Western Australia: Voluntary Assisted Dying Act 2019 (WA)

Western Australia Voluntary Assisted Dying Act 2019 Western Australia Voluntary Assisted Dying Act 2019 Contents Part 1 — Preliminary Division 1 — Introductory provisions 1. Short title 2 2. Commencement 2 3. Act binds Crown 2 Division 2 — Principles 4. Principles 2 Division 3 — Interpretation 5. Terms used 4 6. Decision‑making capacity 9 7. Voluntary assisted dying substance 9 8. When request and assessment process completed 10 Division 4 — Other provisions 9. Registered health practitioner may refuse to participate in voluntary assisted dying 10 10. Health care worker not to initiate discussion about voluntary assisted dying 10 11. Contravention of Act by registered health practitioner 12 12. Voluntary assisted dying not suicide 12 13. Inherent jurisdiction of Supreme Court not affected 12 14. Relationship with Medicines and Poisons Act 2014 and Misuse of Drugs Act 1981 12 Part 2 — Requirements for access to voluntary assisted dying 15. When person can access voluntary assisted dying 13 16. Eligibility criteria 13 Part 3 — Requesting access to voluntary assisted dying and assessment of eligibility Division 1 — Eligibility requirements for medical practitioners 17. Eligibility to act as coordinating practitioner or consulting practitioner 15 Division 2 — First request 18. Person may make first request to medical practitioner 16 19. No obligation to continue after making first request 17 20. Medical practitioner to accept or refuse first request 17 21. Medical practitioner to record first request and acceptance or refusal 18 22. Medical practitioner to notify Board of first request 18 23. Medical practitioner becomes coordinating practitioner if first request accepted 19 Division 3 — First assessment 24. First assessment 19 25. Coordinating practitioner to have completed approved training 20 26. Referral for determination 20 27. Information to be provided if patient assessed as meeting eligibility criteria 21 28. Outcome of first assessment 22 29. Recording and notification of outcome of first assessment 23 30. Referral for consulting assessment if patient assessed as eligible 24 Division 4 — Consulting assessment 31. Medical practitioner to accept or refuse referral for consulting assessment 24 32. Medical practitioner to record referral and acceptance or refusal 25 33. Medical practitioner to notify Board of referral 26 34. Medical practitioner becomes consulting practitioner if referral accepted 26 35. Consulting assessment 26 36. Consulting practitioner to have completed approved training 27 37. Referral for determination 27 38. Information to be provided if patient assessed as meeting eligibility criteria 28 39. Outcome of consulting assessment 28 40. Recording and notification of outcome of consulting assessment 29 41. Referral for further consulting assessment if patient assessed as ineligible 30 Division 5 — Written declaration 42. Patient assessed as eligible may make written declaration 30 43. Witness to signing of written declaration 32 44. Certification of witness to signing of written declaration 32 45. Coordinating practitioner to record written declaration 33 46. Coordinating practitioner to notify Board of written declaration 33 Division 6 — Final request and final review 47. Patient may make final request to coordinating practitioner 34 48. When final request can be made 34 49. Coordinating practitioner to record final request 35 50. Coordinating practitioner to notify Board of final request 35 51. Final review by coordinating practitioner on receiving final request 36 52. Technical error not to invalidate request and assessment process 37 53. No obligation for patient to continue after completion of request and assessment process 37 Part 4 — Accessing voluntary assisted dying and death Division 1 — Eligibility requirements for administering practitioners 54. Eligibility to act as administering practitioner 38 Division 2 — Administration of voluntary assisted dying substance 55. Application of Division 39 56. Administration decision 39 57. Revocation of administration decision 40 58. Self‑administration 41 59. Practitioner administration 43 60. Coordinating practitioner to notify Board of administration decision and prescription of substance 44 61. Certification by administering practitioner following administration of prescribed substance 45 62. Witness to administration of prescribed substance 46 63. Transfer of administering practitioner's role 47 Division 3 — Contact person 64. Application of Division 48 65. Patient to appoint contact person 48 66. Contact person appointment form 49 67. Role of contact person 50 68. Contact person may refuse to continue in role 51 Division 4 — Prescribing, supplying and disposing of voluntary assisted dying substance 69. Information to be given before prescribing substance 51 70. Prescription for substance 53 71. Authorised supplier to authenticate prescription 54 72. Information to be given when supplying prescribed substance 54 73. Labelling requirements for prescribed substance 55 74. Authorised supplier to record and notify of supply 55 75. Disposal of prescribed substance by authorised disposer 56 76. Authorised disposer to record and notify of disposal 56 77. Disposal of prescribed substance by administering practitioner 57 78. Administering practitioner to record and notify of disposal 58 Division 5 — Other matters 79. Authorised suppliers and authorised disposers 59 80. Certain directions as to supply or administration prohibited 59 81. Structured administration and supply arrangement not to be issued for substance 60 82. Notification of death 60 Part 5 — Review by Tribunal 83. Terms used 62 84. Application for review of certain decisions by Tribunal 62 85. Notice of decision and right to have it reviewed 63 86. Consequences of review application 63 87. Review application taken to be withdrawn if patient dies 64 88. Decision of Tribunal 64 89. Effect of decision under s. 88(a), (c) or (e) 65 90. Effect of decision under s. 88(b), (d) or (f) 66 91. Coordinating practitioner may refuse to continue in role 67 92. Constitution and membership of Tribunal 67 93. Hearings of Tribunal to be held in private 67 94. Notice requirements 68 95. Coordinating practitioner to give Tribunal relevant material 69 96. Tribunal to give written reasons for decision 69 97. Published decisions or reasons to exclude personal information 70 98. Interim orders 71 Part 6 — Offences 99. Unauthorised administration of prescribed substance 72 100. Inducing another person to request or access voluntary assisted dying 72 101. Inducing self‑administration of prescribed substance 72 102. False or misleading information 73 103. Advertising Schedule 4 or 8 poison as voluntary assisted dying substance 73 104. Cancellation of document presented as prescription 73 105. Contact person to give unused or remaining substance to authorised disposer 74 106. Recording, use or disclosure of information 75 107. Publication of personal information concerning proceeding before Tribunal 76 108. Failure to give form to Board 77 Part 7 — Enforcement 109. Application of Medicines and Poisons Act 2014 Part 7 78 110. Court to notify CEO of conviction of offence under Act 78 111. Who may commence proceedings for simple offence 79 112. Time limit for prosecution of simple offence 79 Part 8 — Protection from liability 113. Protection for persons assisting access to voluntary assisted dying or present when substance administered 80 114. Protection for persons acting in accordance with Act 80 115. Protection for certain persons who do not administer lifesaving treatment 80 Part 9 — Voluntary Assisted Dying Board Division 1 — Establishment 116. Board established 82 117. Status 82 Division 2 — Functions and powers 118. Functions of Board 82 119. Powers of Board 83 120. Delegation by Board 83 Division 3 — Staff and assistance 121. Staff and services 84 122. Assistance 84 Division 4 — Accountability 123. Minister may give directions 84 124. Minister to have access to information 85 Division 5 — Membership 