Questions of consent raised at Geraldton community forum on voluntary assisted dying

West Australian

19-05-2025

A community forum in Geraldton has reignited debate around one of the most sensitive issues in WA's voluntary assisted dying laws — the role of consent, particularly for people diagnosed with degenerative brain diseases.
The forum on May 9 was one of two local sessions hosted by the WA Voluntary Assisted Dying Statewide Care Navigator Service in partnership with Rural Health West, the Midwest Gascoyne Health Professional Network and the Midwest Palliative Care Service.
While the first session focused on educating rural health professionals, the second was open to the public and offered a platform for community questions and concerns.
In the first three years of the legislation, which came into effect in WA in July 2021, 69 first requests to access VAD were recorded in the Mid West, making it the third-highest region in the State after the South West and Great Southern, according to the 2023-24 annual report of the Voluntary Assisted Dying Board.
During that time, 40 people were assessed as eligible and underwent a first clinical assessment, while there were two participating VAD medical practitioners in the Mid West.
Almost 2500 people requested VAD across WA between 2021 and 2024., with 737 deaths recorded.
Statewide, VAD accounts for about 1.6 per cent of all deaths.
A person must meet specific criteria to access VAD, including being 18 or older, an Australian citizen or permanent resident who has lived in WA for 12 months, have a qualifying disease or illness, act voluntarily and without coercion, have an enduring request, and have decision-making capabilities.
One attendee at the forum asked whether the current legislation could ever change to allow people in the early stages of dementia or Alzheimer's to make an advanced request for VAD, knowing they would eventually lose the ability to give consent.
Under WA's current VAD laws, the legislation requires individuals to maintain full decision-making capacity throughout the entire process — for those with neurodegenerative diseases, they must have a prognosis of no more than 12 months to live.
If that capacity is lost at any point, the process cannot go ahead.
While VAD is intended to offer a compassionate choice for end of life, it does not currently accommodate advanced directives for those facing progressive degenerative conditions.
When asked if advanced consent would be something considered in WA legislation, Alice Morison, a nurse co-ordinator from WA VAD Statewide Care, said while it may not be something that happens soon, it was at the forefront of most discussions about VAD.
'If I know that I have dementia, could I put something in place? If I meet specific criteria at that time, the doctor would assist me to die? We're not there yet, and I don't think we're going to be there soon, but it's on the table,' she said.
'I just don't think it will happen soon, because I think we need a bit more time to understand what this looks like.
'We're not going to know really exactly what that will look like just yet, but at the end of the day, you'd be asking someone to administer a medication that would cause your death when you can't ask for it, and that's a tricky thing.'
Leesa Thomas, Rural Health West general manager education and engagement, said providing education on VAD helped to start important conversations and breakthrough the stigma surrounding the topic.
'The events empower both healthcare workers and community members to make informed choices, strengthens local care capacity, and promote respectful conversations around health and wellbeing,' she said.
'Delivering education where people live is especially important in rural and remote WA, where distance and isolation can often hinder access to information and support. By offering sessions locally, communities can engage in meaningful dialogue about important health topics that affect them directly.'