What is voluntary assisted dying?

Voluntary assisted dying (VAD) is when someone chooses medical assistance to end their life. Terms such as ‘physician-assisted suicide', ‘physician-assisted dying' and ‘euthanasia' refer to VAD.

VAD is voluntary. You can only choose VAD if you are an adult who is able to make decisions and if you choose VAD on your own. No one can force you.

There are 2 main types of VAD:

• self-administered — when a person takes VAD medicine that an eligible healthcare practitioner has prescribed for them
• practitioner-administered — when an eligible healthcare practitioner administers VAD medicine to a person

Is voluntary assisted dying legal?

VAD is legal and available in Queensland, New South Wales, South Australia, Victoria, Western Australia and Tasmania.

Contact your state's health department for the latest VAD information relevant to your state.

In the past, Commonwealth laws stopped Australian territories (Northern Territory and Australian Capital Territory) from making new laws on VAD. Recent changes now allow the territories to pass VAD laws, so it is possible that VAD will be legalised in the territories in the future.

What are the eligibility criteria for voluntary assisted dying?

There is strict eligibility criteria in all states where VAD is available. The criteria between the states are similar, but there are some differences. The person must:

• be an adult (18 years or older)
• be an Australian citizen or permanent resident who has been a resident in Australia for at least 3 continuous years when the first request is made
• have lived for at least 12 months in the state in which they are requesting VAD — exemptions may apply
• be able to make decisions
• make it their own choice without pressure or duress from others
• have a disease, illness or medical condition that is likely to cause death within a specified time
• have an advanced condition that causes intolerable suffering
• make an enduring request for VAD (meaning that their request must be ongoing)

Which medical conditions may make me eligible for voluntary assisted dying?

To be eligible for VAD in most states, a medical condition must be expected to cause death within 6 months, or 12 months in the case of a neurodegenerative (progressive neurological) condition. In Queensland, the expected timeframe is 12 months for all medical conditions.

People with dementia are generally not eligible for VAD. This is because dementia advanced enough to allow a person to qualify for VAD is likely to hinder their ability to make decisions.

A disability or mental illness alone does not make a person eligible for VAD, unless they meet all of the other eligibility criteria listed above.

What is end-of-life care?

End-of-life care includes the support and assistance you may get when you are diagnosed with a terminal condition.

Palliative care

The goal of palliative care is to relieve pain and other distressing symptoms, and to improve your quality of life, without necessarily curing your illness.

You can choose palliative care alongside other medical treatments, including those that aim to cure your disease. You can also get palliative care if you choose VAD.

Many states require that medical professionals who give information about VAD also give information about palliative care.

Advanced care planning

Advanced care planning is the process of considering your current and future health choices. It's how you can make sure that your loved ones and medical team are aware of your wishes if you ever lose the ability to make decisions.

As part of advanced care planning, you can formalise your preferences in an advance care directive. This legal document outlines your values and choices for your future care. You can also use it to appoint a substitute decision-maker who can make medical decisions for you if you are not able to.

You cannot request VAD as part of your advance care directive. This is because your advance care directive comes into effect only once you no longer have decision-making capacity. But even if you are considering VAD, it's still a good idea to make an advanced care directive, in case you unexpectedly are no longer able to make decisions.

The process for creating an advance care directive varies slightly from state to state.

Visit Advance Care Planning Australia for more information and to create your own advance care directive.

Who should I talk to if I am considering voluntary assisted dying?

If you are thinking about VAD, ask your doctor or healthcare professional about it. In some states, some medical professionals are not legally allowed to start a conversation about VAD, so you will need to ask them. Your doctor or healthcare practitioner will give you more information about VAD and other end-of-life care choices, such as ongoing treatment or palliative care.

Some medical practitioners choose not to assist with VAD requests. If your doctor does not assist with VAD requests, they may refer you to another healthcare practitioner. In some states, even healthcare practitioners who do not assist with VAD requests must refer you to someone who does.

What is the process for voluntary assisted dying?

The exact process differs slightly from state to state, but the basic process involves these steps:

1. A person requests VAD from an eligible medical practitioner.
2. The same eligible medical practitioner does an eligibility assessment for VAD.
3. A second eligible medical practitioner does an eligibility assessment for VAD.
4. The person requests for VAD again, in writing.
5. The person makes a final request for VAD.
6. Officials authorise VAD.
7. An eligible healthcare practitioner prescribes and dispenses VAD medicine.
8. Either:
   • an eligible person takes VAD medicine, or
   • an eligible healthcare practitioner gives the eligible person VAD medicine

If you take the VAD medicine yourself (known as self-administration), you can choose a suitable time and place to do so. If you wish, other people, such as friends and family, can be there.

If VAD medicine is given by a healthcare practitioner, most states require a witness.

It's important to remember that you can withdraw (stop) your request for VAD at any time, even after you have had an assessment or made a request in writing.

Where can I get support if I'm considering voluntary assisted dying?

Coping with a terminal condition and end-of-life decisions can be emotional and stressful. There are many people who can support you as you come to terms with your condition and make important decisions about your health.

Your doctor or medical team can give you information and support while you consider VAD, as well as information about other end-of-life care choices, including ongoing treatment and palliative care.

Your family, friends or other support people, such as carers, can support you as you consider your end-of-life choices. Many people find it difficult to discuss end-of-life matters with their friends and family, especially if friends and family do not agree with their decisions. Your doctor can help support you in discussing VAD with your loved ones.

If you need more support, your doctor or medical team may refer you to a counsellor. You can also contact the support services referred to below.

Many states have VAD Care Navigator services to help you find out about VAD in your state. Check your local Department of Health website to see if your state has a VAD Care Navigator service.

Where can friends, family and carers get support?

Friends and family can help to support someone with a terminal illness. However, many people find it difficult and emotional to discuss end-of-life choices with their loved ones, especially if views differ.

If someone close to you is considering VAD, healthcare professionals and services can provide information and support, including:

• your doctor
• your loved one's doctor, if your loved one consents for their doctor to discuss their medical situation with you
• in-person counselling services
• phone counselling services, listed below

Resources and support

• For more information about VAD in your state, visit your health department.
• For more information about palliative care, visit the Palliative Care Australia website.
• If you are a carer, you can search the Carer Gateway website, call 1800 422 737 or use their interactive service finder to locate your nearest carer support services.
• Anyone involved with voluntary assisted dying in Western Australia — including patients, the family and carers of patients, community members, health professionals and service providers — can access the WA Voluntary Assisted Dying Statewide Care Navigator Service.

For emotional support, contact:

• Griefline on 1300 845 745
• Grief Australia on 1800 642 066
• Lifeline (for anyone having a personal crisis) on 13 11 14 or chat online, 24 hours a day