125. Membership of Board 85 126. Chairperson and deputy chairperson 86 127. Term of office 86 128. Casual vacancies 86 129. Extension of term of office during vacancy 87 130. Alternate members 87 131. Remuneration of members 88 Division 6 — Board meetings 132. Holding meetings 88 133. Quorum 88 134. Presiding member 88 135. Procedure at meetings 89 136. Voting 89 137. Holding meetings remotely 89 138. Resolution without meeting 89 139. Minutes 89 Division 7 — Disclosure of interests 140. Disclosure of material personal interest 89 141. Voting by interested member 90 142. Section 141 may be declared inapplicable 90 143. Quorum where s. 141 applies 91 144. Minister may declare s. 141 and 143 inapplicable 91 Division 8 — Committees 145. Establishment of committees 91 146. Directions to committee 91 147. Committee to determine own procedures 92 148. Remuneration of committee members 92 Division 9 — Information 149. Board to send information to contact person for patient 92 150. Request for information 92 151. Disclosure of information 93 152. Board to record and retain statistical information 93 Division 10 — Miscellaneous 153. Board to notify receipt of forms 94 154. Execution of documents by Board 94 155. Annual report 94 Part 10 — Access standard 156. Standard about access to voluntary assisted dying 96 Part 11 — General 157. Transfer of coordinating practitioner's role 97 158. Communication between patient and practitioner 98 159. Information about voluntary assisted dying 99 160. CEO may approve training 100 161. CEO may approve forms 100 162. Interpreters 100 163. Regulations 101 164. Review of Act 101 Part 12 — Consequential amendments to other Acts Division 1 — Constitution Acts Amendment Act 1899 amended 165. Act amended 103 166. Schedule V amended 103 Division 2 — Coroners Act 1996 amended 167. Act amended 103 168. Section 3A inserted 103 3A. Death under Voluntary Assisted Dying Act 2019 not reportable death 103 Division 3 — Guardianship and Administration Act 1990 amended 169. Act amended 104 170. Section 3B inserted 104 3B. Act does not authorise decisions about voluntary assisted dying 104 Division 4 — Health and Disability Services (Complaints) Act 1995 amended 171. Act amended 104 172. Section 3 amended 105 Division 5 — Medicines and Poisons Act 2014 amended 173. Act amended 105 174. Section 3 amended 105 175. Section 7 amended 106 176. Section 14 amended 107 177. Section 28 amended 110 178. Section 83 amended 110 179. Section 115 amended 110 Division 6 — Misuse of Drugs Act 1981 amended 180. Act amended 111 181. Section 5C inserted 111 5C. Authorisation under Voluntary Assisted Dying Act 2019 111 182. Section 5 amended 112 183. Section 6 amended 112 184. Section 7 amended 113 185. Section 7B amended 113 186. Section 27 amended 113 Notes Compilation table 115 Defined terms Western Australia Voluntary Assisted Dying Act 2019 An Act — * to provide for and regulate access to voluntary assisted dying; and * to establish the Voluntary Assisted Dying Board; and * to make consequential amendments to other Acts. Part 1 — Preliminary Division 1 — Introductory provisions 1. Short title This is the Voluntary Assisted Dying Act 2019. 2. Commencement This Act comes into operation as follows — (a) Part 1 (other than Divisions 2 to 4) — on the day on which this Act receives the Royal Assent; (b) the rest of the Act — on a day fixed by proclamation. 3. Act binds Crown This Act binds the Crown in right of Western Australia, and so far as the legislative power of the Parliament permits, the Crown in all its other capacities. Division 2 — Principles 4. Principles (1) A person exercising a power or performing a function under this Act must have regard to the following principles — (a) every human life has equal value; (b) a person's autonomy, including autonomy in respect of end of life choices, should be respected; (c) a person has the right to be supported in making informed decisions about the person's medical treatment, and should be given, in a manner the person understands, information about medical treatment options including comfort and palliative care and treatment; (d) a person approaching the end of life should be provided with high quality care and treatment, including palliative care and treatment, to minimise the person's suffering and maximise the person's quality of life; (e) a therapeutic relationship between a person and the person's health practitioner should, wherever possible, be supported and maintained; (f) a person should be encouraged to openly discuss death and dying, and the person's preferences and values regarding their care, treatment and end of life should be encouraged and promoted; (g) a person should be supported in conversations with the person's health practitioners, family and carers and community about treatment and care preferences; (h) a person is entitled to genuine choices about the person's care, treatment and end of life, irrespective of where the person lives in Western Australia and having regard to the person's culture and language; (i) a person who is a regional resident is entitled to the same level of access to voluntary assisted dying as a person who lives in the metropolitan region; (j) there is a need to protect persons who may be subject to abuse or coercion; (k) all persons, including health practitioners, have the right to be shown respect for their culture, religion, beliefs, values and personal characteristics. (2) In subsection (1), the reference to a person exercising a power or performing a function under this Act includes the Tribunal exercising its review jurisdiction in relation to a decision made under this Act. Division 3 — Interpretation 5. Terms used In this Act, unless the contrary intention appears — administering practitioner, for a patient, means — (a) the coordinating practitioner for the patient; or (b) a person to whom the role of administering practitioner is transferred under section 63(2); administration, in relation to a voluntary assisted dying substance, includes self‑administration; administration decision means a self‑administration decision or a practitioner administration decision; approved form means a form approved by the CEO under section 161 for the purposes of the provision in which the term is used; approved training means training approved by the CEO under section 160; authorised disposal form has the meaning given in section 76(1); authorised disposer has the meaning given in section 79(4); authorised supplier has the meaning given in section 79(2); Board means the Voluntary Assisted Dying Board established by section 116; business day means a day other than a Saturday, a Sunday or a public holiday throughout Western Australia; CEO means the chief executive officer of the Department; completed, in relation to the request and assessment process, has the meaning given in section 8; consulting assessment means an assessment of a patient conducted under section 35(1); consulting assessment report form has the meaning given in section 40(2); consulting practitioner, for a patient, means a medical practitioner who accepts a referral to conduct a consulting assessment of the patient; contact details, in relation to a person, includes the address, telephone number and email address of the person; contact person, for a patient, means the person appointed by the patient under section 65(1); contact person appointment form has the meaning given in section 66(1); coordinating practitioner, for a patient, means — (a) a medical practitioner who accepts the patient's first request; or (b) a consulting practitioner for the patient who accepts a transfer of the role of coordinating practitioner under section 157; decision‑making capacity, in relation to voluntary assisted dying, has the meaning given in section 6(2); Department means the department of the Public Service principally assisting in the administration of this Act; disability has the meaning given in the Disability Services Act 1993 section 3; eligibility criteria means the criteria set out in section 16(1); family member, of a person, means the