Hospice is not a place, but rather a form of medical care that enables the probability of a peaceful death for most people. Committees. Not only do you have to think about your own death, but there are medical and legal decisions that aren’t easy. Phyllis Shacter Phyllis Shacter is a VSED advocate from Washington state. Palliative care and hospice care are often confused, yet they are very similar when it comes to the most important issue for dying people: care. Hospice can help people remain in control and die at home. End of Life Washington provides client services to those who are facing the end of life and desire a peaceful death. Current policy environment In May 2018 the DOH released the WA End-of-Life and Palliative Care Strategy 2018-2028 (the Strategy), which provides strategic, statewide policy direction and outlines the vision, values and priorities for end-of-life and palliative care in WA to 2028. It is an important Medicare benefit for terminally ill patients who may only have months to live. 2. End of Life Choices. There is no one right answer or choice; preferences vary from person to person. That a Joint Select Committee of the Legislative Assembly and Legislative Council on End of Life Choices be established. Since the early 1980s the principal objective of Dying with Dignity WA has been to advocate for enhanced choice at the end of life, and to work for the successful passage through the WA Parliament of voluntary assisted dying legislation that is both safe and workable. Legislative Assembly. Joint Select Committee on End of Life Choices Report 1) 328.365 Not aimed at curing illness, the focus is on comfort, dignity and quality of life. The WA Government supports recommendations 1 to 6, noting a range of dependencies. Forego Treatment Hospice and Palliative Care VSED: Voluntary Stopping Eating and Drinking Death with Dignity (DWD): Medical Aid in Dying Palliative Sedation. Training should also include those working in aged care. The establishment of a purpose-built central electronic register for Advance Health Directives that is accessible by health professionals 24 hours per day and a mechanism for reporting to Parliament annually the number of Advance Health Directives in WA. The Minister for Health should ensure regional palliative care be adequately funded to meet demand. The Government is committed to ensuring the highest quality end of life and palliative care for all Western Australians. The Committee handed down its report My Life, My Choice (the Report) to both Houses of Parliament on 23 August 2018 that outlined 52 findings and made 24 recommendations in relation to end-of-life choices. Hospice can help people remain in control and die at home. Report 1) Joint Select Committee on End of Life Choices … Thank you for inviting The Royal Australasian College of Physicians (RACP) to provide a submission addressing the terms of reference of the Joint Select Committee(JSC) on End of Life Choices. For some terminally ill people, aggressive treatment may not be helpful and may prolong the dying process. That the Committee inquire into and report on the need for laws in Western Australia to allow citizens to make informed decisions regarding their own end of life choices and, in particular, the Committee should – The goal of good end-of-life care is to prevent as much physical and emotional suffering as possible. Of this, $30.2 million has been assigned to the WA Country Health Service to expand regional palliative care teams, including additional specialist palliative care nurses, Aboriginal health workers, and seven days per week telehealth and after-hours support. End of Life Washington developed the combined Durable Power of Attorney for Health Care and Health Care Directive after years of committed research and development. We will also be providing a group this year for those whose loved ones Voluntarily Stopped Eating and Drinking (VSED). It is covered by Medicare, Medicaid, HMOs (such as Kaiser Permanente), the Veterans Administration, and most private health insurers. Joint Select Committee Inquiry into End of Life Choices. Within 30 calendar days of writing a prescription for medication under this act, the attending physician must send the following completed, signed, and dated forms by mail to the State Registrar, Center for Health Statistics, P.O. That a Joint Select Committee of the Legislative Assembly and Legislative Council on End of Life Choices be established. Most hospices will not deny care to a patient pursing the option of DWD, although they may choose to opt out of supporting a patient on the day of ingesting medications. For more information about any of these end-of-life options and to request our free client support services, contact End of Life Washington. Neither leaders nor civilians from warring nations were prepared for the length and brutality of the war, which took the lives of millions by its end in 1918. The review should examine the benefits and risks of each model and the accessibility of each across the state as well as the admission criteria for hospice care. Compassion & Choices envisions a society that affirms life and accepts the inevitability of death, embraces expanded treatment options for compassionate dying, and empowers everyone to choose end-of-life care that reflects their values, priorities, and beliefs. The treatment must be specifically noted in the medical record as 'terminal sedation.'