremongering”. He is being unduly sanguine. The Western Australian assisted dying bill is significantly more permissive than the one passed by Victoria in 2017.
Western Australian adults will be eligible for assisted suicide or euthanasia if they have been diagnosed with a terminal illness, have six months or less to live (12 months in the case of neurodegenerative illness), and are suffering in a manner that they deem to be intolerable. A patient must make three requests – two verbal and one in writing – and must be assessed by two medical practitioners.
Unlike Victoria, WA will not require a patient to be assessed by a specialist. Two GPs, for example, could approve a request for euthanasia from a patient with pancreatic cancer or motor neurone disease even if they have never treated patients with these conditions before. Critics warn that non-specialists may provide inaccurate diagnoses and prognoses for terminally ill patients, leading to wrongful deaths. “[If] we get it wrong in relation to a diagnosis, what number [of wrongful deaths] is acceptable?”says former Labor MP Tim Hammond, a vocal opponent of the bill.
Critics also claim that people with mental illness will be at risk. Doctors in Victoria are advised by the state’s legislation to refer patients to a psychiatrist if they have a mental illness that affects their decision-making capacity. The WA bill contains no such provision. Suicide prevention advocate and former SANE Australia director Michael Perrott slammed this oversight, arguing that “we need specially trained people to deal with those who are mentally unwell”.
One hotly debated issue was that the bill will allow doctors to initiate conversations about euthanasia. This is problematic. Doctors may be tempted to suggest the easiest (and cheapest) solution. What if a neurologist proposes euthanasia as “the best option” for a patient diagnosed with an inoperable brain tumour?
This bill exposes patients to undue influence from doctors. In addition, Indigenous groups, culturally and linguistically diverse populations and patients with disabilities may misinterpret a doctor’s words. But it also leaves doctors exposed to pressure from families who want them to recommend euthanasia.
The upper house accepted amendments to an earlier draft, including a clause that ensures that witnesses and practitioners involved in a patient’s application for euthanasia are not beneficiaries of the patient’s will. Yet other amendments were rejected, including provisions for equitable access to palliative care in rural areas and adequate oversight for patients with mental illness.
The method of assisted dying in WA will be either the self-administration of a lethal dose of medication (assisted suicide), or administration of the drug by a medical practitioner (euthanasia). In Victoria, a doctor can only administer the drug if a patient is physically incapable.
This is important. Rates of euthanasia are higher in Canada, for instance, where patients can choose either euthanasia or assisted suicide. There may be a far higher rate of patients in WA choosing to end their lives than most politicians have anticipated.
Victoria’s legislation was described by Premier Daniel Andrews as “the most conservative euthanasia law in the world”. Perhaps the Western Australian bill should be described as the most liberal euthanasia law in Australia. It leaves sick and elderly Australians open to coercion at the most vulnerable moments of their lives.
Xavier Symons is a research associate in the Institute for Ethics and Society at the University of Notre Dame.