person's spouse, de facto partner, parent, sibling, child or grandchild; final request means a final request for access to voluntary assisted dying made under section 47(1); final review means a review conducted under section 51(1)(a) by the coordinating practitioner for a patient; final review form has the meaning given in section 51(1)(b); first assessment means an assessment of a patient conducted under section 24(1); first assessment report form has the meaning given in section 29(2); first request means a request for access to voluntary assisted dying made under section 18(1); health service has the meaning given in the Health Services Act 2016 section 7; medical practitioner means a person registered under the Health Practitioner Regulation National Law (Western Australia) in the medical profession (other than as a student); medicine has the meaning given in the Medicines and Poisons Act 2014 section 3; member means a member of the Board; metropolitan region has the meaning given in the Planning and Development Act 2005 section 4(1); nurse practitioner means a person registered under the Health Practitioner Regulation National Law (Western Australia) in the nursing profession whose registration under that Law is endorsed as nurse practitioner; palliative care and treatment means care and treatment that — (a) is provided to a person who is diagnosed with a disease, illness or medical condition that is progressive and life‑limiting; and (b) is directed at preventing, identifying, assessing, relieving or treating the person's pain, discomfort or suffering in order to improve their comfort and quality of life; patient means a person who makes a request for access to voluntary assisted dying under this Act; personal information has the meaning given in the Freedom of Information Act 1992 Glossary clause 1; practitioner administration decision has the meaning given in section 56(1)(b); practitioner administration form has the meaning given in section 61(3); practitioner disposal form has the meaning given in section 78(1); prepare, in relation to a prescribed substance — (a) means to do anything necessary to ensure that the substance is in a form suitable for administration; and (b) includes to decant, dilute, dissolve, mix, reconstitute, colour or flavour the substance; prescribe, in relation to a voluntary assisted dying substance, means to issue a prescription for the substance; prescribed substance means — (a) a voluntary assisted dying substance prescribed for a patient by the coordinating practitioner for the patient; and (b) in relation to a patient, the voluntary assisted dying substance prescribed for the patient by the coordinating practitioner for the patient; prescription, in relation to a voluntary assisted dying substance, has the same meaning as it has, in relation to a Schedule 4 or 8 poison, in the Medicines and Poisons Act 2014 section 7(1); professional care services means any of the following provided to another person under a contract of employment or a contract for services — (a) assistance or support, including the following — (i) assistance with bathing, showering, personal hygiene, toileting, dressing, undressing or meals; (ii) assistance for persons with mobility problems; (iii) assistance for persons who are mobile but require some form of assistance or supervision; (iv) assistance or supervision in administering medicine; (v) the provision of substantial emotional support; (b) a disability service as defined in the Disability Services Act 1993 section 3; regional resident means a person who ordinarily resides in an area of Western Australia that is outside the metropolitan region; registered health practitioner means a person registered under the Health Practitioner Regulation National Law (Western Australia) to practise a health profession (other than as a student); request and assessment process means the process that consists of the following steps — (a) a first request; (b) a first assessment; (c) a consulting assessment; (d) a written declaration; (e) a final request; (f) a final review; self‑administration decision has the meaning given in section 56(1)(a); supply, in relation to a voluntary assistance dying substance, has the same meaning as it has, in relation to a poison, in the Medicines and Poisons Act 2014 section 8; Tribunal means the State Administrative Tribunal; voluntary assisted dying means the administration of a voluntary assisted dying substance and includes steps reasonably related to that administration; voluntary assisted dying substance has the meaning given in section 7(2); written declaration means a written declaration made under section 42(1). 6. Decision‑making capacity (1) In this section — voluntary assisted dying decision means — (a) a request for access to voluntary assisted dying; or (b) a decision to access voluntary assisted dying. (2) For the purposes of this Act, a patient has decision‑making capacity in relation to voluntary assisted dying if the patient has the capacity to — (a) understand any information or advice about a voluntary assisted dying decision that is required under this Act to be provided to the patient; and (b) understand the matters involved in a voluntary assisted dying decision; and (c) understand the effect of a voluntary assisted dying decision; and (d) weigh up the factors referred to in paragraphs (a), (b) and (c) for the purposes of making a voluntary assisted dying decision; and (e) communicate a voluntary assisted dying decision in some way. (3) For the purposes of this Act, a patient is presumed to have decision‑making capacity in relation to voluntary assisted dying unless the patient is shown not to have that capacity. 7. Voluntary assisted dying substance (1) The CEO may, in writing, approve a Schedule 4 poison or Schedule 8 poison (as those terms are defined in the Medicines and Poisons Act 2014 section 3) for use under this Act for the purpose of causing a patient's death. (2) A poison approved under subsection (1) is a voluntary assisted dying substance. 8. When request and assessment process completed For the purposes of this Act, the request and assessment process has been completed in respect of a patient if the coordinating practitioner for the patient — (a) has completed the final review form in respect of the patient; and (b) has certified in the final review form that the request and assessment process has been completed in accordance with this Act. Division 4 — Other provisions 9. Registered health practitioner may refuse to participate in voluntary assisted dying (1) A registered health practitioner who has a conscientious objection to voluntary assisted dying has the right to refuse to do any of the following — (a) participate in the request and assessment process; (b) prescribe, supply or administer a voluntary assisted dying substance; (c) be present at the time of the administration of a voluntary assisted dying substance. (2) Subsection (1) is not intended to limit the circumstances in which a registered health practitioner may refuse to do any of the things referred to in that subsection. 