Who is eligible for voluntary assisted dying? Is it the same as euthanasia? Can I die at home? Answers to these questions and more.
Kindly contributed by Go Gentle Australia.
Voluntary assisted dying allows a dying person who is suffering in the final stages of life to ask their doctor for medication to help them die. The person must be an adult, have decision making capacity and be assessed as eligible by two independent doctors.
Technically, euthanasia means a doctor administers the life-ending substance to a dying person - rather than the person taking it themselves.
In Australia, the term ‘voluntary assisted dying’ covers both practices.
In the majority of cases in Victoria, people have taken the medication themselves. This is because in Victoria self-administration is the default method and only in cases where the person is too sick to take it themselves can a doctor step in to help. In Western Australia, where people are permitted to choose the method of administration, a significant majority elect for their doctor to administer the medication for them.
The term voluntary assisted dying is preferred in Australia because it also centres the dying person’s choice. VAD is not something that happens to you, but something you choose.
Other countries have chosen different words. For example, Canada uses the abbreviation MAiD, which stands for medical assistance in dying.
Yes. Every state has passed its own voluntary assisted dying law. The only one yet to take effect is New South Wales, which will be available from 28 November 2023.
The Northern Territory and the ACT do not yet have voluntary assisted dying laws. However, in December 2022 the federal government lifted its 25-year ban on the Territories debating VAD, meaning the NT and ACT are now free to discuss and pass their own voluntary assisted dying laws. The ACT government plans to begin this process in 2023. The NT has not yet made any commitment to passing a VAD law. Sign up for free updates here.
The Northern Territory and the ACT do not yet have voluntary assisted dying laws. The ACT plans to debate a law in 2023. The NT is yet to commit to a timeline.
However, there are some exceptional circumstances where an eligible person in the ACT or NT could access a voluntary assisted dying law in New South Wales or Queensland if
a) you live on the border and receive the majority of your health care in that state or
b) you can show on compassionate grounds (e.g. your family live in the state) why you should be able to access their voluntary assisted dying laws.
If you think this applies to you, please email [email protected] and we can provide further details.
Australian assisted dying laws are some of the most restrictive in the world, intended to help a small number of terminally ill adults in extreme circumstances. To access voluntary assisted dying a person must:
- Have a terminal illness likely to end their life within six months (or 12 months for neurological conditions. Queensland has a blanket 12 month timeframe for all illnesses) and experience unbearable suffering
- Have decision-making capacity about voluntary assisted dying
- Act freely and without coercion
- Be aged 18+ and an Australian citizen/meet residency requirements
- Have lived in the state for at least 12 months
Advanced age, disability or mental health conditions by themselves do not make a person eligible for voluntary assisted dying. To be eligible, a person must be terminally ill and satisfy all other eligibility requirements.
While there is an emerging ‘Australian model’ of voluntary assisted dying, each state’s law is slightly different. Visit GoGentle's Voluntary assisted dying law in my state page to find out more.
The best people to speak to are the Voluntary Assisted Dying Care Navigators in your state. This is a free service and they are experts in providing the right information about your state’s law. Visit GoGentle's VAD in my state page and select your state to get their details.
The successful operation of voluntary assisted dying laws relies on there being enough participating doctors. Thank you for seeking further information in this important area.
If you are a medical practitioner interested in providing voluntary assisted dying services to your patients, you are required to complete an online training program and pass an eligibility assessment.
Click on your state to find out more: Health Practitioner information Victoria, Health Practitioner information Western Australia, Health Practitioner information Tasmania
Voluntary assisted dying is one of several options for terminally ill people at the end of life.
Palliative care and end-of-life care are excellent in Australia. They help the vast majority of people to die without excessive pain and suffering.
However, in a small number of cases palliative care cannot relieve all suffering. Palliative Care Australia estimates this to happen to around 4% of people. For those dying people, voluntary assisted dying is another option.
Speak to your doctor to find out about your end-of-life options.
There is a strict assessment process with multiple safeguards, including sign-off from two independent doctors that the person meets all the eligibility criteria. If there are any doubts, a specialist and/or psychiatrist will give a third opinion.
If doctors suspect a person is under pressure or being coerced to request assisted dying, the process stops immediately.
A person can pause or stop their application at any time.
