Voluntary assisted dying – what you need to know

There is not universal access and people cannot demand VAD. A VAD Review Board has been established to ensure compliance with the new laws and to monitor permit applications for the VAD substance.

Here are some key points you need to know about your role in assessing patients for VAD.

Who is eligible for VAD?

To be eligible for access to VAD, a person must:

• be over 18 years of age, an Australian citizen or permanent resident, and a resident of Victoria for at least one year; and
• have decision-making capacity in relation to VAD; and
• be diagnosed with a disease, illness or medical condition that is:
  
  • incurable; and
  • advanced, progressive and will cause death; and
  • expected to cause death within weeks or months, not exceeding six months (or 12 months for a neurodegenerative condition); and
  • causing suffering to that person which cannot be relieved in a tolerable manner.

What medical assessments are involved?

A medical practitioner may decline to assist a person seeking access to VAD on the basis that they are a conscientious objector or are unavailable. They can refuse to assist in any process related to VAD.

The first practitioner who agrees to assist becomes known as the ‘Co-ordinating Medical Practitioner’. This practitioner becomes responsible for assessing the person’s eligibility, providing information, reporting to the VAD Review Board, arranging an assessment from a second medical practitioner,and forwarding various documentation to the VAD Review Board when applying for a permit.

The second practitioner, who becomes known as the ‘Consulting Medical Practitioner’, must consider the same eligibility criteria and provide the same information before providing a second assessment to the VAD Review Board.

What information do you need to give the patient?

Once eligibility for VAD has been established, the person must be counselled regarding:

• diagnosis and prognosis
• treatment options and the likely outcome of treatment
• palliative care options and likely outcomes of care
• the potential risk of taking a VAD substance and that death is the expected outcome.

The person must also be made aware that they may decide at any time not to continue, and should be encouraged to consult other treating doctors in relation to the request.

Who can access VAD?

A person can access VAD if:

• they have met the eligibility criteria; and
• they have been given the information (as outlined above) by both the Co-ordinating Medical Practitioner and the Consulting Medical Practitioner; and
• they are acting voluntarily and without coercion; and
• their request for VAD is enduring.

Two self-explanatory types of permits are available for VAD – a Self-Administration Permit and a Practitioner Administration Permit.

What are the safeguards?

• Both the Co-ordinating Medical Practitioner and the Consulting Medical Practitioner must undergo approved assessment training before commencing an assessment.
• If either medical practitioner is unable to determine whether a person has decision-making capacity in relation to VAD, they must refer the person to a medical practitioner with appropriate skills and training, e.g. a psychiatrist.
• If either medical practitioner is unable to determine whether the person’s disease, illness or medical condition meets the eligibility requirements, they must refer the person to an appropriate specialist.
• VAD substances will only be available at the pharmacy at the Alfred Hospital in Melbourne.
• A ‘Contact Person’ must be appointed to return any unused or remaining VAD substance to the dispensing pharmacist.
• A medical practitioner who supplies a VAD substance to a patient without a permit will be guilty of aiding and abetting suicide.

 

More resources

Victoria Health: Voluntary assisted dying

Gayle Peres da Costa
Medico-legal Adviser, MDA National