. An Expert Panel will be appointed by the Attorney General in accordance with recommendation 1; the Panel will also address recommendations 2 and 3. There are tools, pathways, resources and clinical information to help you meet the needs of your patient and their family. While hospice has no legal role in the Death with Dignity (DWD) process, some hospices – particularly those affiliated with religious organizations – are less supportive of DWD than others. They. Must be able to self-ingest the medication either orally or by pushing through an NG tube. WEST PERTH WA 6005 Website: www.parliament.wa.gov.au Published by the Parliament of Western Australia, Perth. Parliament. An additional $5 million has been made available for the new 38-bed Carnarvon Aged and Palliative Care Facility, bringing the total budget for this facility to $16.6 million. The Minister for Health should ensure that any bill to introduce a legislative framework for voluntary assisted dying is introduced by the government. A Ministerial Expert Panel (MEP) will be appointed to assist in the consultation and development of legislation for a safe and compassionate voluntary assisted dying framework for Western Australia. End of Life Decisions: Current Western Australian Debate 31 Jan 2018 The Chief Psychiatrist’s position on voluntary assisted dying, as given in evidence to the Western Australian Parliamentary Joint Select Committee on End of Life Choices, is summarised below. To improve understanding of palliative care in Western Australia, WA Health should: The Minister for Health should prioritise policy development and improved governance structures for the delivery of palliative care by WA Country Health Services. Select Committee on End of Life Choices Legislative Assembly Parliament House PERTH WA 6000 Submissions can also be forwarded electronically to eolcc@parliament.wa.gov.au (iv) Other important information Please note that, unless the Committee decides otherwise, submissions are part of the Committee’s public record. The Minister for Health should ensure that legislation require that death be reasonably foreseeable as a consequence of the condition. The Ministry of Justice and Ministry of Health confirmed that, "The Bill uses “assisted dying” to refer to both euthanasia and assisted suicide. Recommendations 1 to 6 are related to Advance Care Planning (ACP) and in particular Advance Health Directives (AHD). Unlike adequate pain and symptom management, however, palliative sedation is not necessarily a “right.” While it can be requested, it is up to the medical provider to determine if it is appropriate. The Compassion & Choices Action Network is the largest national 501(C)4 organization who is exclusively devoted to authorizing and defending federal and state policies that improve care and expand options at the end of life. Investigate how World War I heightened divisions between “we” and “they” among people and nations and left behind fertile ground for Nazi Germany in the following decades. Joint Select Committee on End of Life Choices. August 2018. The Minister for Health recommends to the Council of Australian Governments an amendment to the Medicare rebate schedule to include preparation of advance health directives with general practitioners. Recommendations 4-6 relating to Advance Care Planning and Advance Health Directives will be led by the WA Department of Health. If having hospice support for the decision to pursue the option of DWD is important, be sure to question potential hospice providers about their policies. Your Life, Your Choices offers free, two-hour group sessions directed at helping you make informed decisions about your end-of-life care. $5.8 million has been allocated to the planning and sector wide consultation for the My Life, My Choice recommendations around advance health directives and advance care planning; end-of-life and palliative care; and voluntary-assisted dying. There is also information about the legal and administrative requirements … Voluntary assisted dying will be a legal end of life choice for eligible Western Australians from 1 July 2021. The goal of hospice is to improve quality of life in the patient’s last months, focusing on comfort care, control of pain, and symptom management, as opposed to continuing curative treatments. The Minister for Health should ensure that community palliative care providers, such as Silver Chain, are adequately funded to provide for growing demand. Establish a consistent definition of palliative care to be adopted by all health professionals; Provide comprehensive, accessible and practical information and education services about palliative care to health professionals and the community; Encourage knowledge sharing by palliative care specialists with their generalist colleagues; and. WA Health should provide specific guidelines on the use of terminal sedation by health professionals for patients at the end of life. The MEP will undertake the required consultation in order to provide expert advice and direction on the development of the legislation.”