Co-ordinating and consulting medical practitioner information

Voluntary assisted dying means a person in the late stages of advanced disease can take a medication prescribed by a doctor that will bring about their death at a time they choose. Only people who meet the requirements and follow the steps set out in the law can access voluntary assisted dying.

Medical practitioners should consider their level of involvement in voluntary assisted dying. Medical practitioners involved in the provision of end of life care may receive requests for information from patients about voluntary assisted dying.

For medical practitioners providing access to voluntary assisted dying or caring for patients who may be considering access to voluntary assisted dying, the Guidance for health practitioners provides comprehensive guidance about voluntary assisted dying.

Medical practitioners who may be interested in supporting patients to access voluntary assisted dying should consider completing the voluntary assisted dying training. A medical practitioner must complete this training before conducting an eligibility assessment for voluntary assisted dying.

There is also guidance available for health services to assist them in implementing voluntary assisted dying.

Medical practitioner participation in voluntary assisted dying

A medical practitioner may choose whether or not they participate in voluntary assisted dying

• This decision may be made based on whether they have appropriate skills and training, whether they are available to perform the duties of the role, or if they have a conscientious objection to participating.
• A medical practitioner may also choose what level of involvement they have with voluntary assisted dying. For example, they may be comfortable providing a patient with general information, but may choose to take no further part.
• Medical practitioners should work with their health service to determine their level of involvement in voluntary assisted dying and how patients can be supported.

What roles do medical practitioners perform in voluntary assisted dying?

• Voluntary assisted dying will be provided by medical practitioners who hold a fellowship with a specialist medical college or who are a vocationally registered general practitioner and who have undertaken specific training.
• If a medical practitioner is interested in supporting patients to access voluntary assisted dying they must complete the voluntary assisted dying training. A medical practitioner must complete this training before conducting an eligibility assessment for voluntary assisted dying.
• A patient will need to be assessed as eligible by two medical practitioners prior to receiving access to voluntary assisted dying. These two medical practitioners are the co-ordinating and consulting medical practitioner.
• Other medical practitioners may also be asked to conduct additional assessments if there is uncertainty about whether or not the person meets one of the eligibility criteria. To conduct these assessments a medical practitioner does not need to complete the voluntary assisted dying training.

How will a patient access voluntary assisted dying?

• Voluntary assisted dying will not be legal until 19 June 2019.
• To access voluntary assisted dying a patient will need to make a request to a doctor, who may choose whether or not to accept their request.
• A health practitioner will not be allowed to raise voluntary assisted dying with their patients. A patient must raise voluntary assisted dying themselves. If a patient does so, the health practitioner may provide them with information.

What is a co-ordinating medical practitioner?

• A co-ordinating medical practitioner is the medical practitioner who receives and accepts the patient's first request for voluntary assisted dying.
• The co-ordinating medical practitioner will be responsible for conducting the first assessment to determine whether or not the patient meets the eligibility criteria.
• If the patient does meet the eligibility criteria, the co-ordinating medical practitioner will be responsible for referring the patient to the consulting medical practitioner.
• The co-ordinating medical practitioner will also be responsible for ensuring all the forms are completed and must report these to the Voluntary Assisted Dying Review Board through the voluntary assisted dying portal.
• The co-ordinating medical practitioner will also be responsible for applying for a permit, and prescribing the voluntary assisted dying medications.

What is a consulting medical practitioner?

• A consulting medical practitioner is the medical practitioner who receives and accepts a referral from the co-ordinating medical practitioner.
• The consulting medical practitioner will be responsible for conducting the consulting assessment and must independently satisfy themselves the person meets each of the eligibility criteria.
• The consulting medical practitioner must also report their assessment to the Voluntary Assisted Dying Review Board through the voluntary assisted dying portal.

Where can I find more information about voluntary assisted dying?

• The implementation of voluntary assisted dying is being supported by an Implementation Taskforce. The Taskforce and the Department of Health and Human Services are developing a range of materials to support health practitioners with the implementation of the Act.
• The Implementation Taskforce will also work with health services and existing professional organisations to provide health practitioners with information and support.
• More information can be found elsewhere in the voluntary assisted dying section of health.vic.

Voluntary Assisted Dying Statewide Pharmacy Service

To ensure that Voluntary Assisted Dying is provided in accordance with the Voluntary Assisted Dying Act 2017, and is provided in a safe and compassionate manner, the Government has established a Statewide Pharmacy service.

The voluntary assisted dying medication will be available through the Statewide Pharmacy Service for people who have been prescribed the medication after completing the request and assessment process under the Voluntary Assisted Dying Act 2017.

The specific roles of the Voluntary Assisted Dying Statewide Pharmacy Service are to:

• liaise with the co-ordinating medical practitioner
• communicate with the patient
• dispense the prescription
• provide the medication to the patient.

Co-ordinating medical practitioners are required to complete approved assessment training prior to commencing the first assessment of a patient for voluntary assisted dying. The Statewide Pharmacy Service involvement will commence only when a Permit has been approved by the Department of Health and Human Services and the prescription has been provided to the service by the co-ordinating medical practitioner.

The Statewide Pharmacy Service will not provide medication protocols upon request. Medication protocols will be provided to co-ordinating medical practitioners by the Department of Health and Human Services only.

To have a prescription dispensed

• The prescription will be sent directly to the Statewide Pharmacy Service by the patient's co-ordinating medical practitioner.
• The Statewide Pharmacy Service will dispense the voluntary assisted dying medication only when the patient directly requests this from the service.
• The Statewide Pharmacy Service will visit the patient anywhere in Victoria to provide the medication and education regarding the voluntary assisted dying medication.
• Any individuals that the patient wishes are welcome to be present during the pharmacist visit.

Phone: (03) 9076 5270
Email: statewidepharmacy@alfred.org.au

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