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First published in the Australian Health Law Bulletin 2026 and reproduced with the kind permission of Lexis Nexis

This article outlines the extraordinary circumstances giving rise to consent orders by the State Administrative Tribunal (Western Australia (WA)) in October 2025. A general practitioner in WA provided a prescription of insulin to the mother of one of his patients (a severely disabled child), knowing that the child had no medical requirement for insulin and that administration of same could be fatal. The mother administered the insulin and the child was taken for emergency medical treatment by her father, however she ultimately survived.

Background

The background facts of this matter are drawn from an agreement (annex A) between the parties—Dr Pieter Austin and the Medical Board of Australia. Dr Austin was registered (initially in 2008) as a medical practitioner with general and specialist registration (general practice) pursuant to the National Law and worked in Albany, WA. As at January 2022, Dr Austin was the general practitioner for Patient A (PA) who was 6 years old, who attended with her mother. PA’s extensive medical history included cerebral palsy, global developmental delay, and Aicardi-Goutieres syndrome.1 She was non-verbal, required nasogastric feeding and was quadriplegic. There was no medical requirement for PA or any of PA’s family to be prescribed insulin.  However:

• In December 2021, PA’s mother asked Dr Austin to write an insulin script for PA so that she could administer it to PA and Dr Austin did so as a handwritten script — but did not make a record of it.

• In January 2022, PA’s mother asked Dr Austin to write another insulin script for PA as, although she had filled the last script, she had thrown out the insulin. Dr Austin generated a computer script then deleted it from the practice records.

PA’s mother attended a pharmacy and obtained the second insulin medication, which she injected into PA, who became unwell. PA was driven to Denmark Hospital (apparently by her father, not by her mother), then transferred to Albany Hospital and ultimately to Perth Children’s Hospital. Medical tests reported that PA had potentially fatal levels of synthetic insulin in her body due to an external source administration of insulin. PA survived.

Criminal proceedings

Within weeks of the above, Dr Austin was arrested and charged with one count of attempt to unlawfully kill pursuant to s 283(1) of the Criminal Code (WA). He pleaded guilty, was convicted and was sentenced to 5.5 years imprisonment. His later appeal in respect of the sentence was dismissed.2 Dr Austin also agreed to give evidence in the criminal trial of the mother of PA. Although not referred to in the conduct decision, media reports indicated that the mother denied an intent to murder and said that she injected PA with insulin so that she would be admitted to hospital and seen by doctors. A jury acquitted her of attempted murder but found her guilty of doing an act with the intention of causing harm that would endanger the child’s life.3 The mother was later sentenced to a 3-year prison term.4

Conduct proceedings

The Medical Board of Australia issued disciplinary proceedings against Dr Austin, the respondent, which were ultimately settled as between the parties following a mediation in October 2025. The State Administrative Tribunal (WA) was satisfied that proper cause existed for disciplinary action against Dr Austin.

The Tribunal held that Dr Austin had behaved in a way that constitutes professional misconduct for the purposes of s 196(1)(b)(iii) of the Health Practitioner Regulation National Law (WA) Act 2010 (National Law), in that:

• On 13 December 2021 and 5 January 2022, he issued prescriptions for Insulin As part and 12 Australian health law bulletin February 2026 provided them to PA’s mother when: — there was no medical requirement for PA or any of PA’s family to have insulin — he knew that PA’s mother intended to inject the insulin into PA and — he knew that administration of the prescribed insulin to PA could be fatal

• He failed to maintain adequate clinical records by: — not recording details of the 13 December 2021 insulin prescription within the records of PA or PA’s mother and — deleting details of the 5 January 2022 insulin prescription from the computer records • He attempted to conceal the 5 January 2022 insulin prescription by deleting details of the same from the Practice’s computer records.

• From 20 January 2022 to his arrest on 3 February 2022, he failed to contact clinicians at Perth Children’s Hospital to provide details of insulin administration to inform assessment and treatment of PA’s condition.

• He failed to maintain professional boundaries with PA’s mother when he booked and paid for her to stay in a hotel on 24 January 2022. • On 19 December 2022, he was convicted on one charge of attempt to unlawfully kill pursuant to s 283(1) of the Criminal Code WA.

• He breached ss 2.1, 2.2, 3.1, 3.2.2, 3.2.4, 3.2.9, 3.5, 4.2.2, 4.6.1, 10.1, 10.2.1, 10.5.1, 10.5.5 and 10.12.2 of the Code of Conduct.5 The full text of the relevant parts of the Code of Conduct provisions were set out in annex B to the decision. Unsurprisingly, these included the safe practice of medicine,6 maintaining adequate records,7 offering assistance in an emergency8 and observing principles of ethical conduct.9 Orders were then made as follows:

• The respondent is reprimanded under s 196(2)(a) of the National Law. • The respondent’s registration is cancelled under s 196(2)(e) of the National Law.

