Voluntary Assisted Dying in Tasmania

Frequently Asked Questions

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What is voluntary assisted dying (VAD)?

Voluntary assisted dying refers to a situation where a person who is dying chooses to access prescribed medication to end their life.

To access voluntary assisted dying, when it is allowed in Tasmania, people will have to meet requirements in relation to their medical condition, decision-making capacity, whether they are acting voluntarily, and their age and residency.

If they meet the requirements and safeguards in the law, voluntary assisted dying allows people who are already near the end of their life to decide how and when they die.

Most people will get the support they need from palliative care and end of life services, which improve quality of life for people with advanced disease. However even with the best care, some people getting close to the end of their life can experience suffering that cannot be relieved in a way that is tolerable to them and may want to ask for assistance to die.

When will Tasmanians be able to access voluntary assisted dying?

Tasmania has passed legislation which will allow eligible adults to request voluntary assisted dying from 23 October 2022.

Under the voluntary assisted dying law, there is an 18-month implementation period to administer the effective introduction of voluntary assisted dying for Tasmanians.

This work will include the establishment of the Voluntary Assisted Dying Commission, the development of training courses, decisions about service delivery to support voluntary assisted dying, and the development of many forms, policies, guidelines and processes.

Stakeholders in the medical profession and the community will need to be consulted on many aspects and this will take time.

Who will be able to access voluntary assisted dying?

To access voluntary assisted dying, a person will have to meet requirements in relation to their medical condition, decision-making capacity, whether they are acting voluntarily, and their age and residency. These requirements are summarised below.

Medical condition – a person must be suffering intolerably due to an advanced, incurable and irreversible disease, illness, injury or medical condition for which there is no reasonably available treatment that the person finds acceptable. The medical condition must be expected to cause their death within six months, or within 12 months if it is a neurodegenerative disease, although it will be possible to apply for an exemption to these timeframes (further guidelines will be released on this in future).

Decision-making capacity – a person must be able to:

  • understand, remember and use or evaluate information and advice regarding access to voluntary assisted dying, and
  • communicate their decision and opinions. This includes communicating verbally, in writing, or by gesture.

Acting voluntarily – The decision to access voluntary assisted dying must be a person’s own decision. There must not be duress, coercion, threats or rewards associated with their decision.

Age – a person must be 18 years or older to access voluntary assisted dying in Tasmania.

Residency – a person must have been living in Tasmania for the 12 months prior to requesting access to voluntary assisted dying. They must also be an Australian citizen or permanent resident, or have been living in Australia for at least three years prior to making the request.

Can somebody with a disability or mental illness access voluntary assisted dying?

People with disability or mental illness have the same right to ask for voluntary assisted dying as others in the community.

Like others, they will only be able to access voluntary assisted dying if they meet the criteria set out in the law in relation to their condition, decision-making capacity, voluntariness, age, and residency. This includes that they must be suffering intolerably due to an advanced, incurable and irreversible disease, illness, injury or medical condition that is expected to cause death within 6 months (or 12 months if it is a neurodegenerative disease).

There are provisions in the law for people who have difficulty communicating to have support in their communications, including use of an interpreter.

What will be the process for accessing voluntary assisted dying?

Access to voluntary assisted dying requires multiple requests and multiple assessments of eligibility. The following summarises the process for access to voluntary assisted dying.

First Request:

A person asks their doctor for access to voluntary assisted dying.

  • This is called the "first request ".  You can only make a "first request" if your doctor has first provided you, in person, with information regarding voluntary assisted dying.

The doctor accepts the request

  • The doctor may also decline to accept the request.

The doctor assesses the person as eligible to access voluntary assisted dying

  • This requires the doctor to make a written determination that the requirements set out in the Act in relation to the medical condition, decision-making capacity, voluntariness, age and residency are met.
  • The doctor may also assess the person as ineligible.

Second Request:

The person asks their doctor again for access to voluntary assisted dying

  • This is called the "second request".

