Voluntary assisted dying first request

The information below is intended to assist medical practitioners to understand what their obligations are in relation to receiving a first request for voluntary assisted dying (VAD) from a patient. It is recommended that practitioners refer to the WA VAD Guidelines and the Voluntary Assisted Dying Act 2019 where required. Practitioners can also seek information and support from the WA VAD Statewide Care Navigator Service on (08) 9431 2755 or VADcarenavigator@health.wa.gov.au

What is a first request for VAD?

Any registered medical practitioner who receives a request for VAD from a patient has obligations under the Voluntary Assisted Dying Act 2019 (Act) if the request for VAD from the patient is:

• Clear and unambiguous
• Made during a medical consultation or appointment
• Made in person (or, if this is not practical, via audiovisual communication where the patient can be seen and heard)

A request that meets these conditions is known as a first request.

What are my legal obligations if I receive a first request?

Under the Act, all medical practitioners (including those who are not eligible, able or willing to provide VAD) must do 4 things in response to a first request. You must:

1.  Decide if you are going to accept or refuse the first request and inform the patient of your decision
   
   
2.  Give the patient the approved information booklet

   If you hold conscientious objection to VAD you must complete Steps 1 and 2 immediately upon receiving the first request. In all other circumstances, you can take up to 2 business days to complete these steps.
   
   

3.  Document the following in the patient’s medical record:
   • The first request
   • The decision to accept or refuse the first request
   • If refused, the reason for refusal
   • Whether the patient has been given the approved information booklet
     
     
4.  Complete and submit the First Request Form to the Voluntary Assisted Dying Board (online through VAD-IMS or via fax)

Steps 3 and 4 must be completed within 2 business days of informing the patient of the decision to accept or refuse the first request.

The following resources may assist you in submitting the First Request Form to the VAD Board:

• Quick Reference Guide - First Request Form (PDF 1.2MB)
• Quick Reference Guide – Upload a signed form (PDF 735KB)
• Demo video - First Request Form (external site)

Should I accept or refuse the first request?

If you accept the first request, you will become the coordinating practitioner for the patient (if eligible) and will coordinate the VAD process in accordance with the Act.

There are several reasons you may decide to refuse a first request:

• You do not meet the eligibility criteria (e.g. you’re a junior doctor)
• You are unwilling to accept the first request (e.g. you do not want to be the coordinating practitioner for the patient)
• You are unable to accept the first request (e.g. you cannot commit the time required)
• You hold a conscientious objection to VAD

If you hold a conscientious objection or you already know you are ineligible to act in the role of coordinating practitioner for the patient, you must refuse the first request.

If you are likely to be eligible to be the coordinating practitioner for the patient, deciding whether to accept or refuse the first request is a personal choice. You can take up to 2 business days to confirm your eligibility and inform the patient of your decision.

While you can accept the first request without completing the mandatory approved training, you must complete the training before you commence the assessment process for the patient. Practitioner eligibility requirements are covered in Access to the WA VAD Approved Training In some cases it is better to refer the patient to the WA VAD Statewide Care Navigator Service who can help them find a VAD provider.

WA VAD Statewide Care Navigator Service

Phone: (08) 9431 2755

Email:  VADcarenavigator@health.wa.gov.au