Applying for voluntary assisted dying is a complicated process with robust safeguards, and for this reason it takes time. After several years of voluntary assisted dying operating in Victoria, the advice is to start as early as possible to avoid delays.
In extreme circumstances, applications can be accelerated. However, this should be avoided as it adds stress at an already challenging time. Starting early is best.
There are a range of health practitioners who can help with voluntary assisted dying. Depending on who you see, you may be able to claim some of the costs on Medicare. However, there may also be some out-of-pocket expenses you need to plan for. It's always best to check with your doctor first. You may also need to factor in travel to see a doctor or specialist, or pay for documents such as proof of residency and citizenship.
Voluntary assisted dying does not affect life insurance claims or death benefits from superannuation funds. Although most life insurance policies exclude claims if a person has died by suicide, Australian laws make clear that voluntary assisted dying and suicide are two different things. A person’s death certificate lists their illness as the cause of death, not voluntary assisted dying.
There are no guarantees a person will be able to die at home; this depends on someone’s circumstances and the services in their area. That said, people are often better able to plan ahead if they know they are going to have an assisted death. For many that will mean planning to be at home, often with loved ones present.
Voluntary assisted dying can also happen in hospitals and residential facilities like nursing homes.
All Australian laws require you to have been resident in the state for at least 12 months before using their voluntary assisted dying law. There are exceptions in Queensland, Tasmania and New South Wales where you can apply for a special consideration if you live outside the state but have ‘substantial connections’ (such as being a former resident or your family living in Queensland).
Australia’s voluntary assisted dying laws are some of the most regulated in the world. Victoria, whose law began operation in 2019, shows the law is working safely and as intended. A Review Board oversees every application and publishes annual reports. Former Supreme Court Judge Justice Betty King, the Board’s inaugural Chair, said: I have been looking, believe me - I have seen no indication of any type of coercion.
There have been no reported complications and the drugs work effectively. Doctors say the most common words they hear loved ones use to describe the assisted deaths are ‘perfect’, ‘beautiful’ and ‘peaceful’. Read an account from a Victorian family whose loved one died by voluntary assisted dying.
You should discuss your end-of-life options with your doctor. However, some medical professionals do not agree with voluntary assisted dying and the law grants them the right to conscientiously object. This means they do not have to agree to assess you. In this case, they are legally obliged to let you know so you can find another doctor willing to provide you with information.
Best practice in Australian healthcare is that you (the patient) are central to all decisions about your care and treatment. This is often called ‘person-centred care’. This means if your doctor will not discuss voluntary assisted dying with you, you’re entitled to look for another who will.
For some people, death and dying are still taboo and difficult to talk about. But it’s important that we do, so we can plan ahead and make the right choices for us. Visit Advance Care Planning Australia for resources to help you start the conversation.
Ideally, your family will respect whatever choice you make. However, if you prefer, you can keep the conversation confidential between you and your doctor. Just like any other aspect of your healthcare and treatment, you do not have to share details if you don’t want to.
People seeking voluntary assisted dying are not suicidal; they don’t want to die but are dying of a terminal illness and simply want to control how and when it happens and how much they need to suffer at the end.
Australian laws expressly state that voluntary assisted dying is not suicide.
If you are affected by the issue of suicide or want to support someone experiencing suicidal ideation, visit Conversations Matter or Beyond Blue
If you (or someone you know) require immediate assistance, contact one of the following 24/7 crisis support services: Lifeline (13 11 14), Suicide Call Back Service (1300 659 467), MensLine (1300 78 99 78), Beyond Blue (1300 22 4636), Kids Helpline (1800 55 1800) or Headspace (1800 650 890).
Australians are overwhelmingly in favour of voluntary assisted dying. Polls from the past 20 years show public support at more than 70%. The vast majority of peak medical bodies are either supportive or neutral on Voluntary Assisted Dying, including Palliative Care Australia, Royal Australian College of GPs, Australian Nursing and Midwifery Federation, Australian and New Zealand College of Anaesthetists, Australian Psychological Society and Australian Association of Social Workers to name a few.
For more information about voluntary assisted dying laws and policies in Australia, please visit:
Voluntary assisted deaths make up a tiny proportion of all deaths in Australia. In Victoria, it's around 0.5% of total deaths each year. In Western Australia, voluntary assisted deaths account for around 1% of deaths annually. This is consistent with other countries where assisted deaths represent 0.5%–4% of all deaths.