. Life … The nature, purpose and effect of advance health directives and enduring powers of guardianship, How to identify a valid advance health directive; and. The Joint Select Committee on End of Life Choices has spent the last 12 months hearing the views of stakeholders, organisations and residents in relation to euthanasia. Submission to WA Inquiry about end of life choices This document is a submission made in 2017 by the APS to the Western Australian Parliamentary Inquiry into the need for laws to allow citizens to make informed decisions regarding their own end of life choices. The Western Australian government develop and introduce legislation for voluntary assisted dying having regard to the recommended framework and following consultation with the Panel established under Recommendation 21. Two days earlier Mr Gaffney had tabled 109 submissions on the proposed legislation most expressing support for his assisted dying legislation. It is important to note that palliative care is for anyone with a serious illness. “The WA Government supports recommendations 19, 21 and 24. End-of-life choices can be hard to make. How to Make Your Choices. End of Life Washington believes that hospice is an essential component of end-of-life care and encourages all individuals who have received a terminal diagnosis to enroll in hospice. Consulting with your physician and arranging for palliative (comfort) care are essential before stopping treatment. If reading this information on voluntary assisted dying has raised distressing issues for you the following helplines can be contacted for support: LifeLine WA 13 11 14 (available 24/7) or online chat www.lifelinewa.org.au WA Health should provide ongoing professional development – beyond undergraduate training – for health professionals about the transition from curative to non-curative end of life care and effective discussions with patients and families about futile treatments. In 2017, a Joint Select Committee on End of Life Choices was established by the Parliament of Western Australia. WA Health should implement a process to determine the unmet demand for palliative care and establish an ongoing process to measure the delivery of palliative care services with the aim of making those services available to more Western Australians. Hospice can also be provided in long-term care facilities, such as nursing homes. Speaking of Dying End of Life Washington (formerly Compassion & Choices of Washington) guides people in planning for the final days of their lives. in WA . This means that your submission may be published on the Parliament’s … End of Life Washington believes that hospice is an essential component of end-of-life care and encourages all individuals who have received a terminal diagnosis to enroll when they become eligible. Palliative sedation, also referred to as terminal sedation, is the practice of relieving difficult-to-manage distress for a terminally ill person in the last days and hours of life, usually by means of a sedative drug which renders the patient unconscious. This journey starts with the diagnosis of a life-limiting illness, even if the prognosis is ambiguous or unknown. The Minister for Health should ensure that health professionals are not compelled to participate if any voluntary assisted dying framework is developed for Western Australia. WA Health should provide ongoing professional development – beyond undergraduate training – for all health professionals regarding the absolute right of a competent patient to refuse food and water. Recommendations that include specific detail on the development of the legislation (Recommendations 20, 22, 23) are supported, noting that the MEP will provide advice on these matters. On 23 August 2017, the Parliament established a Joint Select Committee of the Legislative Assembly and Legislative Council to inquire and report on the need for laws in Western Australia to allow citizens to make informed decisions regarding their own end of life choices, in particular, the Committee should – This objective was achieved in December 2019 when the Voluntary Assisted Dying Act 2019 passed into law. End of Life Decisions: Current Western Australian Debate. Establish a palliative care information and community hotline. The loss of life was greater than in any previous war in history, in part because militaries were using new technologies, including tanks, airplanes, submarines, machine guns, modern artillery, flamethrowers, and poison gas. Hospice caregivers control pain and other symptoms and provide counseling, family support, and many other services. With an ever-growing and ageing population, a renewed focus on these issues is vital so that people with life-limiting or terminal illness can live their lives fully and as comfortably as possible. If you are considering Death with Dignity and/or do not qualify for Death with Dignity, there are additional end-of-life options. Hospice is essential for terminally ill people who choose to stop treatment and/or voluntarily stop eating and drinking, especially if they wish to remain in their homes. The Minister for Health should facilitate the establishment of an inpatient specialist palliative care hospice providing publicly funded beds in the northern suburbs of Perth. 