Health practitioner participation in voluntary assisted dying

A health 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 health 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.
  • Health services may also determine whether or not they want to participate in voluntary assisted dying. This decision will depend on whether they have staff with appropriate skills and expertise, whether they have the capacity to provide the service, and whether participation aligns with the values of the health service.
  • Health practitioners should work with their health service to determine their level of involvement in voluntary assisted dying and how patients can be supported.

What happens if a health practitioner conscientiously objects to voluntary assisted dying?

  • If a health practitioner conscientiously objects to voluntary assisted dying they are under no obligation to participate.
  • The health practitioner is under no obligation to refer the patient to someone who will assist them, but should not inhibit a person’s access to treatment. The health practitioner should inform the patient as soon as practicable that they will not assist them.

What roles do health practitioners perform in voluntary assisted dying?

  • Voluntary assisted dying will be provided by doctors who hold a fellowship with a specialist medical college or who are a vocationally registered general practitioner and who have undertaken specific training.
  • A limited number of pharmacists will be responsible for dispensing the voluntary assisted dying substance and for disposing of any unused substance.
  • Other health practitioners will not have responsibility for providing voluntary assisted dying, but they may provide care to patients who have requested voluntary assisted dying or who are considering requesting access to voluntary assisted dying. Health practitioners will continue to provide care to these patients, in the same manner as patients receiving any other type of treatment.
  • Other health practitioners may also get asked about voluntary assisted dying. Only a doctor may receive a formal request for voluntary assisted dying. Other health practitioners will be provided with additional information and support to manage questions about voluntary assisted dying.

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.

Which doctors can participate in voluntary assisted dying?

  • To participate in voluntary assisted dying a doctor must hold a fellowship with a specialist medical college or be a vocationally registered general practitioner.
  • Prior to conducting an assessment to determine whether or not a patient is eligible for voluntary assisted dying, the doctor must complete specific voluntary assisted dying training. The training is currently being developed and will be available prior to the commencement of the Act on 19 June 2019.
  • A doctor may receive a request from a patient and then choose to undertake the training because they want to assist their patient.

What should doctors who are interested in participating do now?

  • If a doctor is interested in participating they should discuss this with their health service and their colleagues.
  • The doctor should also consider the process and whether they have appropriate skills and expertise.
  • Once the voluntary assisted dying training is available, they should undertake the training.

What should other health practitioners who are interested in providing support to patients accessing voluntary assisted dying do now?

  • If a health practitioner is interested in supporting patients who are accessing voluntary assisted dying they should discuss this with their health service and their colleagues.
  • It is important that health services have systems and processes in place to manage requests for voluntary assisted dying. Even if the health service will not be providing voluntary assisted dying, patients may still make requests and health services should consider how they will manage this situation.

Where can I find further 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.
  • Further information can be found in the voluntary assisted dying section of health.vic

Health service participation in voluntary assisted dying

Health services should be considering the extent of their participation in voluntary assisted dying

  • A health service may determine whether or not they participate in voluntary assisted dying.
  • This decision will depend on whether they have staff with appropriate skills and expertise, whether they have the capacity to provide the service, and whether participation aligns with the values of the health service.
  • Regardless of whether a health service will provide voluntary assisted dying, they should develop policies and procedures for when a patient requests voluntary assisted dying or requests information about voluntary assisted dying.

What do health services need to consider if they are thinking about providing voluntary assisted dying?

  • To access voluntary assisted dying a person must complete the request and assessment process. This process requires them to be assessed as eligible by two doctors who hold either a fellowship with a specialist medical college or is a vocationally registered general practitioner. Specific voluntary assisted dying training for medical practitioners is being developed and will be available prior to the commencement of the Act.
  • Health services should consider how they can facilitate this process and support patients and their families through the process.
  • Health services should consider whether they can provide or facilitate access to doctors who hold appropriate qualifications and training.
  • Health services should also consider the views of their staff and whether staff are willing to participate in voluntary assisted dying and whether they have appropriate skills and expertise.
  • Health services should also consider how it will support staff if it decides to provide voluntary assisted dying.

What happens if a health service decides not to provide voluntary assisted dying?

  • The health service should determine how it will respond to requests for voluntary assisted dying or requests for information.
  • The health service is under no obligation to refer the patient to someone who will assist them, but should not inhibit a person’s access to treatment. The health service should inform the patient as soon as practicable that they will not assist them.
  • The health service should also consider how it will support staff and patients in having these conversations.

Will health services be supported if they provide voluntary assisted dying?

  • Yes. 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 services and health practitioners with the implementation of the Act.
  • The Implementation Taskforce is working with the Victorian Healthcare Association to develop models of care for health services.
  • These models of care will be developed for different sized health services, recognise varying levels of involvement and allow for flexibility depending on location and availability and capability of the workforce.
  • The models of care will help to provide consistency across Victoria, which will help patients navigate the system.
  • The Victorian Healthcare Association will liaise with health services over the next year to give health services time for the models of care to be reflected in their policies prior to voluntary assisted dying becoming legal on 19 June 2019.
  • Four Voluntary Assisted Dying Care Coordinator positions will be funded to provide ongoing coordination throughout the voluntary assisted dying process, including emotional support and follow up for the person, their carer/s and family, identification of any gaps in existing support, practical support and bereavement support.

What are some of the issues health services should be considering now?

  • The views of their staff and whether staff are willing to participate in voluntary assisted dying.
  • Whether staff need further information about voluntary assisted dying to help them understand the upcoming changes to the law.
  • How staff can be supported to find information on voluntary assisted dying and what information and support the health service will provide to their staff.
  • What policy and procedures will need to be implemented to support staff to manage a request for voluntary assisted dying.
  • The governance and leadership arrangements necessary to respond to voluntary assisted dying.
  • Whether patients who request voluntary assisted dying will be referred to other health services, and how this could be facilitated.
  • How patients requesting access to voluntary assisted dying will be supported.

Where can I find further information about voluntary assisted dying?

  • The Implementation Taskforce will continue to work with health services and existing professional organisations to provide information and support.
  • Further information can be found in the voluntary assisted dying section of health.vic.