WA euthanasia update: Five things to know

The West Australian Voluntary Assisted Dying Board recently released its annual report, covering the period from 1 July 2022 to 30 June 2023.

It can be tempting to treat these reports as proforma documents that provide the data required by law and not much else.

However, these brief reports still reveal a great deal about what is going on in the world of euthanasia and assisted suicide. 

Here are some insights from the latest WA report.

Just five doctors are responsible for a third of the euthanasia deaths

It is alarming to note that a very small group of doctors is responsible for around a third of the state’s 358 practitioner-administered (euthanasia) deaths.

This table, taken from the annual report, shows that five doctors administered lethal drugs to more than 20 patients each, meaning that amongst the five doctors, they were responsible for at least 105 deaths – around a third of the euthanasia deaths on record for the year.

No information is given as to who these doctors are or whether they are subject to additional oversight, given it appears that they are specialising in euthanasia.

Cancer is the main underlying condition; very few oncologists are participating

According to the report, 73% of patients found eligible to access euthanasia or assisted suicide have a cancer-related diagnosis. However, only four doctors (or 4% of the practitioners registered to participate in euthanasia) are oncology specialists. 

This means that overwhelmingly, euthanasia and assisted suicide patients are suffering from cancer, but their assessments for death are not being conducted by a specialist in their disease.

The implications for safeguards around proper diagnosis and prognosis are clear.

Most participating practitioners are not specialists in anything

There are 45 general practitioners who are registered to participate in the euthanasia and assisted suicide regime, which is 44.6% of the total of registered practitioners, as well as 8 psychiatrists (7.9%), 7 nurses (6.9%) and 7 anaesthetists (6.9%).

These numbers indicate that two-thirds of the practitioners who are registered for euthanasia are not specialists in the terminal illnesses of the patients whose death they are authorising.

As noted above, the implications for supposed safeguards dealing with proper diagnosis and prognosis are clear.

Pain isn’t in the top three reasons for a euthanasia or assisted suicide request

The top reason patients gave for requesting euthanasia and assisted suicide was that they were “less able to engage in activities making life enjoyable, or concern about it” (70.6%.) This was followed by “losing autonomy, or concern about it” (66.4%) and “loss of dignity, or concerns about it (55.9%).

Fewer than half of the patients (44.8%) cited “inadequate pain control, or concern about it” as a reason, while more than a third (35.3%) cited “burden on family, friends and caregivers, or concern about it” as a reason for asking for death.

This is consistent with the experience in other countries that record this data: euthanasia requests are less about pain or fear of pain, and more about existential questions.

Some people died as little as two days after their first request

The report shows that both in metropolitan Perth and regional WA, the shortest number of days between a patient making a first request and a patient dying was two days. 

Alarmingly, 19% of patients died within 9 days of making their first request for euthanasia or assisted suicide, even though the law stipulates that the period between first request and death must be a minimum of 9 days, other than in exceptional circumstances.

Having almost a fifth of patients die in the minimum time frame of less speaks to a failure of the supposed ‘safeguard’ of a nine-day cooling off period.

The annual report reveals much more about the euthanasia and assisted suicide regime than one might expect. As the saying goes, ‘the devil is in the detail.’