1. Parliament. People who receive hospice care no longer receive curative treatment for their underlying disease. If having the option of palliative sedation is important, discuss it with hospice or other medical providers well before it becomes necessary. This represents a total investment by the State Government for palliative care services of $206.2 million over the next four years. The actual spend by WA Health on palliative care on a year-by-year and like-for-like basis, across all aspects of palliative care provision, including community service providers, area health services (including WA Country Health Services) and delineating between inpatient, consultancy and community care. Many people are unaware that stopping treatment can result in a peaceful death. Committees. 2. As per any other medical treatment, the requirement for informed consent must be clear. It has been widely praised by health care professionals, advance planning advocates, and attorneys who specialize in … On Thursday 27 August the End of Life Choices (Voluntary Assisted Dying) Bill 2020 was tabled in the Tasmanian Parliament by Mersey MLC Mike Gaffney. Palliative sedation is usually provided in a hospital or a skilled nursing or inpatient hospice facility. 1. Our Volunteer Client Advisors help patients explore their options for end of life. Legislative Assembly. The Attorney General, in consultation with the Minister for Health, appoint an expert panel to review the relevant law and health policy and practice – and provide recommendations in relation to the following matters: The Attorney General, in consultation with WA Health, and relevant health professional bodies, undertake an immediate and extensive program to educate health professionals about: The Attorney General, in consultation with WA Health, provide greater education for the wider community about: WA Health immediately develop a strategy to ensure that when an AHD is provided by a patient to a hospital, it is easily accessible and stored prominently on the medical record – until there is a central database. The Committee undertook an Inquiry into the need for laws in Western Australia (WA) to allow citizens to make informed decisions regarding their own end-of-life choices. The Suicide Call Back Service 1300 659 467 (available 24/7) or online chat www.suicidecallbackservice.org.au, Advance Care Planning – Recommendations 1 to 6, End-of-Life and Palliative Care – Recommendations 7 to 18, Voluntary assisted dying – Recommendations 19 to 24, Joint Select Committee on End of Life Choices (external site), Western Australian Government response to, Independent review – Consumer perspectives of palliative care service models – Summary report (PDF 588KB), Independent review – Consumer perspectives of palliative care service models – Summary report at a glance (PDF 216KB), Goals of Care and End-of-life in the COVID-19 environment. Honoring Choices Pacific Northwest is a joint initiative between the Washington State Hospital Association and Washington State Medical Association. A referral from a doctor, who usually remains your primary care physician during hospice care, is required. It provides relief from distressing symptoms including pain, shortness of breath, nausea, problems with sleep, anxiety, and side effects of medications. If you are mourning the loss of a loved one who chose Death with Dignity or VSED, contact facilitator Sally Thomae, MSW at sthomae@endoflifewa.org to ask about our upcoming groups. For more information, request or see our handout: or go to the Washington State Hospice and Palliative Care Organization’s website, www.wshpco.org. In 2017 a Joint Select Committee (the Committee) on End-of-Life Choices was established by the Parliament of Western Australia. A joint initiative of the WSMA and the Washington State Hospital Association, Honoring Choices Pacific Northwest is inspiring adults of all ages to create their personal end-of-life care plans, with tools they need to get started and guidance for sharing those plans with their loved ones and health care teams. The WA Parliament has established a Committee to investigate end-of-life choices Similar to the Victorian Parliamentary inquiry in 2015/16, the move is a strong step forward in assessing current practice and recommending improvements to both legislative and regulatory oversight of end-of-life for Australians in the west. End of Life Washington can help you manage some of the most intimate