The doctor again assesses the person as eligible to access voluntary assisted dying

  • This requires the doctor to make a second written determination that the requirements set out in the Act in relation to the medical condition, decision-making capacity, voluntariness, age and residency are met. The doctor may also assess the person as ineligible.

Second Opinion:

A second doctor provides a second opinion and assesses the person as eligible

  • A different doctor assesses whether the person meets the requirements in the Act and makes a written determination. Doctors can refuse to accept referrals, and can also assess a person as ineligible

Final request:

The person asks the first doctor again for access to voluntary assisted dying

  • This is called the "final request ".

The doctor again assesses the person as eligible to access voluntary assisted dying

  • This requires the doctor to make their third written determination that the requirements set out in the Act in relation to the medical condition, decision-making capacity, voluntariness, age and residency are met. The doctor may also assess the person as ineligible.

Voluntary assisted dying substance authorisation:

The voluntary assisted dying substance is prescribed and supplied

  • A doctor applies to the voluntary assisted dying Commission and is granted authorisation to prescribe the voluntary assisted dying substance. The voluntary assisted dying Commission may also refuse authorisation to prescribe the substance.

Final determination

A health practitioner assesses the person's decision-making capacity and whether they are acting voluntarily

This is called the "final determination ". This may be done by the doctor from earlier stages of the processor may be done by another health practitioner, including a registered nurse.

Final Permission

The person provides their final permission stating that they wish to access voluntary

  • This must be done within 48 hours of the "final determination". The final permission sets out the person's wishes including how they wish to have the voluntary assisted dying substance administered to them.

Administration

Administration of the voluntary assisted dying substance in accordance with the person’s wishes.

What is the role of doctors, nurses and other health practitioners in voluntary assisted dying?

All health practitioners will have a choice as to whether they assist their patients to access voluntary assisted dying. If a health practitioner is uncomfortable, they will not have to play any active role in the voluntary assisted dying process although there are some obligations under the law, as set out below.

Health practitioners will be a vital part of the voluntary assisted dying process. Medical practitioners (doctors) will be responsible for assessing a person’s eligibility to access voluntary assisted dying – this process will involve at least two different doctors and at least four assessments. Other health practitioners – registered nurses – will also be able to play a role by supporting a person through the final stages of voluntary assisted dying, including assisting them to obtain and administer the voluntary assisted dying substance.

Although it will be their choice whether to participate in voluntary assisted dying, some obligations will apply to all medical practitioners (doctors):

  • all doctors will be legally required to provide people who express a wish to access voluntary assisted dying with the contact details of the Voluntary Assisted Dying Commission (the Commission). This means the doctor will not have to be involved, but the patient will be referred to the Commission, which can assist them to access voluntary assisted dying if they wish, and
  • a doctor who is not involved in assisting a patient to access voluntary assisted dying may be legally required to provide medical records of that patient to another doctor.

Doctors and nurses who choose to participate in the voluntary assisted dying process will have to complete a voluntary assisted dying training course before they can assist people to access voluntary assisted dying. This training course will be developed, and approved by the Commission, prior to voluntary assisted dying becoming available. It is expected to be available for health practitioners to complete in mid-2022.

There will also be materials produced to support all health practitioners to exercise their choice as to whether to be involved in voluntary assisted dying, by clarifying their rights and obligations.

I haven't been able to find the information I want on this page

While voluntary assisted dying has passed Parliament, it is not yet legal in Tasmania and some information about how it will operate is not yet available. Decisions still need to be made about service delivery to support voluntary assisted dying and many forms, policies, guidelines and processes still need to be developed and implemented. The voluntary assisted dying law that was passed by Parliament included an 18-month implementation period to allow the completion of this work.

This page will be updated regularly with further information as it is developed. To subscribe to email updates, please send a blank email to vad@health.tas.gov.au with “subscribe” as the subject. You can also email vad@health.tas.gov.au with any specific queries.  The End-of-Life Choices (Voluntary Assisted Dying) Act 2021 is also available online.