Glossary of terms
Not sure what a term means? This page helps explain some of the main concepts around voluntary assisted dying and end of life in the Australian context.
A
Accredited interpreter
In the context of VAD, this is a qualified interpreter recognised by the National Accreditation Authority for Translators and Interpreters. The interpreter helps with communication during consultations and with medical professionals.
Administering practitioner
The doctor, nurse practitioner or registered nurse who administers or gives the person the VAD medication.
Administration decision
The decision, made together with the coordinating practitioner, about how the VAD medications will be administered: either to self administer the voluntary assisted dying substance, or have it administered by a medical practitioner.
Advance care directive (also advance health directive)
A legal document that sets out a person’s future healthcare treatment preferences. These preferences must be followed if the person can no longer communicate their wishes. A decision to choose voluntary assisted dying cannot be recorded in an advance care directive because you need to have decision-making capacity at every step of the process.
Advance care planning
Planning for your future health care, including making decisions now about the health care you would or would not like to receive if you were to become seriously ill and unable to communicate. The decisions may be written into a formal, legal document. See also Advance Care Directive
Assisted dying
The act of legally administering medication with the aim of ending a person's life. Also refers to the steps and process related to that administration. See also voluntary assisted dying (VAD).
C
Care navigator (VAD Care Navigator Statewide Service)
A health care worker, usually a registered nurse or social worker, who provides information and assistance about voluntary assisted dying.
Coordinating practitioner
The doctor who accepts the person’s first request for voluntary assisted dying and coordinates the process, including interactions with the Review Board.
Conscientious objection
The right, protected in law, of a registered health practitioner to not participate in any aspect of the voluntary assisted dying process due to personal beliefs, values, or moral concerns.
Consulting practitioner
The second doctor who completes the consulting assessment for the person requesting voluntary assisted dying, independent of the first doctor (known as the coordinating practitioner). In some states (Vic and SA), the consulting practitioner must be a specialist in the illness from which the person is expected to die.
Contact person
A person 18 years or older, who is nominated by the person seeking VAD, to:
- receive the voluntary assisted dying substance from the state-wide pharmacy (if self-administration)
- supply the substance to the person and, in some states, assist with the preparation and mixing of the substance
- return any unused substance, usually to the dispensing pharmacist, for disposal
- inform the coordinating practitioner if the person dies either through self-administration of the substance or from some other cause within a stipulated time frame.
D
Decision making capacity
A person has decision-making capacity in relation to voluntary assisted dying if they can: comprehend and retain the information needed to make the decision, including the consequences of the decision; and use and weigh that information as part of their decision-making process.
Doctor administration
The administration of the voluntary assisted dying substance by an administering practitioner to the person. Also practitioner administration
Death doula
A death doula is a companion or professional advocate who helps a dying person and their family navigate the end-of-life process.
DNR (Do Not Resuscitate)
A medical order to withhold cardiopulmonary resuscitation (CPR) techniques. This can be stipulated in an Advance Care Directive.
E
Eligibility criteria
The list of requirements set out in the voluntary assisted dying law that a person must meet to access voluntary assisted dying. Australia’s VAD laws include strict criteria:
- Have an eligible condition.
- Be aged at least 18 years of age.
- Have decision-making capacity.
- Be acting voluntarily and without coercion.
- Fulfil residency requirements (i.e., be an Australian citizen, permanent resident or ordinarily have lived in the state in question for 12 months before making the ‘first request’. Exemptions to residency requirements may apply in some states).
Euthanasia
The practice of ending the life of a person to limit their suffering. The term voluntary euthanasia is sometimes used interchangeably with voluntary assisted dying. However, the term euthanasia does not accurately capture the process of self-administration for voluntary assisted dying.
F
Final request
The third and final request to the coordinating practitioner for access to voluntary assisted dying. This request must be clear, unambiguous and made by the person themselves.
Final review
The review that the coordinating practitioner (first doctor) completes when they receive a person's final request for voluntary assisted dying. It includes a review of all paperwork and confirms the person has decision-making capacity and is acting voluntarily and without coercion.
First assessment
The initial assessment by the coordinating practitioner to determine if a person is eligible for voluntary assisted dying. If the person is assessed as eligible, they will be referred for a consulting assessment.