and important decisions you will ever make. People considering the option of Death with Dignity (DWD) should be aware of all of their end-of-life options. A Washington State nonprofit that promotes consumer choice for end-of-life arrangements. End of Life Washington - Death With Dignity End of Life Washington End of Life Washington (formerly Compassion & Choices of Washington) guides people in planning for the final days of their lives. A Government bill will be introduced into Parliament for voluntary assisted dying. Your Life, Your Choices offers free, two-hour group sessions directed at helping you make informed decisions about your end-of-life care. WA Statewide Voluntary Assisted Dying Pharmacy Service (PDF 881KB) Making the first request (PDF 883KB) Assistance with communication (PDF 881KB) Review of certain decisions (PDF 882KB) Completing the written declaration (PDF 884KB) Choosing the Contact Person (PDF 881KB) Considerations at end-of-life (894KB) Being the Contact Person (PDF 884 KB) Download our Practical Guide to VSED - includes additional information and FAQs, Caregiver Advice and Managing Symptoms Suggestions, Sample Letter to Physician, statement, My Decision to Voluntarily Stop Eating and Drinking Statement. Once a consistent definition of palliative care has been established by WA Health in accordance with Recommendation 11, the Minister for Health should appoint an independent reviewer to audit: WA Health should provide ongoing professional development for all health professionals – beyond undergraduate training – about the right of a patient to refuse medical treatment. Must be of sound mind and exhibit appropriate decision-making capabilities to the attending physician. End of life care This section is for health professionals providing care and support across a patient’s end of life journey. Palliative care is treatment of the discomfort, symptoms, and stress of serious illness, with comfort and quality of life as primary goals. We hold that mentally competent adults who suffer from a terminal illness, intractable physical pain, chronic or progressive physical disabilities, or who face loss of autonomy and selfhood through dementia, have a basic human right to choose to end their lives when they judge their quality of life to be unacceptable. All nutrition and hydration is stopped, and the patient usually dies within a few days. As part of responding to the recommendations of the Committee, the Government has recently made an additional $41 million commitment to palliative care, with a total of $35.2 million allocated to regional and remote Western Australia. WA Health should consider how it might effectively educate the community about end of life decision-making, and implement appropriate health promotion in this area. Australian Medical Association (WA) Statement on End-of-Life Choices and Palliative Care Voluntary Assisted Dying The AMA (WA) endorses the Federal AMA Position Statement on Euthanasia and Physician Assisted Suicide (2016) - that doctors should not be involved in interventions that have as their primary intention the ending of a person’s life. Under some circumstances stopping treatment can be combined with hospice and palliative care and/or voluntary stopping eating and drinking (see below) to shorten the dying process and reduce suffering. WA Health should conduct an independent review, from a patient’s perspective, of the three models of palliative care in Western Australia; inpatient, consultative and community. The Minister for Health hosted a Palliative Care Summit on 24 August 2019 to progress the implementation of the Committee’s end of life and palliative care recommendations, the 2018-2028 End-of-Life and Palliative Care Strategy and the Sustainable Health Review recommendations on end of life care. 31 Jan 2018. To qualify for hospice, a person usually has six months or less to live and will be required to decline further curative treatments. Not only do you have to think about your own death, but there are medical and legal decisions that aren’t easy. People considering the option of Death with Dignity (DWD) should also be aware of other end-of-life options. These guidelines should include an agreed name and definition of the treatment. Bereavement groups meet via Zoom, and provide an opportunity to share with others whose loved ones exercised their right to use Washington’s Death with Dignity Law. Additionally, hospice helps people remain in control and die at home, where most people prefer to die. Harvest Terrace Email: eolcc@parliament.wa.gov.au PERTH WA 6000 Website: www.parliament.wa.gov.au Published by the Legislative Assembly, Parliament of Western Australia, Perth. California End of Life Option Act (Medical Aid in Dying) Eligibility Requirements to Access the Law: Must be 18 years or older. LEARN MORE about what they do. We work openly and without detriment to support volunteers, staff and clients, without regard to their beliefs or backgrounds. decisions regarding their own end of life choices People with Disabilities (WA) Inc. (PWdWA) and