Frequently asked questions: Voluntary assisted dying

Voluntary assisted dying (VAD) is the assistance provided by a health practitioner to a person with a terminal disease, illness or medical condition who wishes to end their life. It includes:

• self-administration, where the person takes the VAD medication themselves, and
• practitioner administration, where the person is administered the medication by a health practitioner.

Yes. VAD is legal and operating in all Australian States and the Australian Capital Territory (ACT). VAD is illegal in the Northern Territory.

No. A person can only access VAD if they are eligible. Each jurisdiction has its own eligibility criteria for VAD. In all jurisdictions, the person must:

• be an adult,
• have decision-making capacity,
• have a disease, illness or medical condition that will cause death within a specified time period (except in the ACT where there is no timeframe until death), and
• have a condition that is advanced and causing intolerable suffering.

VAD is only available for people who are close to death. In most States, their condition must be expected to cause death within six months, or 12 months if the person has a neurodegenerative disease (such as motor neurone disease). In Queensland, a person must be expected to die within 12 months to be eligible. In the ACT, there is no time frame.

A person will not be able to access VAD for dementia. This is because a person must have decisionmaking capacity to request VAD. In the States, a person with a neurodegenerative condition is not eligible for VAD unless their death is expected to occur within 12 months of the request. A person whose dementia is so advanced that they are within 12 months of death will not have decision-making capacity. In the ACT, the person’s condition must be advanced, meaning they are approaching the end of their life. A person with advanced dementia is unlikely to have capacity to choose VAD.

A person who is in the early stages of dementia and also has a terminal illness (e.g. cancer) may be eligible for VAD if they have decision-making capacity and meet the other eligibility criteria.

No. VAD is different from providing pain and symptom relief, and palliative care. It is not VAD where a resident dies after receiving medication to relieve their pain e.g. morphine. This is because the health practitioner was intending to relieve pain, not hasten the person’s death. It is always good clinical practice to provide pain relief to manage a person’s pain and symptoms at the end of life.

Yes. Many people who request VAD also receive palliative care. A resident accessing VAD will continue to receive palliative care and medical treatment, and access end of life care services e.g. specialist palliative care, social work, spiritual care up until their death.

No. A person cannot request VAD in an Advance Care Directive or other advance care planning documents. This is because VAD cannot be requested after a person has lost capacity.

No. A request for VAD must be made by the resident. It cannot be requested by another person e.g. a family member, carer or substitute decision-maker on their behalf. This is to ensure that a decision to access VAD is voluntary i.e. it is the resident’s own choice, made of their own free will. There can be no pressure from another person to access VAD.

Yes. A person who has requested VAD and started the process can change their mind at any time. They do not have to continue the VAD process. If a person has been prescribed or dispensed the VAD medication, they can choose not to take it.

No. Medical practitioners, nurse practitioners, registered nurses, allied health professionals, and enrolled nurses have the right to conscientiously object to participating in VAD. Personal care workers can also choose not to be involved with VAD. However, in some jurisdictions, objecting health professionals may still have certain legal obligations, such as to provide information to a person requesting VAD.

Residential facilities e.g. RACFs and nursing homes can decide whether to provide some, all or no VAD services to residents who are seeking VAD. However, in South Australia, Queensland, New South Wales, and the ACT, residential facilities who choose not to provide VAD services still have legal obligations to enable a resident to access VAD if they wish.

There are restrictions on when health care professionals can initiate discussions about VAD with a person. Only some health professionals can do this, and in some jurisdictions they must provide information set out by their jurisdiction’s health department (in addition to general information about VAD) when they have discussions. These laws are different in each jurisdiction.

Health professionals and personal care workers in all jurisdictions can provide information about VAD to a resident, or to a resident’s family, friend, carer, or substitute decision-maker, where requested.

In all jurisdictions, medical practitioners can assess a person’s eligibility for VAD. In the ACT, nurse practitioners may also do this. To assess a person’s eligibility, practitioners must undertake mandatory training provided by their jurisdiction’s health department and meet requirements about their registration and years of experience.

Medical practitioners, nurse practitioners (in Western Australia, New South Wales, Queensland, Tasmania, and the ACT), and registered nurses (in Queensland, Tasmania, and the ACT only) may administer VAD medication to an eligible person. This is known as practitioner administration. To do this, medical practitioners and nurses must undertake mandatory training and meet other requirements about their registration and years of experience.

The answer to this will be different for each person. It depends on where they live (e.g. at home or in a residential facility) and in which jurisdiction, and how they will have the VAD medication.

A person receiving home care can choose to have the medication at home if circumstances permit. In some jurisdictions, a resident may be unable to take the VAD medication at their residential facility, if the facility chooses not to provide VAD. Also, if a person needs a practitioner to administer the VAD medication to them, this might have to take place in a particular location e.g. a hospital.