Voluntary assisted dying (VAD) was enacted in Queensland on 1st January 2023. VAD allows eligible adults who are dying and suffering intolerably an additional end-of-life choice, allowing them to choose the timing and circumstances of their death. This presentation concerns a brief introduction to the establishment of the VAD system in Queensland, an outline of the VAD process, a summary of VAD activity to date and an overview of on-going challenges.
Planning for governance of VAD began in September 2021 when the VAD ACT was passed. In short measure, an implementation taskforce was established as were a Review Board, a central VAD Unit, committees, an information management system, the Queensland VAD Support and Pharmacy Service, an Authorised Practitioner training system and Hospital and Health Services governance systems.
The demand for VAD has outstripped modelling and is disrupting the provision of quality end-of-life planning and delivery. VAD intersects with advance care planning, palliative care and delivery of hospital, residential aged care and community-based care. By 31st March 2024 there had been 1,749 first assessments, 77% with a cancer diagnosis, 80% known to specialist palliative care services, 85% living at home and 808 VAD deaths in Queensland. Despite the majority of Queensland’s population living in southeast Queensland, 59% of substance deliveries occurred outside metropolitan areas (MM1).
Immediate and on-going challenges for VAD include a steadily increasing demand for VAD coupled with a limited workforce and care impediments due to an antiquated Commonwealth Criminal Code. In addition, clinicians’ personal responses to VAD can impact individuals’ choices for end-of-life care. Finally, limited awareness of VAD can lead to late VAD referrals that require expedited processes which can poorly impact patient, carer and clinician outcomes.
VAD is in a nascent period and on-going research is required to ensure delivery of best practice, integrated VAD services.