the Australian Federation of Disability Organisations (AFDO) would like to thank the Western Australian State Parliament for inviting our organisations to make a joint submission on this topic. Box 47856, Olympia, WA 98504-7856: A requirement that health professionals must search the register for a patient’s Advance Health Directives, except in cases of emergency where it is not practicable to do so. The Minister for Health establish an expert panel including health and legal practitioners and health consumers to undertake consultation and develop legislation for voluntary assisted dying in Western Australia, and that this report, together with the Framework contained at the end of Chapter 7, be considered by that Panel. That the Committee inquire into and report on the need for laws in Western Australia to allow citizens to make informed decisions regarding their own end of life choices and, in particular, the Committee should – My Life, My Choice 5 3. A cruel set of choices: End of Life Choices in WA Wrap, Part 1 May 12, 2018 May 13, 2018 ~ uueaver Nearly six months after Victoria became the first Australian state to legislate for assisted dying, the West Australian End of Life Choices Committee is considering the question of whether Westralians need a similar law and what form it should take. (Series: Western Australia. The hierarchy of medical treatment decision-makers. He worked with A Sacred Passing and End of Life Washington to put all of the necessary documents in place and identify the markers that would indicate when he was still capable of making the choice for himself- a requirement to be able to VSED. ISBN: 978-1-925724-20-2 (Series: Western Australia. It is available for any age and any stage of an illness, and may include curative treatment. End of Life Washington provides advice and support to people considering all end-of-life decisions, including Death with Dignity. In 2017, a Joint Select Committee on End of Life Choices was established by the Parliament of Western Australia. This follows similar processes in … The WA Cancer and Palliative Care Network Policy Unit is undertaking further consultation and planning on the implementation of recommendations 7 to 18. He communicated to his family and friends that this was his end-of-life choice and found a physician that would support him. More Resources. Amendments to the current Western Australian template for Advance Health Directives in order to match, as a minimum, the leading example across Australia, taking into account Finding 7. The Committee undertook an Inquiry into the need for laws in Western Australia (WA) to allow citizens to make informed decisions regarding their own end-of-life choices. End of Life Washington (EOLWA) honors and accepts people of all races, ethnicity, culture, gender identification, religion, disabilities, age, sexual orientation and nationality. There are many dignified ways to die. End of Life Washington is recognized nationally for its advocacy of choice for the terminally ill. The Department of Health is currently working to ensure the process is safe, appropriate and follows the law when it becomes available from 1 July 2021. Back to Events, classes & Support Groups. However, stopping medical treatments may increase discomfort or suffering. These recommendations cover a number of matters including policy and practice, strategy, governance, reporting and education for health professionals. Despite its … Sound Generations Sound Generations is a comprehensive non-profit organization that serves older adults and adults with disabilities in King County. WA Health should also specifically amend the Consent to Treatment Policy to provide comprehensive information in relation to a competent patient’s absolute right to refuse medical treatment. For many, it is reassuring just to know that options exist. The End of Life Choice Act 2019 is an Act of Parliament in New Zealand that seeks to give people with a terminal illness the option of receiving assisted dying. That the Minister for Health ensure the eligibility requirement in the legislation include that the person is experiencing grievous and irremediable suffering related to an advanced and progressive terminal, chronic or neurodegenerative condition that cannot be alleviated in a manner acceptable to the person. Consider how the increasing number of people diagnosed with dementia can have their health care wishes, end of life planning decisions and advance health directives acknowledged and implemented once they have lost capacity. End-of-life choices can be hard to make. End of Life Washington believes that hospice is an essential component of end-of-life care and encourages all individuals who have received a terminal diagnosis to enroll when they become eligible. We inspire conversations about the care people want at the end of life. This journey starts with the diagnosis of a life-limiting illness, even if the prognosis is ambiguous or unknown. The Committee could not find reliable information about palliative care spending in WA.