Graham Bullock is adamant he has plenty of life left to live.
- WA’s voluntary assisted dying laws come into effect on Thursday
- Community leaders remain split on what impact the laws will have
- Campaigners say the laws provide peace of mind for those suffering
Earlier this year, at the age of 67, he launched himself out of a plane over Rottnest Island in a bid to raise money for the Motor Neurone Disease (MND) Association of WA.
He was diagnosed with the terminal illness in 2019.
“I remember the day quite clearly,” Mr Bullock said.
“It was a bit upsetting. I suppose I was in a bit of shock.”
Today he’s confined to a wheelchair with no function of his legs and he expects his physical condition to deteriorate over the coming months.
“I’ve gone from being reasonably active, probably stupidly active for my age, to this,” he said.
“It just seems to progress, every few months it gets a little bit worse.
Mr Bullock doesn’t know exactly how long he has left but the introduction of voluntary assisted dying (VAD) in Western Australia gives him peace of mind that when the time comes, he might have some choice over what his final months, weeks and days look like.
“Look, I’m 67 years old, I’ve had a really good life, there’s no two ways about it,” he said.
“It just bothers me that I’m going to have this active mind and brain in a body that won’t do anything at all.
“There’s no way I really want to be like that.”
Amid the fear, uncertainty and discomfort that comes with an MND diagnosis, he’s grateful that he may have some control over when he can call time on a life well lived.
Strict criteria govern the process
After an 18-month implementation period, Western Australia’s voluntary assisted dying laws come into effect on Thursday.
In reality, very few people will be eligible, with strict criteria governing the VAD process.
A person must be suffering from a medical condition that is advanced, progressive and is expected to cause death within six months, or within 12 months in the case of a neurodegenerative disease.
They need to make three requests for a voluntary assisted death and two doctors who have completed the relevant training must independently assess the patient’s eligibility.
Voluntary euthanasia laws are already in place in Victoria.
Tasmania and South Australia will be next.
The legislation presents some practical challenges for the doctors tasked with administering the lethal injection that will end a person’s life as well as with some important ethical questions for the broader community.
Many argue physician-assisted dying is the ultimate act of compassion for those facing an otherwise painful demise.
Others, who believe life is sacred from beginning to end, question the morality of the laws.
The VAD campaigner
Belinda Teh has been a fierce advocate for VAD in Western Australia after watching her mother die of cancer in 2016.
“There was a tumour growing in her back that fractured her spine into pieces and she was in unspeakable pain,” Ms Teh said.
Her mother had asked her doctor for assistance to die, but at the time it was not a legal option.
“I watched mum die in a way that will haunt me for the rest of my life,” Ms Teh said.
“Our family has spent a lot of time and energy and spent a long period just dealing with the trauma and not even getting to the grieving because of the way she died.”
She has welcomed the new laws, saying she’s proud of West Australians for backing them.
“What this law is going to mean for the WA community, is not only will we be providing relief for the person who is dying, but also the people who are supporting the dying person.
They will be able to go through their bereavement and grieving process in a way that is so much more healthy.”
The general practitioner
In order to offer consultation and prescriptions to patients interested in accessing VAD, doctors need to undergo additional comprehensive training.
Some advocacy groups have raised concerns that the process is too onerous and has resulted in low uptake from GPs so far.
Dr Simon Torvaldsen is confident that in the coming months, the number of qualified doctors will meet what he believes will be reasonably low demand from the community.
While he believes the WA legislation is as good as it can be, with adequate safeguards built in to protect vulnerable people, he is concerned that once VAD becomes a legal option in WA, there will be less focus on other end of life services.
“I fear that the government may tick the VAD box and say ‘job done’ and not worry about the other resources that need to be put in,” Dr Torvaldsen said.
“I think it’s incumbent upon all of us to keep the pressure on government to make sure we have adequate cancer services, support services and in particular palliative care services to ensure that we do have a real choice.”
The palliative care advocate
The chief executive of Palliative Care WA, Lana Glogowski, shares those concerns.
“Palliative care hasn’t had anywhere near the profile that we need,” she said.
“Voluntary assisted dying is accessed ultimately by less than 2 per cent of the population.
“What about the 98 per cent of the population who won’t be accessing voluntary assisted dying? What are we doing to share with the vast majority of our community about how they plan for the last stage of their life?”
But she welcomes the public debate that the new laws have prompted around end of life care, saying people need to take more proactive steps to prepare for the final stage of their life.
“We need to encourage people not to be death phobic … to realise that at some stage they are going to die,” she said.
“Everybody wants the best death possible.”
Ms Glogowski is hopeful more fit and healthy people will seek out information about advanced care, well before they need to access it.
The religious leader
The voluntary euthanasia legislation has left WA’s religious communities debating doctrine and death.
Anglican Archbishop of Perth Kay Goldsworthy says it presents a number of ethical challenges for the church community.
“This is another piece of legislation … that many Christians have found has asked us to consider again what it is we believe and how it is we live our Christian faith in a fast-changing community and a fast-changing society,” the Archbishop said.
“I do think that life has meaning from birth to death and my own pastoral experience is that even in times of real sadness and pain and extreme difficulty for individuals, their family and intimate circle, that that meaning continues.
“There is still a way that they give, they are present, they teach lessons of love and importance for people.
“In whatever place people find themselves in, whatever grappling they are making with decisions with their health and their ill-health, that we want to be alongside them pastorally and to be with them prayerfully as they grapple.”