Voluntary Assisted Dying: Meeting Expectations with Dignity and Respect

Voluntary Assisted Dying (VAD) is one of the most profound choices a person can make at the end of their life. 

Whilst providers in the aged care or disability sector may hold moral or ethical objections to the practice, the reality is that VAD is legal in most parts of Australia and clients have the right to choose to access VAD. 

Generally, aged care and NDIS providers can decide whether to offer VAD or not.  However, even if they choose not to provide VAD, they must still uphold their relevant obligations under the Aged Care Act 2024 (Cth) (Aged Care Act), National Disability Insurance Scheme Act 2013 (Cth) (NDIS Act) and VAD laws.  This is even more critical for national providers, who must be aware of the differences between the VAD laws in each jurisdiction and ensure that they are able to comply with their obligations.

Under the NDIS Act, providers are required to empower participants to exercise choice and control - this includes offering non-judgmental support when a participant expresses a desire to access VAD.  Similarly, the Aged Care Act requires providers to respect the rights of consumers, even if they have ethical objections.  

VAD is a topic that may arise during care planning and end of life discussions.  The Aged Care Quality Standards require aged care providers to ensure that assessment planning identifies and addresses the consumer’s current needs, goals and preferences.  This includes providing suitable end of life planning and care planning for those seeking to access VAD.

Providers must also manage risks associated with VAD.  For example, if a client chooses to self-administer VAD medication, how will the service ensure that the VAD substance is stored securely, accessible only to the client and posing no risk to others?  Storage requirements for VAD substances also differ from state to state, with some states requiring the substance to be kept in a locked box. Comprehensive policies and procedures, and training and education for staff, are vital to navigate these situations with care and professionalism.

Providers should also consider what kind of support they will provide to clients, families and staff.  For instance, how will they support clients who are deemed ineligible for and denied access to VAD?  What kind of assistance will be provided to staff members who have been involved in the client’s care (and who may be affected by their decision to access VAD)?

The role of providers is not only to uphold the law but to provide compassionate, person-centred care.  This includes maintaining clear boundaries about what staff can and cannot discuss, supporting clients’ choices within the legal framework and ensuring staff have the tools and confidence to respond appropriately.

All providers, regardless of whether they provide VAD or not, are encouraged to implement:

• a position statement to ensure that all staff, clients and families clearly understand their position on providing VAD; and
• policies and procedures to manage VAD, which address matters such as:
  • any restrictions on when health professionals can initiate discussions or provide information about VAD;
  • managing requests for information about or access to VAD;
  • the rights of staff in respect of conscientious objection;
  • the provision of VAD;
  • the storage and disposal of VAD substances; and
  • the support provided for clients, staff and family members.

For advice on managing VAD (including responding to requests for VAD) or implementing VAD policies and procedures, contact Amber Crosthwaite at 9288 6931 or amber.crosthwaite@lavan.com.au.