10. Health care worker not to initiate discussion about voluntary assisted dying (1) In this section — health care worker means — (a) a registered health practitioner; or (b) any other person who provides health services or professional care services. (2) A health care worker who provides health services or professional care services to a person must not, in the course of providing the services to the person — (a) initiate discussion with the person that is in substance about voluntary assisted dying; or (b) in substance, suggest voluntary assisted dying to the person. (3) Nothing in subsection (2) prevents a medical practitioner or nurse practitioner from doing something referred to in subsection (2)(a) or (b) if, at the time it is done, the medical practitioner or nurse practitioner also informs the person about the following — (a) the treatment options available to the person and the likely outcomes of that treatment; and (b) the palliative care and treatment options available to the person and the likely outcomes of that care and treatment. (4) Nothing in subsection (2) prevents a health care worker from providing information about voluntary assisted dying to a person at the person's request. (5) A contravention of subsection (2) by a registered health practitioner is unprofessional conduct for the purposes of the Health Practitioner Regulation National Law (Western Australia). (6) Subsection (5) overrides section 11(1). (7) A contravention of subsection (2) by a provider, as defined in the Health and Disability Services (Complaints) Act 1995 section 3(1), is taken to be unreasonable conduct described in section 25(1)(c) of that Act. 11. Contravention of Act by registered health practitioner (1) A contravention of a provision of this Act by a registered health practitioner is capable of constituting professional misconduct or unprofessional conduct for the purposes of the Health Practitioner Regulation National Law (Western Australia). (2) Subsection (1) applies whether or not the contravention constitutes an offence under this Act. 12. Voluntary assisted dying not suicide For the purposes of the law of the State, a person who dies as the result of the administration of a prescribed substance in accordance with this Act does not die by suicide. 13. Inherent jurisdiction of Supreme Court not affected Nothing in this Act affects the inherent jurisdiction of the Supreme Court. 14. Relationship with Medicines and Poisons Act 2014 and Misuse of Drugs Act 1981 If there is a conflict or inconsistency between a provision of this Act and a provision of the Medicines and Poisons Act 2014 or the Misuse of Drugs Act 1981, the provision of this Act prevails to the extent of the conflict or inconsistency. Part 2 — Requirements for access to voluntary assisted dying 15. When person can access voluntary assisted dying A person may access voluntary assisted dying if — (a) the person has made a first request; and (b) the person has been assessed as eligible for access to voluntary assisted dying by — (i) the coordinating practitioner for the person; and (ii) the consulting practitioner for the person; and (c) the person has made a written declaration; and (d) the person has made a final request to the coordinating practitioner for the person; and (e) the coordinating practitioner for the person has certified in a final review form that — (i) the request and assessment process has been completed in accordance with this Act; and (ii) the practitioner is satisfied of each of the matters referred to in section 51(3)(f); and (f) the person has made an administration decision; and (g) if the person has made a self‑administration decision, the person has appointed a contact person. 16. Eligibility criteria (1) The following criteria must be met for a person to be eligible for access to voluntary assisted dying — (a) the person has reached 18 years of age; (b) the person — (i) is an Australian citizen or permanent resident; and (ii) at the time of making a first request, has been ordinarily resident in Western Australia for a period of at least 12 months; (c) the person is diagnosed with at least 1 disease, illness or medical condition that — (i) is advanced, progressive and will cause death; and (ii) will, on the balance of probabilities, cause death within a period of 6 months or, in the case of a disease, illness or medical condition that is neurodegenerative, within a period of 12 months; and (iii) is causing suffering to the person that cannot be relieved in a manner that the person considers tolerable; (d) the person has decision‑making capacity in relation to voluntary assisted dying; (e) the person is acting voluntarily and without coercion; (f) the person's request for access to voluntary assisted dying is enduring. (2) A person is not eligible for access to voluntary assisted dying only because the person has a disability or is diagnosed with a mental illness (as defined in the Mental Health Act 2014 section 4). Part 3 — Requesting access to voluntary assisted dying and assessment of eligibility Division 1 — Eligibility requirements for medical practitioners 17. Eligibility to act as coordinating practitioner or consulting practitioner (1) In this section — general registration means general registration under the Health Practitioner Regulation National Law (Western Australia) in the medical profession; limited registration means limited registration under the Health Practitioner Regulation National Law (Western Australia) in the medical profession; provisional registration means provisional registration under the Health Practitioner Regulation National Law (Western Australia) in the medical profession; specialist registration means specialist registration under the Health Practitioner Regulation National Law (Western Australia) in the medical profession in a recognised specialty. (2) A medical practitioner is eligible to act as a coordinating practitioner or consulting practitioner for a patient if — (a) the medical practitioner — (i) holds specialist registration, has practised the medical profession for at least 1 year as the holder of specialist registration and meets the requirements approved by the CEO for the purposes of this subparagraph; or (ii) holds general registration, has practised the medical profession for at least 10 years as the holder of general registration and meets the requirements approved by the CEO for the purposes of this subparagraph; or (iii) is an overseas-trained specialist who holds limited registration or provisional registration and meets the requirements approved by the CEO for the purposes of this subparagraph; and (b) the medical practitioner is not a family member of the patient; and (c) the medical practitioner does not know or believe that the practitioner — (i) is a beneficiary under a will of the patient; or (ii) may otherwise benefit financially or in any other material way from the death of the patient, other than by receiving reasonable fees for the provision of services as the coordinating practitioner or consulting practitioner for the patient. (3) The CEO must publish the requirements approved for the purposes of subsection (2)(a)(i), (ii) and (iii) on the Department's website. Division 2 — First request 18. Person may make first request to medical practitioner (1) A person may make a request to a medical practitioner for access to voluntary assisted dying. (2) The request must be — (a) clear and unambiguous; and (b) made during a medical consultation; and (c) made in person or, if that is not practicable, in accordance with section 158(2)(a). (3) The person may make the request verbally or in another way (for example, by gestures). 19. No obligation to continue after making first request (1) A person who makes a first request may decide at any time not to continue the request and assessment process. (2) The request and assessment process ends if the person decides not to continue the process. (3) If the request and assessment process ends under subsection (2), the person may begin a new request and assessment process by making a new first request. 20. Medical practitioner to accept or refuse first request (1) If a first request is made to a medical practitioner, the practitioner must accept or refuse the request. (2) The reasons for which the medical practitioner can refuse the first request are as follows — (a) the practitioner has a conscientious objection to voluntary assisted dying or is otherwise unwilling to perform the duties of a coordinating practitioner; (b) the practitioner is unable to perform the duties of a coordinating practitioner because of unavailability or some other reason; (c) the practitioner is required to refuse the request under subsection (3). (3) The medical practitioner must refuse the first request if the practitioner is not eligible to act as a coordinating practitioner. (4) Unless subsection (5) applies, the medical practitioner must, within 2 business days after the first request is made — (a) inform the patient that the practitioner accepts or refuses the request; and (b) give the patient the information approved by the CEO for the purposes of this section. (5) If the medical practitioner refuses the first request because the practitioner has a conscientious objection to voluntary assisted dying, the practitioner must, immediately after the first request is made — (a) inform the patient that the practitioner refuses the request; and (b) give the patient the information referred to in subsection (4)(b). 