Voluntary assisted dying guidance for health services

Health services should have voluntary assisted dying policies and processes

Health services can decide whether or how they will support access to voluntary assisted dying. This depends on whether:

• they have staff with appropriate skills and expertise
• they have the capacity to support the process
• supporting access to voluntary assisted dying aligns with the values of the health service.

Health services should have patient-centred policies and processes for managing requests for voluntary assisted dying. All staff should be aware of and be able to access information about the health service’s position on voluntary assisted dying.

Health services are expected to have a process in place to support staff to respond to a person's request for information about voluntary assisted dying.

Policies and processes should provide clinical support and guidance to all health practitioners, even if the health service does not support access to some or all voluntary assisted dying services.

A health service's capacity to support access to voluntary assisted dying can change as staff move in and out of the health service or additional staff complete voluntary assisted dying training.

Responding to patients who ask about or for voluntary assisted dying

Patients should have access to information

All patients should be able to access information about the health service's position on voluntary assisted dying.

A patient who asks for information about, or access to, voluntary assisted dying should be provided with information and support.

Health services should have staff members who can respond to patient enquiries about voluntary assisted dying. These staff members may provide information about the Statewide Care Navigator Service or may refer patients to appropriate service providers within or external to the health service.

Patients need to know if their health service cannot provide information or assist them

A health service should tell the patient as soon as possible if they cannot support access to voluntary assisted dying and refer them to the Statewide Care Navigator Service for assistance. They should not obstruct or unnecessarily delay a patient's access to voluntary assisted dying.

Health services should continue to provide necessary healthcare and support to a patient who has asked for information about or is accessing voluntary assisted dying, even if the health service does not support access to voluntary assisted dying.

Support for staff members

Health practitioners are not required to support access to voluntary assisted dying. Some may conscientiously object to some or all aspects of voluntary assisted dying.

Health services should support all staff and promote a culture of mutual respect. This includes respecting a health practitioner's right to conscientiously object.

Health services should support staff to:

• access professional supports such as clinical supervision, debriefing and peer support networks, and voluntary assisted dying specific supports such as pre-briefing and debriefing.
• contact an Employee Assistance Program, professional association or similar support services if discussing voluntary assisted dying raises wellbeing concerns.

Managing voluntary assisted dying substance

A patient may be admitted with voluntary assisted dying substance or may want to have their substance delivered while they are an inpatient.

Health services should be prepared to respond to the patient's request in line with the health service's policies and processes.

All staff should be aware of or be able to access information about the health service's position on a patient receiving, storing or taking a voluntary assisted dying substance in the health service.

Review voluntary assisted dying policies, processes and capacity regularly

Health services should review voluntary assisted dying policies, processes and capacity every two years or following any significant changes to its workforce.

When reviewing voluntary assisted dying policies, processes and capacity, health services should consider:

• patient and family feedback
• staff views
• whether their staff are willing to support access to voluntary assisted dying
• whether their staff have appropriate and necessary skills, expertise and training.

Supports for staff should also be reviewed and confirmed.

Medical practitioners must complete voluntary assisted dying training before they can assess a patient's eligibility for voluntary assisted dying. The Statewide Care Navigator Service hold group sessions throughout the year or medical practitioners can complete the training independently. Health services should consider how they can support medical practitioners to complete this training.

Voluntary Assisted Dying Statewide Care Navigator Service

Care navigators work closely with patients, their carers, family and friends, medical practitioners and healthcare teams to provide support, information and education. For example, they may assist with identifying appropriate service referral pathways and connecting people to health practitioners and services that best meet their specific needs and goals of care.

Care navigators provide education to health services and health practitioners on voluntary assisted dying. They can also run medical practitioner training days for health services.

The care navigator service is based at the Peter MacCallum Cancer Centre and care navigators are integrated into Victoria's regional health services.

For more information, see Statewide Care Navigator Service.

Voluntary Assisted Dying Statewide Pharmacy Service

The Statewide Pharmacy Service provides and delivers voluntary assisted dying substances to people who have been prescribed the voluntary assisted dying substance.

The Voluntary Assisted Dying Statewide Pharmacy Service:

• Liaises with the co-ordinating medical practitioner.
• Communicates with the patient.
• Dispenses the prescription.
• Provides the substance to the patient.

The Statewide Pharmacy Service becomes involved after the Secretary of the Department of Health approves a permit and the co-ordinating medical practitioner has given the prescription to the service.

To have a prescription dispensed

1. The patient's co-ordinating medical practitioner provides a prescription to the Statewide Pharmacy Service.
2. The patient, or medical practitioner, indicates a date for the Statewide Pharmacy Service to provide the voluntary assisted dying substance.
3. The Statewide Pharmacy Service visits the patient anywhere in Victoria to deliver the substance and provide information about the voluntary assisted dying substance.

A patient can choose to have other people with them when the pharmacist visits to provide the substance.

For admitted patients, the Statewide Pharmacy Service will talk to the co-ordinating medical practitioner. The co-ordinating medical practitioner is responsible for providing information to relevant health professionals caring for a patient who has been admitted to a health service.

Phone: (03) 9076 5270
Email: statewidepharmacy@alfred.org.au