43Patient assessed as eligible may make written declaration

#### 43 Patient assessed as eligible may make written declaration 43 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 patient’s coordinating practitioner, and > > > > > (b) the patient’s consulting practitioner. > > > (2) The written declaration must be— > > > > > (a) in the approved form, and > > > > > (b) given to the patient’s coordinating practitioner. > > > (3) The written declaration must— > > > > > (a) state that the patient— > > > > > > > (i) makes the declaration voluntarily, and > > > > > > > (ii) does not make the declaration because of pressure or duress, and > > > > > > > > Note— > > > > > > > > See the definition of pressure or duress in the Dictionary in Schedule 1. > > > > > > > (iii) 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 patient’s name, date of birth and contact details, > > > > > > > (ii) if the patient was assisted by an interpreter—the interpreter’s name, contact details and accreditation details, > > > > > > > (iii) the name and contact details of the patient’s coordinating practitioner. > > > (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) is an adult, 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.