Penny Neller, End of Life Law Toolkit Developer, End of Life Directions for Aged Care
End of Life Directions for Aged Care (ELDAC)
Voluntary assisted dying (VAD) is an emerging area for aged care in Australia. With VAD operating in all Australian States by the end of November 2023, aged care providers and staff will increasingly receive questions about VAD from those they care for and their families. Some common queries about VAD in aged care are discussed in ELDAC’s new FAQs factsheet and below.
Is VAD legal everywhere in Australia?
Every State in Australia has passed VAD laws. VAD is operating in all States except New South Wales, where it will start on 28 November 2023. VAD is currently illegal in the Territories. Each States’ laws are similar but there are key differences.
Can anyone with a terminal illness receive VAD?
No. To access VAD a person must meet all eligibility criteria in their State. This includes having:
- decision-making capacity
- a disease, illness or medical condition that will cause death within six months, or 12 months if the person has a neurodegenerative disease (such as motor neurone disease) or is in Queensland
- a condition that is advanced and causing intolerable suffering.
Can a person with dementia access VAD?
A person will not be able to access VAD for dementia. This is because a person must have decision-making capacity to request VAD. A person whose dementia is so advanced that they are within 12 months of death will not have decision-making capacity. However, a person who is in the early stages of dementia and has a terminal illness (e.g., cancer) may be eligible for VAD if they have decision-making capacity and meet the other eligibility criteria.
Who can request VAD?
Only the person who will receive VAD. It cannot be requested by a family member, friend, substitute decision-maker, or aged care staff. A person cannot ask for VAD in their Advance Care Directive.
How does a person access VAD?
The process is different in each State. Generally, a person will need to make three requests for VAD and be assessed as eligible by at least two different medical practitioners who meet particular requirements.
Can a person who asks for VAD also receive palliative care and other treatment?
Yes. They can continue to receive palliative care and other medical treatment up until their death.
Do health professionals and care workers have to participate in VAD?
No. Healthcare professionals have the right to conscientiously object to participating in VAD. However, in some States they may still have legal obligations, such as to provide information to a person requesting VAD. Care workers can also choose not to be involved in VAD.
Do residential facilities have to provide VAD?
Residential facilities can decide whether to provide some, all, or no VAD services. However, in South Australia, Queensland and New South Wales residential facilities that choose not to provide VAD services still have legal obligations to enable a resident to access VAD if they wish.
Can health professionals and care workers discuss VAD or give information about VAD?
Health professionals and care workers can provide information about VAD to a resident or others e.g., family if asked. However, there are restrictions on when healthcare professionals can start a discussion about VAD. Only some health professionals can do this, and in some States, they must provide certain information when they have discussions.
Want to know more? Visit ELDAC’s End of Life Law Toolkit for everything you need to know about VAD in aged care. You can also download printable VAD factsheets for residential facilities (tailored to the State or Territory you work in) and different health professionals.
*The views and opinions expressed in Knowledge Blogs are those of the authors and do not necessarily reflect those of ARIIA, Flinders University and/or the Australian Government Department of Health and Aged Care.