Voluntary Assisted Dying Information
Everything you need to know can be found online at: https://ww2.health.wa.gov.au/voluntaryassisteddying
As JMOs, our main interaction with this process is in the instance of a First Formal Request, which is a patient’s first verbal request to begin the process of applying to access this process. This request must be clear and unambiguous, made to a medical practitioner during a medical consult and made in person where possible (can be done via video-conference).
To accept the request, you must be eligible to do the training (VAD - Approved Practitioner Training) to allow you to become the patient’s Coordinating Practitioner. So in essence, as JMOs we cannot accept these requests. Instead, you should document refusal as above, complete the steps required of all medical practitioners, and escalate to your senior.
NMHS VAD Coordinator (email: nmhs.vad@health.wa.gov.au) can help the patient with next steps if a Coordinating Practitioner is not available in the treating team.
Steps (as outlined on website) for responding to a voluntary assisted dying request:
Give the patient the “Approved Information for a Person Making a First Request for Voluntary Assisted Dying” booklet within 2 business days of the request (https://ww2.health.wa.gov.au/.../Approved-information-for...).
Decide if you are going to accept or refuse the First Request.
Inform the patient of your decision.
Complete and submit the online First Request Form to the VAD Board (https://vad-ims.health.wa.gov.au/VAD/).
Document the following in the patient’s medical record: that the patient has made a first request, whether you have accepted or refused (if refused provide reasoning e.g. ineligible, unable, conscientious objection), document that the information booklet was given and the First Request online form has been lodged.
Other important points that you need to know include:
Doctors are not to initiate discussion about VAD to a patient unless all options for treatment, including palliative care, are discussed in the same consult.
You are allowed to abstain from this process on the basis of conscientious objection by refusing a patient’s First Formal Request on these grounds. However, you are legally required to inform the patient immediately and give the patient the approved information booklet (and document as above). Therefore, this doesn’t change the process for JMOs as you will still need to follow all of the steps above, but the reason for rejecting the request would be conscientious objection rather than being unable to accept.
You must not mention VAD on a death certificate, instead list the underlying condition. If a patient dies as a result of VAD, you must also notify the VAD Board via the VAD-IMS website (https://vad-ims.health.wa.gov.au/VAD/).
Not conforming to these guidelines can lead to penalties.
If you are not sure about any of these steps, you can contact the NMHS VAD Coordinator, (email: nmhs.vad@health.wa.gov.au).