21. Medical practitioner to record first request and acceptance or refusal The medical practitioner must record the following in the patient's medical record — (a) the first request; (b) the practitioner's decision to accept or refuse the first request; (c) if the practitioner's decision is to refuse the first request, the reason for the refusal; (d) whether the practitioner has given the patient the information referred to in section 20(4)(b). 22. Medical practitioner to notify Board of first request (1) Within 2 business days after deciding to accept or refuse the first request, the medical practitioner must complete the approved form (the first request form) and give a copy of it to the Board. (2) The first request form must include the following — (a) the name, date of birth and contact details of the patient; (b) the name and contact details of the medical practitioner; (c) the date when the first request was made; (d) whether the first request was made in person or using audiovisual communication and whether it was made verbally or in another way (for example, by gestures); (e) the medical practitioner's decision to accept or refuse the first request; (f) if the medical practitioner's decision is to refuse the first request, the reason for the refusal; (g) the date when the medical practitioner informed the patient of the practitioner's decision and gave the patient the information referred to in section 20(4)(b); (h) the signature of the medical practitioner and the date when the form was signed. 23. Medical practitioner becomes coordinating practitioner if first request accepted If the medical practitioner accepts the first request, the practitioner becomes the coordinating practitioner for the patient. Division 3 — First assessment 24. First assessment (1) The coordinating practitioner for a patient must assess whether the patient is eligible for access to voluntary assisted dying. (2) For the purposes of subsection (1), the coordinating practitioner must make a decision in respect of each of the eligibility criteria. (3) Nothing in this section prevents the coordinating practitioner from having regard to relevant information about the patient that has been prepared by, or at the instigation of, another registered health practitioner. 25. Coordinating practitioner to have completed approved training The coordinating practitioner must not begin the first assessment unless the practitioner has completed approved training. 26. Referral for determination (1) Subsection (2) applies if the coordinating practitioner is unable to determine whether — (a) the patient has a disease, illness or medical condition that meets the requirements of section 16(1)(c); or (b) the patient has decision‑making capacity in relation to voluntary assisted dying as required by section 16(1)(d). (2) The coordinating practitioner must refer the patient to a registered health practitioner who has appropriate skills and training to make a determination in relation to the matter. (3) If the coordinating practitioner is unable to determine whether the patient is acting voluntarily and without coercion as required by section 16(1)(e), the coordinating practitioner must refer the patient to another person who has appropriate skills and training to make a determination in relation to the matter. (4) If the coordinating practitioner makes a referral under subsection (2) or (3), the coordinating practitioner may adopt the determination of the registered health practitioner or other person, as the case requires, in relation to the matter in respect of which the referral was made. (5) A registered health practitioner or other person to whom the patient is referred under subsection (2) or (3) must not be — (a) a family member of the patient; or (b) a person who knows or believes that they — (i) are a beneficiary under a will of the patient; or (ii) may otherwise benefit financially or in any other material way from the death of the patient, other than by receiving reasonable fees for the provision of services in connection with the referral. 27. Information to be provided if patient assessed as meeting eligibility criteria (1) If the coordinating practitioner is satisfied that the patient meets all of the eligibility criteria, the coordinating practitioner must inform the patient about the following matters — (a) the patient's diagnosis and prognosis; (b) the treatment options available to the patient and the likely outcomes of that treatment; (c) the palliative care and treatment options available to the patient and the likely outcomes of that care and treatment; (d) the potential risks of self‑administering or being administered a voluntary assisted dying substance likely to be prescribed under this Act for the purposes of causing the patient's death; (e) that the expected outcome of self‑administering or being administered a substance referred to in paragraph (d) is death; (f) the method by which a substance referred to in paragraph (d) is likely to be self‑administered or administered; (g) the request and assessment process, including the requirement for a written declaration signed in the presence of 2 witnesses; (h) that if the patient makes a self‑administration decision, the patient must appoint a contact person; (i) that the patient may decide at any time not to continue the request and assessment process or not to access voluntary assisted dying; (j) that if the patient is receiving ongoing health services from a medical practitioner other than the coordinating practitioner, the patient is encouraged to inform the medical practitioner of the patient's request for access to voluntary assisted dying. (2) In addition to informing the patient about the matters referred to in subsection (1), the coordinating practitioner must take all reasonable steps to fully explain to the patient and, if the patient consents, another person nominated by the patient — (a) all relevant clinical guidelines; and (b) a plan in respect of the administration of a voluntary assisted dying substance. (3) Nothing in this section affects any duty a medical practitioner has at common law or under any other enactment. 28. Outcome of first assessment (1) The coordinating practitioner must assess the patient as eligible for access to voluntary assisted dying if the coordinating practitioner is satisfied that — (a) the patient meets all of the eligibility criteria; and (b) the patient understands the information required to be provided under section 27(1). (2) If the coordinating practitioner is not satisfied as to any matter in subsection (1) — (a) the coordinating practitioner must assess the patient as ineligible for access to voluntary assisted dying; and (b) the request and assessment process ends. 29. Recording and notification of outcome of first assessment (1) The coordinating practitioner must inform the patient of the outcome of the first assessment as soon as practicable after its completion. (2) Within 2 business days after completing the first assessment, the coordinating practitioner must complete the approved form (the first assessment report form) and give a copy of it to the Board. (3) As soon as practicable after completing the first assessment report form, the coordinating practitioner must give a copy of it to the patient. (4) The first assessment report form must include the following — (a) the name, date of birth and contact details of the patient; (b) the following information in respect of the patient — (i) gender; (ii) nationality; (iii) ethnicity; (iv) whether the patient has a disability; (v) whether the patient's first language is a language other than