Voluntary Assisted Dying in Australia and the Road Ahead

The choices are changing

Voluntary assisted dying (VAD) has become one of the most significant changes in Australian healthcare in recent years. It touches not only on medical ethics and legal systems, but on deeply personal experiences of dignity, suffering and control at the end of life. With all six Australian states now implementing VAD laws and the territories not far behind we’re witnessing a quiet shift in how we approach dying. For many people, it’s about having a say in how they go when faced with terminal illness. For doctors, it’s about navigating a complex and emotional space with professionalism and care.

A quiet transformation

Not long ago, VAD was a topic that sparked heated debate, and was only spoken about behind closed doors. Today, it’s part of the medico-legal landscape across Australia. Victoria was the first to introduce it in 2019, with Western Australia, Tasmania, South Australia, Queensland and New South Wales following in quick succession. The Australian Capital Territory passed legislation in 2024, and the Northern Territory is now considering its own version.

Public support has grown steadily. A 2023 Roy Morgan poll found that 85 per cent of Australians back VAD laws under strict safeguards. But legalisation alone doesn’t guarantee access. If you live in a capital city, support may be available, but for those in rural or remote areas, limited services, institutional objections or restrictions on telehealth make VAD difficult to access.

The AMA’s position

The Australian Medical Association (AMA) updated its position on VAD in 2025. It doesn’t take a side for or against, but instead acknowledges the diversity of views within the medical profession. The AMA supports doctors whether they choose to be involved in VAD or not. The focus is on respecting decisions, protecting ethical integrity and ensuring patients are not left without options. The statement provides a framework for ethical practice while also reinforcing that participation should always be voluntary for both doctors and patients. It’s a realistic and mature approach, one that accepts the complexity of this space while emphasising compassion and communication. 

One of the strongest messages in the AMA’s position is that VAD must not come at the expense of palliative care. Palliative care helps people with life-limiting illnesses live with the highest quality of life possible. It focuses on easing suffering and supporting emotional, social and spiritual needs. For the vast majority of people at the end of life, this is the care they will receive and value. But there are cases where even the best palliative care can’t relieve a person’s suffering or sense of loss. In those moments, VAD can provide an additional option. The AMA is clear that no one should feel pushed toward VAD because they couldn’t get access to proper palliative care.

The reality, though, is that access to palliative services is patchy. As Palliative Care Australia reports, more than 80 per cent of people who could benefit from it aren’t receiving it. This gap needs urgent attention.

Balancing ethics

VAD is not a simple issue. Doctors carry personal and professional values into every decision they make. Some feel they can support patients through the VAD process, whilst others can’t. The AMA defends that choice but also expects doctors to communicate clearly and respectfully with patients who ask about VAD. Doctors who don’t provide VAD must still let patients know they have the right to seek it elsewhere. That balance of professional respect and patient rights is at the heart of the AMA’s guidance.

It’s also important to acknowledge the emotional toll VAD can have on doctors and nurses. The AMA is pushing for better access to counselling, professional debriefing and support services for staff involved in this work.

Access barriers

One of the biggest challenges now is making sure VAD is available equally across the country. Right now, laws vary by state, which creates confusion and barriers for patients, especially in cross-border areas. Some states allow telehealth for VAD consultations, but federal laws still restrict this in others. That means patients in regional or remote areas might have to travel long distances just to begin the process. For people who are seriously unwell, that’s not realistic.

The AMA is clear that it wants to see national consistency in VAD laws, guidelines and access. This includes proper funding for trained staff, information services and VAD care navigators who can help patients and families understand their options.

Education also plays a key role, and many Australians still don’t know what VAD actually involves or how it works alongside palliative care. The AMA is calling for better public awareness and culturally appropriate resources so people can make informed choices, whatever their background.

End of Life Law for Clinicians course (ELLC)

Understandably, many clinicians are seeking clear, accessible information to guide their practice. Knowing the legal, ethical and cultural frameworks around end-of-life care is essential, not just for those directly involved in VAD, but for all healthcare providers supporting patients in their final stages of life.

One valuable resource available to clinicians is the End of Life Law for Clinicians (ELLC) course, provided by Palliative Care and Education Training Collaborative, an Australian group providing national education to all health care professionals in the space. This free, online program is designed for doctors, nurses, allied health professionals and students. It takes approximately 11 hours to complete and can be done at your own pace, making it both flexible and accessible for busy professionals.

The course includes 13 modules covering a wide range of topics relevant to end-of-life care. These include the legal principles of capacity and consent, how to approach advance care planning and directives, and the legal protections involved in administering pain and symptom relief. It also explores complex situations such as withholding or withdrawing life-sustaining treatment, managing conflict between parties, and the legal considerations around what constitutes futile or non-beneficial treatment.

Importantly, the program dedicates content to voluntary assisted dying, outlining the current laws and how they operate across different jurisdictions. It also addresses more nuanced areas of care, including end-of-life decision-making for children, the perspectives and rights of Aboriginal and Torres Strait Islander peoples, and inclusive care for diverse populations.

For clinicians who may feel uncertain about how to approach VAD discussions, or who want to strengthen their overall understanding of the legal landscape around dying, the ELLC course offers a practical and relevant starting point. It can be accessed via the link here – https://app.medcpd.com/courses/3425