It is important for doctors to understand voluntary assisted dying laws due to commence in Victoria on 19 June 2019, and the potential implications for their practice.
The Voluntary Assisted Dying Act 2017 will allow doctors to prescribe patients a medication to cause their death, if the person meets strict eligibility criteria and has completed the request and assessment process. The legislation applies to patients aged 18 years or more with an incurable disease, illness or condition which will cause their death within six months and is causing them suffering that cannot be relieved in a manner that they consider tolerable or a neurodegenerative disease, illness or condition which is expected to cause their death within 12 months. The patient must have been living in Victoria for at least 12 months.
In preparation for the commencement of the Act, the Voluntary Assisted Dying Implementation Taskforce and the Department of Health and Human Services have created a range of resources to support medical practitioners and the community.
There are two key roles for doctors in assessing a patient’s eligibility for voluntary assisted dying: the coordinating doctor and the consulting doctor. If neither one of these doctors is able to determine whether the patient has decision-making capacity in relation to voluntary assisted dying, they must refer the patient to a registered health practitioner with appropriate skills or training for a specialist opinion. This latter category of health practitioner, or any other doctor requested to provide an opinion on a particular element of the eligibility criteria, is not required to complete voluntary assisted dying training before undertaking these assessments.
Guidance for doctors
Comprehensive guidance for doctors is now available. The document provides information and advice for doctors about each stage of the voluntary assisted dying process and their role. The guidance will be an important reference for any medical practitioner involved in voluntary assisted dying. The law protects doctors and other health practitioners, such as nurses, who do not want to participate in voluntary assisted dying because they have a conscientious objection.
Training for doctors
Prior to assessing a patient’s eligibility for voluntary assisted dying, a doctor must complete voluntary assisted dying training. The training may be undertaken online and will take approximately six hours, including an assessment module to complete the training. The training focuses on voluntary assisted dying and the new legal requirements, it is not intended to provide comprehensive training on end-of-life care more generally.
Community and consumer information
A range of community and consumer information is available in various languages and pitched at different levels. Doctors should be aware of what is available so they can refer patients to appropriate information, if requested.
It should be noted that doctors cannot initiate discussions about voluntary assisted dying with their patients, and should not display information about voluntary assisted dying around a health service or in a waiting room.
A medication protocol has also been developed for doctors who are providing voluntary assisted dying. This medication protocol will only be made available to doctors who have completed the training.
There will also be two new services to support consumers and doctors who need information and guidance about voluntary assisted dying.
Voluntary Assisted Dying Care Navigators will provide information and support to doctors and the community across Victoria. Care navigators will perform a range of roles, including providing information about voluntary assisted dying and linking people with voluntary assisted dying and other end-of-life care services.
The Voluntary Assisted Dying Statewide Pharmacy Service has also been established. The statewide pharmacy service will be responsible for dispensing all voluntary assisted dying medications and provide support and advice to doctors and the community.
Visit the Victoria State Government’s website for a range of resources for doctors and their patients.
A Voluntary Assisted Dying Implementation Conference will be held from 8 – 10 May 2019. Further information can be found on the website and registration is free for Victorians.
View Avant’s position statement on Voluntary Assisted Dying.
This update has been provided by the Victoria State Government’s Department of Health and Human Services.