English; (vi) whether the coordinating practitioner engaged an interpreter in accordance with section 162(2) to communicate the information in section 27 to the patient; (c) the name and contact details of the coordinating practitioner; (d) a statement confirming that the coordinating practitioner meets the requirements of section 17(2); (e) the date when the first request was made; (f) the date when the first assessment was completed; (g) the outcome of the first assessment, including the coordinating practitioner's decision in respect of each of the eligibility criteria; (h) the date when the patient was informed of the outcome of the first assessment; (i) if the patient was referred under section 26(2) or (3), the outcome of the referral (including a copy of any report given by the registered health practitioner or other person to whom the patient was referred); (j) if the patient was assisted by an interpreter when having the first assessment, the name, contact details and accreditation details of the interpreter; (k) the palliative care and treatment options available to the patient and the likely outcomes of that care and treatment; (l) the signature of the coordinating practitioner and the date when the form was signed. 30. Referral for consulting assessment if patient assessed as eligible If the coordinating practitioner assesses the patient as eligible for access to voluntary assisted dying, the practitioner must refer the patient to another medical practitioner for a consulting assessment. Division 4 — Consulting assessment 31. Medical practitioner to accept or refuse referral for consulting assessment (1) If a patient is referred to a medical practitioner for a consulting assessment under section 30, 41 or 157(6)(a), the practitioner must accept or refuse the referral. (2) The reasons for which the medical practitioner can refuse the referral are as follows — (a) the practitioner has a conscientious objection to voluntary assisted dying or is otherwise unwilling to perform the duties of a consulting practitioner; (b) the practitioner is unable to perform the duties of a consulting practitioner because of unavailability or some other reason; (c) the practitioner is required to refuse the referral under subsection (3). (3) The medical practitioner must refuse the referral if the practitioner is not eligible to act as a consulting practitioner. (4) Unless subsection (5) applies, the medical practitioner must, within 2 business days after receiving the referral, inform the patient and the coordinating practitioner for the patient that the practitioner accepts or refuses the referral. (5) If the medical practitioner refuses the referral because the practitioner has a conscientious objection to voluntary assisted dying, the practitioner must, immediately after receiving the referral, inform the patient and the coordinating practitioner for the patient that the practitioner refuses the referral. 32. Medical practitioner to record referral and acceptance or refusal The medical practitioner must record the following in the patient's medical record — (a) the referral; (b) the practitioner's decision to accept or refuse the referral; (c) if the practitioner's decision is to refuse the referral, the reason for the refusal. 33. Medical practitioner to notify Board of referral (1) Within 2 business days after deciding to accept or refuse the referral, the medical practitioner must complete the approved form (the consultation referral form) and give a copy of it to the Board. (2) The consultation referral form must include the following — (a) the name, date of birth and contact details of the patient; (b) the name and contact details of the medical practitioner; (c) the date when the referral was received; (d) the medical practitioner's decision to accept or refuse the referral; (e) if the medical practitioner's decision is to refuse the referral, the reason for the refusal; (f) the date when the medical practitioner informed the patient and the coordinating practitioner for the patient of the practitioner's decision; (g) the signature of the medical practitioner and the date when the form was signed. 34. Medical practitioner becomes consulting practitioner if referral accepted If the medical practitioner accepts the referral, the practitioner becomes the consulting practitioner for the patient. 35. Consulting assessment (1) The consulting practitioner for a patient must assess whether the patient is eligible for access to voluntary assisted dying. (2) For the purposes of subsection (1), the consulting practitioner must make a decision in respect of each of the eligibility criteria. (3) For the purposes of subsection (1), the consulting practitioner must independently of the coordinating practitioner form their own opinions on the matters to be decided. (4) Nothing in this section prevents the consulting practitioner from having regard to relevant information about the patient that has been prepared by, or at the instigation of, another registered health practitioner. 36. Consulting practitioner to have completed approved training The consulting practitioner must not begin the consulting assessment unless the practitioner has completed approved training. 37. Referral for determination (1) Subsection (2) applies if the consulting practitioner is unable to determine whether — (a) the patient has a disease, illness or medical condition that meets the requirements of section 16(1)(c); or (b) the patient has decision‑making capacity in relation to voluntary assisted dying as required by section 16(1)(d). (2) The consulting practitioner must refer the patient to a registered health practitioner who has appropriate skills and training to make a determination in relation to the matter. (3) If the consulting practitioner is unable to determine whether the patient is acting voluntarily and without coercion as required by section 16(1)(e), the consulting practitioner must refer the patient to another person who has appropriate skills and training to make a determination in relation to the matter. (4) If the consulting practitioner makes a referral under subsection (2) or (3), the consulting practitioner may adopt the determination of the registered health practitioner or other person, as the case requires, in relation to the matter in respect of which the referral was made. (5) A registered health practitioner or other person to whom the patient is referred under subsection (2) or (3) must not be — (a) a family member of the patient; or (b) a person who knows or believes that they — (i) are a beneficiary under a will of the patient; or (ii) may otherwise benefit financially or in any other material way from the death of the patient, other than by receiving reasonable fees for the provision of services in connection with the referral. 38. Information to be provided if patient assessed as meeting eligibility criteria (1) If the consulting practitioner is satisfied that the patient meets all of the eligibility criteria, the consulting practitioner must inform the patient about the matters referred to in section 27(1). (2) Nothing in this section affects any duty a medical practitioner has at common law or under any other enactment. 39. Outcome of consulting assessment (1) The consulting practitioner must assess the patient as eligible for access to voluntary assisted dying if the consulting practitioner is satisfied that — (a) the patient meets all of the eligibility criteria; and (b) the patient understands the information required to be provided under section 38(1). (2) If the consulting practitioner is not satisfied as to any matter in subsection (1), the consulting practitioner must assess the patient as ineligible for access to voluntary assisted dying. 