• The respondent is disqualified from applying for registration for a period of 20 years under s 196(4)(a) of the National Law.

• The respondent is prohibited from providing any health service until reregistered under s 196(4)(b)(i) of the National Law. • The respondent is prohibited from using the title “Doctor” until reregistered under s 196(4)(b)(ii) of the National Law.

• The respondent is ordered to pay the applicant’s costs of the proceedings under s 87(2) of the State Administrative Tribunal Act 2004 (WA), fixed in the amount of $3000 to be paid within 28 days or as otherwise agreed by the applicant.

Comments

Unfortunately, this matter is not entirely novel. A medical practitioner in New South Wales (NSW) (Dr Crickitt) was convicted of murder following his administration of insulin to his wife in 2010.10 An application for leave to appeal against his conviction was granted but the appeal was dismissed.11 In 2019, the NSW Civil and Administrative Tribunal made an order such that his registration was cancelled and such that he cannot apply for registration for a 20-year period or upon his conviction being overturned.12

The orders made in this case, including the long 20-year period for which Dr Austin was disqualified from applying for registration, are perhaps unsurprising in the circumstances.

Further insight into the thinking of Dr Austin at the time can perhaps be gleaned from submissions made to the Supreme Court of Western Australia during his appeal in respect of his sentence.13 He had made a note that PA was “deemed palliative”, had been “deteriorating a lot”, was “losing weight” and was “clinically in a lot of pain”. He said that the mother of PA had attempted to smother PA on an earlier occasion, but “she just wouldn’t die”.14 It is worth noting that voluntary assisted dying would not have been available to PA as, inter alia, she had not yet reached 18 years of age.15 Dr Austin also appears to have been affected by depression at the relevant time. The primary sentencing judge had said: . . . I am satisfied that you were suffering from depression, and the long hours you were putting into your role as a medical practitioner were highly detrimental to your mental state. The combination of your personality characteristics, your views about the pandemic’s impacts on your patients, your views as to the ‘politics’ of medicine and your mental state provide an explanation as to how you came to see [EG’]s situation as hopeless, and how you came to overly empathise with her mother’s perspective. …16 \

Footnotes

1. A rare inherited disease that affects the brain, immune system and the skin.
2. Austin v Western Australia [2023]WASCA191; BC202408463.
3. R Peppiatt “Jury finds WA mum not guilty of trying to kill severely disabled daughter” WA Today 20 May 2024 www. watoday.com.au/national/western-australia/jury-finds-wa-mum- not-guilty-of-trying-to-kill-severely-disabled-daughter-20240517- p5jek9.html.
4. R Peppiatt and A Wilkinson “Mother jailed after she injected disabled daughter with near-fatal dose of insulin” WA Today 2August 2024 www.watoday.com.au/national/western-australia/ mother-jailed-after-she-injected-disabled-daughter-with-near- fatal-dose-of-insulin-20240802-p5jyyj.html.
5. Medical Board of Australia/Ahpra Good medical practice: a code of conduct for doctors in Australia (2020)www.medicalboard. gov.au/Codes-Guidelines-Policies/Code-of-conduct.aspx.
6. Above, s 2.1, at 5.
7. Above n 5, s 3.2.3, at 6.
8. Above n 5, s 3.5, at 7.
9. Above n 5, s 10.1, at 20.
10. R v Crickitt [2016] NSWSC 1738; BC201610510. The applicant was found guilty following a judge-alone trial before Hoeben CJ at CL. On 5 May 2017, his Honour imposed a sentence of imprisonment for 27 years with a non-parole period of 20 years and 3 months: R v Crickitt (No 2) [2017] NSWSC 542; BC201711119.
11. Crickitt v R [2018] NSWCCA 240; BC201810000.
12. Health Care Complaints Commission v Crickitt [2019]NSWCATOD 141; BC201907952.
13. Austin v Western Australia [2023]WASCA191; BC202408463.
14. Above, at [21]–[22].
15. Voluntary Assisted Dying Act 2019 (WA), s 16.
16. Above n 13, at [48].

This article was written by Bill Madden and Matila Lynch and was published on 4 March, 2026  by Carroll & O’Dea Lawyers and is based on the relevant state of the law (legislation, regulations and case law) at that date for the jurisdiction in which it is published. Please note this article does not constitute legal advice.

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