First request
The first request made by a person to a medical practitioner for access to voluntary assisted dying. The request must be clear, unambiguous and made by the person themselves.
H
Healthcare professional
A qualified person who works in a medical, nursing or allied health profession.
Health worker
A person who works in a health care setting.
Hospice
A program or place that cares for people who are nearing death and have stopped treatment to cure or control their disease. This care often addresses physical, psychological, social and spiritual needs. See palliative care.
I
Implementation period
In the context of voluntary assisted dying, the time period between the passing of a voluntary assisted dying law and the law becoming available. An implementation period of 12 months or more is often required to establish the systems, procedures and training that support voluntary assisted dying.
Institutional objection
A contested right claimed by individual institutions not to participate in voluntary assisted dying. Rules around institutional participation differ in each state. In most states, institutions have the right to refuse to participate in voluntary assisted dying, however they may still have obligations to their patients. These include arranging the transfer of patients to other facilities and, if patients cannot be transferred, not blocking access to voluntary assisted dying services. See the relevant Department of Health website in your State.
L
Life-limiting condition
A disease, illness or condition that can’t be cured and will likely lead to death.
Life sustaining treatment
A medical treatment that prolongs a person's life. Examples may include: cardiopulmonary resuscitation, artificial hydration and nutrition, artificial ventilation, chemotherapy and in some circumstances, antibiotics and blood transfusions.
M
Medical practitioners
A doctor registered in the medical profession (not a student).
N
Neurodegenerative disease
A condition where the nervous system degenerates, especially the neurons in the brain. Examples include motor neurone disease, Parkinson’s disease, Huntington’s disease, multiple sclerosis, corticobasal degeneration. Also neurological disease
Notification of death
A medical certificate for cause of death issued by the coordinating practitioner and sent to the coroner where the cause of death is listed as the disease, illness or medical condition that was the grounds for the person’s access to voluntary assisted dying.
P
Palliative care
Specialist healthcare focused on improving the quality of life and quality of care for people with a life-limiting illness, as well as families. See also Hospice care
Palliative sedation
A method of sedation for patients close to death that induces a state of reduced or complete unconsciousness to minimise symptoms and suffering that is not responsive to treatment. Also known as Terminal Sedation
Patient-centred care
A philosophy of care grounded in dignity and respect that prioritises the involvement of patients in all decisions about their health and treatment.
Practitioner administration
The administration of the voluntary assisted dying substance by a doctor, or in some states a nurse practitioner or registered nurse, to the person. See also doctor administration.
Prognosis
An opinion, or forecast, based on medical experience, of the likely course of a disease or medical condition.
Progressive illness
A disease, illness or physical ailment that is progressing or getting worse over time.
S
Self administration
The self-administration of the voluntary assisted dying substance by the person accessing voluntary assisted dying.
Substance
In the context of voluntary assisted dying, a substance, or combination of substances, approved for use under the relevant state Voluntary Assisted Dying Acts that when administered will cause a person’s death. The substances are listed in Schedule 4 and Schedule 8 of the Commonwealth Poisons Standard.
Suffering
Conscious endurance of pain or distress.
Statewide Pharmacy Service
The pharmacy service that supplies the voluntary assisted dying substance and provides advice and support to people accessing voluntary assisted dying, their families, carers, and practitioners.
T
Terminal illness
An illness or condition that cannot be cured and is likely to lead to a person's death. See also Life-limiting illness
V
Voluntary Assisted Dying (VAD)
The act of legally administering a substance with the aim of ending a person's life. Also refers to the steps and process related to that administration. See also Assisted Dying
Voluntary Assisted Dying Review Board (or Commission)
The statutory Board or Commission established in each state to monitor the voluntary assisted dying process, ensure compliance with the relevant Voluntary Assisted Dying Act and to recommend safety and quality improvements relating to voluntary assisted dying.
W
Waiting period
The mandatory time period a person must wait after the first request for voluntary assisted dying and the final request. Waiting periods are slightly different in each state and range from 4 to 10 days.
Witness
An eligible adult who observes the third and final request for voluntary assisted dying and, in some states, the administration of the substance by a doctor, nurse practitioner or registered nurse. The witness confirms that the person making the final request or receiving the substance has decision-making capacity and is making the request without pressure or coercion.