40. Recording and notification of outcome of consulting assessment (1) The consulting practitioner must inform the patient and the coordinating practitioner for the patient of the outcome of the consulting assessment as soon as practicable after its completion. (2) Within 2 business days after completing the consulting assessment, the consulting practitioner must complete the approved form (the consulting assessment report form) and give a copy of it to the Board. (3) As soon as practicable after completing the consulting assessment report form, the consulting practitioner must give a copy of it to the patient. (4) The consulting assessment report form must include the following — (a) the name, date of birth and contact details of the patient; (b) the name and contact details of the consulting practitioner; (c) a statement confirming that the consulting practitioner meets the requirements of section 17(2); (d) the date when the first request was made; (e) the date when the referral for the consulting assessment was made; (f) the date when the referral for the consulting assessment was received; (g) the date when the consulting assessment was completed; (h) the outcome of the consulting assessment, including the consulting practitioner's decision in respect of each of the eligibility criteria; (i) the date when the patient was informed of the outcome of the consulting assessment; (j) the date when the coordinating practitioner for the patient was informed of the outcome of the consulting assessment; (k) if the patient was referred under section 37(2) or (3), the outcome of the referral (including a copy of any report given by the registered health practitioner or other person to whom the patient was referred); (l) if the patient was assisted by an interpreter when having the consulting assessment, the name, contact details and accreditation details of the interpreter; (m) the palliative care and treatment options available to the patient and the likely outcomes of that care and treatment; (n) the signature of the consulting practitioner and the date when the form was signed. (5) The consulting practitioner must give a copy of the consulting assessment report form to the coordinating practitioner for the patient as soon as practicable after completing the consulting assessment. 41. Referral for further consulting assessment if patient assessed as ineligible If the consulting practitioner assesses the patient as ineligible for access to voluntary assisted dying, the coordinating practitioner for the patient may refer the patient to another medical practitioner for a further consulting assessment. Division 5 — Written declaration 42. Patient assessed as eligible may make written declaration (1) A patient may make a written declaration requesting access to voluntary assisted dying if the patient has been assessed as eligible for access to voluntary assisted dying by — (a) the coordinating practitioner for the patient; and (b) the consulting practitioner for the patient. (2) The written declaration must be in the approved form and given to the coordinating practitioner for the patient. (3) The written declaration must — (a) specify that the patient — (i) makes it voluntarily and without coercion; and (ii) understands its nature and effect; and (b) be signed by the patient, or a person referred to in subsection (4), in the presence of 2 witnesses; and (c) include the following — (i) the name, date of birth and contact details of the patient; (ii) if the patient was assisted by an interpreter, the name, contact details and accreditation details of the interpreter; (iii) the name and contact details of the coordinating practitioner for the patient. (4) A person may sign the written declaration on behalf of the patient if — (a) the patient is unable to sign the declaration; and (b) the patient directs the person to sign the declaration; and (c) the person — (i) has reached 18 years of age; and (ii) is not a witness to the signing of the declaration; and (iii) is not the coordinating practitioner or consulting practitioner for the patient making the declaration. (5) A person who signs the written declaration on behalf of the patient must do so in the patient's presence. (6) If the patient makes the written declaration with the assistance of an interpreter, the interpreter must certify on the declaration that the interpreter provided a true and correct translation of any material translated. 43. Witness to signing of written declaration (1) For the purposes of section 42(3)(b), a person is eligible to witness the signing of a written declaration if the person — (a) has reached 18 years of age; and (b) is not an ineligible witness. (2) For the purposes of subsection (1)(b), a person is an ineligible witness if the person — (a) knows or believes that the person — (i) is a beneficiary under a will of the patient making the declaration; or (ii) may otherwise benefit financially or in any other material way from the death of the patient making the declaration; or (b) is a family member of the patient making the declaration; or (c) is the coordinating practitioner or consulting practitioner for the patient making the declaration. 44. Certification of witness to signing of written declaration (1) In this section — ineligible witness means a person who is an ineligible witness under section 43(2). (2) A witness who witnesses the signing of a written declaration by the patient making the declaration must — (a) certify in writing in the declaration that, in the presence of the witness, the patient appeared to freely and voluntarily sign the declaration; and (b) state that the witness is not knowingly an ineligible witness. (3) A witness who witnesses the signing of a written declaration by another person on behalf of the patient making the declaration must — (a) certify in writing in the declaration that — (i) in the presence of the witness, the patient appeared to freely and voluntarily direct the other person to sign the declaration; and (ii) the other person signed the declaration in the presence of the patient and the witness; and (b) state that the witness is not knowingly an ineligible witness. 45. Coordinating practitioner to record written declaration If a patient gives a written declaration to the coordinating practitioner for the patient, the coordinating practitioner must record the following in the patient's medical record — (a) the date when the written declaration was made; (b) the date when the written declaration was received by the coordinating practitioner. 46. Coordinating practitioner to notify Board of written declaration Within 2 business days after receiving a written declaration made by a patient, the coordinating practitioner for the patient must give a copy of it to the Board. Division 6 — Final request and final review 47. Patient may make final request to coordinating practitioner (1) A patient who has made a written declaration may make a final request to the coordinating practitioner for the patient for access to voluntary assisted dying. (2) The final request must be — (a) clear and unambiguous; and (b) made in person or, if that is not practicable, in accordance with section 158(2)(a). (3) The patient may make the final request verbally or in another way (for example, by gestures). 48. When final request can be made (1) In this section — designated period means the period of 9 days beginning on the day on which the patient made the first request. (2) The final request cannot be made — (a) before the end of the designated period, except as provided in subsection (3); and (b) in any case, until after the day on which the consulting assessment that assessed the patient as eligible for access to voluntary assisted dying was completed. (3) The final request can be made before the end of the designated period if — (a) in the opinion of the coordinating practitioner for the patient, the patient is likely to die, or to lose decision‑making capacity in relation to voluntary assisted dying, before the end of the designated period; and (b) the opinion of the coordinating practitioner is consistent with the opinion of the consulting practitioner for the patient. 49. Coordinating practitioner to record final request The coordinating practitioner for the patient must record the following in the patient's medical record — (a) the date when the final request was made; (b) if the final request was made before the end of the designated period as defined in section 48(1), the reason for it being made before the end of that period. 