CULTURE & DIVERSITY
What you need to know about voluntary assisted dying New toolkit provides guidance for aged care providers With voluntary assisted dying (VAD) operating in all Australian states by the end of November 2023, residential aged care facilities will need to be prepared for what this will mean for them, their staff and the residents in their care. VAD is currently operating in all states except New South Wales, where it is due to commence on 28 November 2023. VAD is currently illegal in the Australian Capital Territory and Northern Territory. Penny Neller and colleagues from the Australian Centre for Health Law Research, Queensland University of Technology, recently developed new ELDAC End of Life Law Toolkit resources on VAD and the legal rights and obligations of health professionals and aged care facilities. “It’s important health professionals and other staff working in aged care know their legal obligations and receive education and training on these, regardless of whether their facility provides VAD, and whether or not they are involved in VAD,” said Penny. “While a health professional or care worker can choose whether they want to participate in providing VAD, in some states, health professionals with a conscientious objection have specific legal obligations they must still comply with, such as to provide information to a resident requesting VAD.” Laws differ between states, and to access VAD, a person receiving aged care must meet all eligibility criteria specific to the laws of the state in which they live. “The eligibility criteria for VAD include that a resident or home care recipient must be an adult with decision-making capacity; have a disease, illness or 64
medical condition that will cause death within a specified period; and have a condition that is advanced and causing intolerable suffering,” said Penny. “Generally, a person will need to make three requests for VAD and be assessed as eligible by at least two different medical practitioners who have completed mandatory training on VAD and meet other requirements. “The request for VAD can only be made by the person and not by a family member, friend or staff member. It cannot be requested by a person in their Advance Care Directive.” While all aged care and home care staff can provide information about VAD if the person asks for it, the rules around starting a conversation about VAD differ by state and profession. For instance, doctors in Victoria and South Australia can’t start a discussion about VAD with a person, but doctors in other states can. While aged care facilities can choose what level of involvement they have in VAD, in some states all facilities have legal obligations that must be followed regardless of whether they provide or object to VAD. “In South Australia, Queensland, and New South Wales all residential aged care homes must allow residents to receive VAD information when requested, and to make a first or final request for VAD at the facility. This means allowing a medical practitioner to visit the facility so a resident can make the request. If the doctor can’t visit, the facility must transfer the resident to and from another place to make their request,” said Penny. “If the resident is a permanent resident, the facility must allow health practitioners to visit the resident at the facility to
conduct VAD consultations and supply or administer VAD medication.” Non-participating facilities in South Australia, Queensland and New South Wales must also clearly communicate this to residents and their families, and make sure this information is made public, for example by publishing it on the home’s website. These legal obligations do not exist in Victoria, Western Australia or Tasmania. However, it is still good practice for non-participating facilities in all states to provide residents with support, such as the contact details for the VAD Care Navigation Service in their state. VAD Care Navigation Services can assist not only residents and families, but also health professionals, aged care staff and management, by providing vital information and support. “Regardless of whether a residential facility or home care service provides VAD, it’s important to have clear position statements, policies, and procedures to help individuals, staff and families understand how VAD is managed at their facility or service,” said Penny. ELDAC is a palliative care and advance care planning project funded by the Australian Government Department of Health and Aged Care to provide access to evidence-based information and resources to support quality care at the end of life for all older Australians. The ELDAC End of Life Law Toolkit, available on the ELDAC website, contains free resources for aged care services and staff about VAD in aged care. Katherine Waller, Project Coordinator – Voluntary Assisted Dying Training Projects, Queensland University of Technology www.eldac.com.au