Queenslanders embrace voluntary assisted dying - report

In the first six months of voluntary assisted dying in Queensland, 591 people commenced the process and 245 people died from administration of a VAD substance, a new report reveals.

Voluntary Assisted Dying (VAD) was “a significant and historic milestone for Queenslanders, providing further choice to eligible people at the end of their life”, according to a new report detailing the first six months of the law's operation. 

Chair of the independent VAD Review Board Professor Helen Irving made the comments in the Board's first report, covering the period 1 January to 30 June 2023.

Prof Irving acknowledged the dedication of health professionals who were offering VAD services and thanked "those who have shared their experiences over the past six months, including stories about why people have accessed voluntary assisted dying, the relief this end-of-life option has provided them".  

Queensland was the fifth Australian state to pass a VAD law, in September 2021. The first six months of access indicated terminally ill Queenslanders were embracing VAD as a legal end-of-life option.

High complicance

The inaugural report, which was tabled in parliament, showed the law was operating as intended with a high compliance rate. The Board said it had reviewed each completed request for VAD and had not referred any issues regarding noncompliance to any of the referral entities specified in the Act.

However, it said it was aware of an incident that had been separately referred to the coroner, which it declined to discuss while investigations continued.

The statistics

The report showed that from 1 January to 30 June 2023:

• 591 people commenced the process
• 562 people were assessed as eligible
• 338 people were supplied with a voluntary assisted dying substance
• 245 people died from administration of a voluntary assisted dying substance.

The report provided details about who had accessed VAD:

• People were aged between 26-95 and the median age was 73
• 56 per cent of people were male
• 49 per cent of people lived in regional, rural or remote parts of the state
• 78 per cent of people had a cancer diagnosis.

Authorised practitioners

The Board thanked health care professionals who had stepped forward to provide VAD services. These included 155 medical practitioners, 19 nurse practitioners and 144 nurses. However, it acknowledged that the majority of the VAD caseload was managed by a small number of authorised practitioners. The Board would “continue to monitor workforce management”, it said.

Recommendations

As a result of the first six months of operation, the Board made five recommendations:

Sustainability of services. The Board recommended there be a continuous review of how VAD is working in practice to ensure adequate, ongoing funding and resources were available to support the needs of people accessing VAD and practitioners in private and public health services.

“Demand for voluntary assisted dying in Queensland has been significant and is expected to continue to increase as public awareness and acceptance grows,” the Board wrote.

“Authorised practitioners … should be provided with dedicated and funded time to enable provision of voluntary assisted dying services.

“Dedicated funding for provision of voluntary assisted dying services will allow Hospital and Health Services to continue to provide timely, high quality, person-centred voluntary assisted dying services,” it said.

Amendments to the Criminal Code Act 1995 (Cth) to enable carriage services (such as telehealth) to be used for the provision of voluntary assisted dying services.

“Concern around the Commonwealth Criminal Code is impacting the use of telehealth for some steps in the voluntary assisted dying process, including discussion around decisions about how the voluntary assisted dying substance will be administered,” the Board wrote.

“As a result, practitioners or people accessing voluntary assisted dying are required to travel, at times long distances, to be able to access the service without risk of breaching the Commonwealth Criminal Code.

Review of the Medicare Benefits Schedule to include the addition of appropriate item numbers for VAD services to ensure fair remuneration of VAD practitioners.

“As voluntary assisted dying is a lawful medical service across most of Australia, a uniform funding approach would enable equitable remuneration to support a sustainable workforce," the Board said.

Adequate resourcing for research and engagement to inform continuous improvement of voluntary assisted dying.

Increased community and stakeholder engagement to improve awareness of voluntary assisted dying in Queensland with a particular focus on supporting individual choice; equity of access to voluntary assisted dying; and individual and organisational obligations.

Read the full report on the Qld Health website