The Voluntary Assisted Dying Act 2022 comes into effect on 28 November 2023, meaning eligible people in NSW will be able to request medical assistance to end their life.
A person must be in the late stages of an advanced disease, illness or medical condition. They must also be experiencing extreme suffering.
If a person meets all the criteria and the steps set out in the law are followed, they can take or be given a voluntary assisted dying (VAD) substance to bring about their death at a time they choose. The substance must be prescribed by an authorised voluntary assisted dying practitioner.
‘Voluntary’ means the choice must be the person’s own. The person must have decision-making capacity throughout the entire process to access voluntary assisted dying.
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 the other eligibility criteria.
During the last 18 months, NSW Health has worked with the community and health, aged care and other stakeholders to implement the framework set out in the legislation, to ensure voluntary assisted dying is safe, accessible and follows the law.
Strict criteria must be met to access voluntary assisted dying. To be eligible, a person must:
- Be an adult (18 years and older), an Australian citizen or a permanent resident of Australia or who has been resident in Australia for at least three continuous years
- Have been living in NSW for at least 12 months (the Voluntary Assisted Dying Board may consider a residency exemption on compassionate grounds for a person with a substantial connection to NSW)
Have at least one disease, illness or medical condition which:
- Is advanced and progressive
- Will, on the balance of probabilities, cause their death within six months (or within 12 months for neurodegenerative diseases like motor neurone disease), and
- Is causing the person suffering which cannot be relieved in a way the person considers tolerable
- Have decision-making capacity in relation to voluntary assisted dying
- Be acting voluntarily and without pressure or duress, and
- Have an enduring request for access to voluntary assisted dying
The exact process for VAD differs slightly from state to state, but the basic process involves these steps:
- A person requests VAD from an eligible medical practitioner
- The same eligible medical practitioner does an eligibility assessment for VAD
- A second eligible medical practitioner does an eligibility assessment for VAD
- The person requests for VAD again, in writing
- The person makes a final request for VAD
- Officials authorise VAD. (The two doctors who assess VAD eligibility must both have undertaken specialised VAD training in the state where they practice)
- An eligible healthcare practitioner prescribes and dispenses VAD medicine
- an eligible person takes VAD medicine, or
- an eligible healthcare practitioner gives the eligible person VAD medicine
If you take the VAD medicine yourself (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 you can withdraw (stop) your request for VAD at any time, even after you have had an assessment or made a request in writing.
There are several VAD services to support and assist patients, family, carers, health practitioners and services providers through the process and steps.
The Voluntary Assisted Dying Care Navigator Service is available to:
- Provide information and support to patients and other community members with questions about or wishing to seek access to voluntary assisted dying
- Support queries from practitioners and coordinate ongoing training and support for coordinating, consulting and administering practitioners
- Advise patients how to raise voluntary assisted dying with their clinical care team and, in some circumstances, connect them with coordinating, consulting, and administering practitioners
The Voluntary Assisted Dying Pharmacy Service is responsible for:
- Coordinating the safe procurement, supply and disposal of the voluntary assisted dying substance across NSW
- Supporting patient access to the voluntary assisted dying substance regardless of their setting, for example, the patient may be in their home, at a residential care facility or a public hospital
The Voluntary Assisted Dying Board is an independent oversight and decision-making body with key functions including to:
- Monitor and report on the operation of the Act
- Decide whether to approve or refuse applications for access to voluntary assisted dying
- Keep a list of registered health practitioners who are willing to provide voluntary assisted dying services
Voluntary assisted dying will be embedded within each local health district’s end-of-life care pathways and patients must be informed about all options available to them, including palliative care and other treatment options, in line with their goals of care.
A person’s decision to seek information about, or access to, voluntary assisted dying has no impact on the person’s access to high-quality palliative care.
It’s also important to note a person cannot request VAD as part of their advance care planning (to ensure your family and medical team are aware of your medical wishes if you lose the ability to make decisions yourself). This is because an advance care directive comes into effect only once you no longer have decision-making capacity.