From 28 November 2023, a terminally ill person in New South Wales has the legal right to ask a doctor for help to die, making NSW the last Australian state to introduce a Voluntary Assisted Dying (VAD) Act.
Victoria was the first in 2017, followed by Western Australia in 2019, then Tasmania, South Australia, and Queensland in 2021.
As in the other States, the eligibility rules in NSW are quite stringent.
To access the VAD Act, you must have a terminal medical condition likely to cause death within six months (or 12 months if you have a neurodegenerative disease such as motor neurone).
You must be suffering in a way you consider intolerable; you must be acting voluntarily, without coercion; and you must be mentally competent, able to understand and make decisions.
Having a disability or a mental illness is not sufficient on their own to make you eligible; you must also have a terminal illness.
The process is not simple and can take weeks. Safeguards are designed to prevent abuse and to ensure your request to die is well-considered.
You have to be assessed as eligible by two independent doctors and they may refer you to a specialist, or perhaps a psychiatrist.
A VAD Board supervises each step in the process. If it agrees that all requirements have been met, it will issue an authority for you to acquire the lethal medication that you need.
A pharmacist dispenses the medication directly to you or your agent, and it is stored in your home in a locked box.
You then decide if you want to self-administer the medication or have a doctor do it for you, and you take it when you choose to.
Some health practitioners may not participate in VAD services because of a conscientious objection, and others may decline for other reasons.
Some faith-based hospitals and aged care facilities may also decline to participate.
Reports so far on the implementation of VAD legislation are positive.
Relatives and carers have valued the fact that their loved ones had control over the end of their life, and that their death was quick, painless, and dignified.
Slightly more men than women have accessed VAD; the median age has been 74; most had cancer; and most were receiving palliative care. A significant proportion lived in regional or rural areas.
In every State, the number of deaths has been considerably less than the number of requests, and the number of deaths has been between 0.5% and 1% of total deaths. In NSW, 1% of total deaths would number about 600.
The NSW Department of Health has spent the past 18 months preparing for the introduction of the legislation.
Among other things, it is establishing a Care Navigator Service to help you find a doctor and manage the process. Its phone number is 1300 802 133.
There will be a VAD coordinator in each of the 15 Local Health Districts in NSW, and the department has also employed a number of visiting medical officers to deliver VAD to patients who have no other access to a VAD provider. Those doctors will be available to travel to regional and remote areas.
There is also a government program that may provide financial help towards travel and accommodation costs when a patient needs to travel long distances for treatment that is not available locally.
If you are considering voluntary assisted dying or if you are a family member, friend or carer of someone who is considering it, please start to talk to them about end-of-life wishes.
A doctor may initiate a talk with you specifically about VAD as part of a discussion about general options for end-of-life care, and their likely outcomes.
These options would include treatments for your medical condition, and palliative care.
For detailed information on all aspects of voluntary assisted dying in NSW, visit this website.
The national Health Direct site has information on VAD here.