Voluntary assisted dying – what you need to know

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If you have a terminal illness there are now laws around how you can get help to die on your own terms, when you choose and in a place of your choosing, in every State of Australia.

Key points:

  • Voluntary assisted dying is now legislated in all States of Australia, but cannot be legislated in the Territories
  • There are different laws in each State, with some similarities
  • A person wanting to access voluntary assisted dying needs to meet eligibility criteria and go through a process designed to prevent misuse of the system

While the specific rules around accessing voluntary assisted dying differ between each State, the overall principle is that people who have a terminal condition and meet the criteria can be given medication to end their life.

This gives people who are in pain and suffering from terminal conditions the chance to control when and where they die, as well as giving them the chance to have family or friends present to support them in that moment.

The Northern Territory and Australian Capital Territory aren’t able to offer voluntary assisted dying because of a Federal law that bans the Territories from legislating their own process, although advocates are working on having this overturned.

Voluntary assisted dying

Voluntary assisted dying is the process of a person with a terminal condition accessing help to end their life.

In Australia medication is given to the person for a controlled and stress-free death.

The medication can be taken by the person themself, also known as self-administration, or be given by a qualified health practitioner, called practitioner-administration.

There are rules around which doctors can give the medication as they need to have undertaken training in distributing the medication, applying the criteria and ensuring patients are not taken advantage of. A health care worker or nurse can’t give a patient access to the medication.

A health practitioner – doctor, nurse, pharmacist or other professional – can also refuse to participate in voluntary assisted dying on the basis of conscience, called a conscientious objection.

Criteria across Australia

The general criteria that a person must meet to access voluntary assisted dying include:

  • Being over 18 years old
  • Being an Australian citizen or permanent resident, living in the State they want to die in for at least 12 months
  • Possessing decision-making capacity
  • Acting voluntarily without coercion from any other person
  • Having an ongoing want for the service, not a once-off request
  • Having an accepted disease, illness or medical condition that is expected to cause death within six months, or 12 months for a neurodegenerative disease
  • The condition is advanced, causing intolerable suffering (according to the person themselves and not any assessment by another person), and it is a progressive condition

Disability or mental health conditions are not always enough for a person to qualify to access voluntary assisted dying, although some conditions and circumstances will meet the criteria – for example Motor Neurone Disease.

It is important to note that a person must have decision making capacity to be able to request voluntary assisted dying, which could be difficult to establish in the late stages of some progressive conditions that result in cognitive symptoms, such as Huntington’s disease.

Even a person legally appointed to make health decisions for a person with terminal illness cannot request voluntary assisted dying on their behalf.

A person with disability who needs support to communicate their request can use an interpreter, including an Auslan interpreter, a speech pathologist or their preferred communication method, including a communication aid, writing or gestures.

There is a process followed across Australia as well, that is used to ensure the decision to access voluntary assisted dying is not made lightly and that people are protected from exploitation by others.

This process includes the person asking for help three times, at least one of them in writing, and two separate doctors, who have done training in the field, agreeing that the person meets the criteria.

If a person changes their mind at any point the process can be stopped.

Differences between States

Only Victoria and Western Australia currently have voluntary assisted dying services operating.

Tasmanians will be able to access voluntary assisted dying from late 2022, Queensland on 1 January 2023, South Australia in early 2023 and New South Wales in late 2023.

There are slight differences in the eligibility criteria in some States as well.

Queensland only requires any condition to cause death in 12 months, rather than the other States’ requirements of a six month timeframe, while Tasmania doesn’t require a condition to be progressive.

In Victoria, South Australia and Tasmania the condition must be incurable and in Tasmania it also must be irreversible.

The laws on when health care workers and medical practitioners can discuss voluntary assisted dying with patients also differ between States.

In Victoria and South Australia doctors and nurses can discuss it and provide information if the person asks them about it first – they are not allowed to start the conversation.

In Western Australia, Tasmania and Queensland health professionals can start the discussion but they have to provide information about treatment and palliative care as well, and in Tasmania any professionals that are not medical practitioners must also tell the person it is best to discuss voluntary assisted dying with a medical practitioner.

If health practitioners don’t want to participate in the process in Western Australia, Tasmania and Queensland they need to give a patient that wants to access voluntary assisted dying the contact details of another service that will help them.

More information

You can read information on voluntary assisted dying produced by your State or Territory by clicking the links below:

If you are in a situation where you would like to speak to someone in person about the steps to voluntary assisted dying, other options and palliative care you can ask your palliative care team, health services you are in contact with or your doctor.

If reading this article has caused you distress you can call Lifeline on 13 11 14 for support.

What else would you like to know about Voluntary Assisted Dying? Tell us in the comments below.

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How can palliative be more accessible to people with intellectual disabilities?
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