50. Coordinating practitioner to notify Board of final request (1) Within 2 business days after receiving a final request made by a patient, the coordinating practitioner for the patient must complete the approved form (the final request form) and give a copy of it to the Board. (2) The final request form must include the following — (a) the name, date of birth and contact details of the patient; (b) the name and contact details of the coordinating practitioner; (c) the date when the first request was made; (d) the date when the final request was made; (e) whether the final request was made in person or using audiovisual communication and whether it was made verbally or in another way; (f) if the patient was assisted by an interpreter when making the final request, the name, contact details and accreditation details of the interpreter; (g) if the final request was made before the end of the designated period as defined in section 48(1), the reason for it being made before the end of that period; (h) the signature of the coordinating practitioner and the date when the form was signed. 51. Final review by coordinating practitioner on receiving final request (1) On receiving a final request made by a patient, the coordinating practitioner for the patient must — (a) review the following in respect of the patient — (i) the first assessment report form; (ii) all consulting assessment report forms; (iii) the written declaration; and (b) complete the approved form (the final review form) in respect of the patient. (2) When conducting the final review, the coordinating practitioner must have regard to any decision made by the Tribunal under Part 5 in respect of a decision made in the request and assessment process. (3) The final review form must include the following — (a) the name, date of birth and contact details of the patient; (b) the name and contact details of the coordinating practitioner; (c) a statement that the coordinating practitioner has reviewed the forms referred to in subsection (1)(a); (d) a statement certifying whether or not the request and assessment process has been completed in accordance with this Act; (e) if the patient was assisted by an interpreter, the name, contact details and accreditation details of the interpreter; (f) a statement certifying whether or not the coordinating practitioner is satisfied of each of the following — (i) that the patient has decision‑making capacity in relation to voluntary assisted dying; (ii) that the patient in requesting access to voluntary assisted dying is acting voluntarily and without coercion; (iii) that the patient's request to access voluntary assisted dying is enduring; (g) the signature of the coordinating practitioner and the date when the form was signed. (4) Within 2 business days after completing the final review form, the coordinating practitioner must give a copy of it to the Board. 52. Technical error not to invalidate request and assessment process The validity of the request and assessment process is not affected by any minor or technical error in a final review form or a form referred to in section 51(1)(a). 53. No obligation for patient to continue after completion of request and assessment process A patient in respect of whom the request and assessment process has been completed may decide at any time not to take any further step in relation to access to voluntary assisted dying. Part 4 — Accessing voluntary assisted dying and death Division 1 — Eligibility requirements for administering practitioners 54. Eligibility to act as administering practitioner (1) A person is eligible to act as an administering practitioner for a patient if — (a) the person is — (i) a medical practitioner who is eligible to act as a coordinating practitioner for the patient under section 17(2); or (ii) a nurse practitioner who has practised the nursing profession for at least 2 years as a nurse practitioner and meets the requirements approved by the CEO for the purposes of this subparagraph; and (b) the person has completed approved training; and (c) the person is not a family member of the patient; and (d) the person does not know or believe that they — (i) are a beneficiary under a will of the patient; or (ii) may otherwise benefit financially or in any other material way from the death of the patient, other than by receiving reasonable fees for the provision of services as the administering practitioner for the patient. (2) The CEO must publish the requirements approved for the purposes of subsection (1)(a)(ii) on the Department's website. Division 2 — Administration of voluntary assisted dying substance 55. Application of Division This Division applies if — (a) the request and assessment process has been completed in respect of a patient; and (b) the final review form in respect of the patient certifies that the coordinating practitioner for the patient is satisfied of each of the following — (i) that the patient has decision‑making capacity in relation to voluntary assisted dying; (ii) that the patient in requesting access to voluntary assisted dying is acting voluntarily and without coercion; (iii) that the patient's request to access voluntary assisted dying is enduring. 56. Administration decision (1) The patient may, in consultation with and on the advice of the coordinating practitioner for the patient — (a) decide to self‑administer a voluntary assisted dying substance (a self‑administration decision); or (b) decide that a voluntary assisted dying substance is to be administered to the patient by the administering practitioner for the patient (a practitioner administration decision). (2) A practitioner administration decision can only be made if the coordinating practitioner for the patient advises the patient that self‑administration of a voluntary assisted dying substance is inappropriate having regard to 1 or more of the following — (a) the ability of the patient to self‑administer the substance; (b) the patient's concerns about self‑administering the substance; (c) the method for administering the substance that is suitable for the patient. (3) An administration decision must be — (a) clear and unambiguous; and (b) made in person before the coordinating practitioner for the patient or, if that is not practicable, in accordance with section 158(2)(a). (4) The patient may make an administration decision verbally or in another way (for example, by gestures). (5) If the patient makes an administration decision, the coordinating practitioner for the patient must record the decision in the patient's medical record. 57. Revocation of administration decision (1) The patient may at any time — (a) revoke a self‑administration decision by informing the coordinating practitioner for the patient that the patient has decided not to self‑administer a voluntary assisted dying substance; or (b) revoke a practitioner administration decision by informing the administering practitioner for the patient that the patient has decided not to proceed with the administration of a voluntary assisted dying substance. (2) For the purposes of subsection (1), the patient may inform the coordinating practitioner or administering practitioner of the patient's decision in writing, verbally or in another way (for example, by gestures). (3) If the patient revokes an administration decision under subsection (1), the coordinating practitioner or administering practitioner who is informed of the patient's decision must — (a) record the revocation in the patient's medical record; and (b) if the practitioner is not the coordinating practitioner for the patient, inform the coordinating practitioner of the revocation; and (c) within 2 business days after the revocation, complete the approved form (the revocation form) and give a copy of it to the Board. (4) The revocation form must include the following — (a) the name, date of birth and contact details of the patient; (b) the name and contact details of the person complet