Helen George’s mother, Olive, led an active, independent life, regularly visiting her daughter in Perth from her home in the UK, until the mid-1990s, when her physical condition began to deteriorate.

“Since she was losing her mobility, she would say, ‘I’ve had a good life. I’d be happy now if I could just go,'” she said.

Eventually, Olive’s care needs became so great that she had to go into a nursing home, which caused her great distress.

“She was mentally sharp right up until the end. She knew exactly what was going on, she knew exactly what was going on in the world,” Ms. George said.

She added that her mother had repeatedly expressed a desire to allow her to undergo voluntary assisted suicide (VAD) before she finally died at the age of 99 from a stroke.

“She couldn’t swallow anymore and it was very painful for her because she couldn’t eat,” she said.

Olive died in the UK, where no form of VAD occurs.

In her native Perth, Ms George is a passionate advocate for changing Western Australia’s VAD laws, which only apply to patients with terminal diagnoses.

He wants the law to allow older people who feel their lives are coming to an end to opt for voluntary euthanasia.

“What happened to my mother was cruel,” she said.

“It’s definitely a human right to choose. I don’t want anyone to go through what I went through, watching my mother die like that.”

WA regulations under review

Voluntary assisted suicide became legal in Western Australia in July 2021 and is available to people with an illness or condition that is likely to result in their death within six months (or 12 months for neurodegenerative conditions).

Three years after VAD was introduced in Western Australia, the state government has appointed an independent panel to investigate the effectiveness of the legislation.

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However, the review is unlikely to deliver the access to VAD that Helen George and other human rights advocates want. Health Minister Amber-Jade Sanderson has made it clear that the purpose of the review is not to “consider changing the scope of the VAD Act” but rather to check whether the legislation is working as intended.

Speaking at this week’s ABC Radio Perth Spotlight on VAD, Dr Clare Fellingham, clinical lead for VAD at East Metro Health Service, said VAD had proven to be more popular than anticipated when the legislation was introduced.

“In the first two years of operation, somewhere between 200 and 300 per cent more people (than anticipated) sought access,” Dr Fellingham said.

“In its second year of operation, 33 percent more people used the service than in its first year.”

Data shows that in the first two years in Western Australia, 446 people died as a result of voluntary assisted death.

The median age was 75 years, 73% of patients had cancer, and 86% were under palliative care.

Community Views on VAD

Associate Professor Eyal Gringart from Edith Cowan University in Perth recently conducted a national survey of 796 people examining community attitudes towards VAD.

The results have not yet been published, but he said preliminary results indicate broad support.

“The majority of those 796 people basically said they saw it as a basic human right,” Dr Gringart said.

“They also said that in general there should be more talk about death and dying.

“The majority also said they believed VAD should be legal.”

However, the majority of respondents also stated that “palliative care should be improved to such a degree that voluntary assisted death should not be considered at all.”

The study also found a shortage of support for VAD in cases where people did not suffer from a terminal illness and great suffering, but had simply reached old age.

“(However) when we asked people about the possibility of voluntary assisted death for people who are fed up with life, they completely disagreed with it,” he said.

“When we asked them about the availability of voluntary assisted death regardless of people’s age, they also completely disagreed with that.”

His study also found strong opposition to the acceptability of VAD for people who are not in poor health or have mental illness.

“But at the same time, they are concerned that there is a downward spiral here, that once this starts happening, it could lead to people using this service when they might otherwise be getting help.”

Call for a Code of Conduct

Labor MP Sally Talbot, a member of the independent panel currently considering the legislation, said when VAD was first introduced in Western Australia, adequate safeguards were crucial.

“We knew that if we were going to create legislation that would have the support of a majority of Western Australians, it had to have very strong safeguards in place for vulnerable people,” she said.

“For me, this is one of the fundamental provisions of the act. This is one of the reasons why the act has gained such wide acceptance.”

One aspect of the legislation that has come under intense scrutiny is whether it provides sufficient support for people who want to access VAD but are in a religious hospital or care home where staff forbid them from fulfilling their wishes.

Stephen Walker, president of Dying with Dignity WA, said this had posed a significant obstacle in some cases.

“We really want a code of conduct, a change in the legislation that would define people’s rights and force aged care facilities, hospitals and the like to make their position known,” he said.

Mr Walker said that despite the audit committee’s statement that it was not considering extending VAD eligibility, his organisation would continue to push for it to include people like Helen George’s mother.

Regional access more difficult

Dr Fellingham added that another challenge is ensuring VAD is accessible to regional patients, with only 100 doctors in the whole of Western Australia able to offer it, and most of them are in Perth.

This problem is compounded by the fact that some doctor-patient conversations cannot take place over the telephone due to provisions of the Commonwealth Criminal Code.

According to the Code, it is a crime to use transportation services to publish or disseminate materials encouraging someone to commit or attempt suicide.

Ms Talbot said recent court decisions confirmed that VAD was covered by these regulations.