A 70-year-old school teacher and community advocate with motor neuron disease (MND) died by sodium nitrite ingestion on 27 April 2023. She had explicitly expressed wishes to end her life and explored available options. Palliative care practitioners offered palliative sedation therapy (PST) at home, but conflicting medical advice about duration (2 weeks vs a few days) and eventual inability to provide home-based PST due to resource constraints left Ms Williams dissatisfied. She had sought voluntary assisted dying (VAD), which was unavailable in the ACT at that time. The coroner found no matters of public safety and no preventable errors. The case highlighted gaps in end-of-life options for terminally ill patients without access to VAD, leading to the ACT subsequently implementing a VAD scheme in November 2025. No clinical negligence was identified.
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Specialties
palliative carepsychiatryneurology
Drugs involved
sodium nitritesedatives
Clinical conditions
motor neurone diseaseexistential distressintolerable suffering
Procedures
palliative sedation therapy
Contributing factors
motor neuron disease with rapid functional decline
unavailability of voluntary assisted dying in ACT at time of death
inability to provide palliative sedation therapy at home due to resource constraints
conflicting medical advice regarding expected duration of palliative sedation therapy
patient's desire for rapid death that palliative care could not guarantee
Coroner's recommendations
CHH to consider developing a guide/policy for palliative sedation therapy in the community and at home
ACT Policing to review welfare check policies to consider whether changes are desirable when medical professionals are involved, particularly where a medical practitioner has advised against a welfare check or indicated it may increase risk of harm
Development of patient information materials on palliative sedation options (noted as consideration at CHH)
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