Voluntary assisted dying statistics 2023-24 (Voluntary Assisted Dying Board Annual Report 2023-24)

Under Section 124 of the Act, the Voluntary Assisted Dying Review Board collects and reports on voluntary assisted dying statistics in South Australia.

Data is collected through the submission of forms and information to the Voluntary Assisted Dying Clinical Portal by Medical Practitioners, Pharmacists, Care Navigators, VAD Liaisons and the Voluntary Assisted Dying Review Board Secretariat at each stage of the 11 step voluntary assisted dying pathway:

  1. Make a first request for voluntary assisted dying
  2. Doctor completes a first assessment
  3. A consulting doctor completes a second assessment
  4. Complete a written declaration to access voluntary assisted dying
  5. Make a final request for voluntary assisted dying
  6. Choose a contact person
  7. Doctor completes a final review
  8. Doctor prescribes substance once permit approved
  9. Arrange supply of substance with pharmacist
  10. Decide to administer substance
  11. Death certification

1. Make a first request for voluntary assisted dying

First requests

The first step in the voluntary assisted dying pathway is to make a first request to a medical practitioner. Between 1 July 2023 and 30 June 2024, a total of 404 people made a valid first request for voluntary assisted dying. Of these, 398 people had their first request accepted by an eligible medical practitioner.


Figure 2 above shows the number of first requests made per month. There was an average of 34 first requests per month in 2023-24, up from 20 per month in 2022-23.

2. Doctor completes a first assessment

Once a person has had their first request accepted by a participating medical practitioner, that practitioner becomes the Coordinating Practitioner for the patient.

The Coordinating Practitioner then undertakes a first assessment to determine whether the person meets the eligibility criteria for voluntary assisted dying as defined under section 26 of the Act.

First assessments

Of the 398 people who had a first request to access voluntary assisted dying accepted in 2023-24, 380 underwent a first assessment.

Reasons for not proceeding from a first request to a first assessment include deciding to withdraw from the pathway or dying prior to the first assessment. Of the 380 people who had a first assessment in 2023-24, 344 were assessed as eligible for voluntary assisted dying after the first assessment.

If a person has been deemed eligible for voluntary assisted dying by their Coordinating Practitioner, the Coordinating Practitioner must refer the patient to another participating practitioner to undertake a consulting assessment. If the second practitioner accepts the referral, they become the Consulting Practitioner.


Figure 3 below shows there was an average of 32 first assessments per month in 2023-24 which is an increase from 22 per month in 2022-23.

3. A consulting doctor completes a second assessment

The Consulting Practitioner must undertake a consulting assessment (which is similar to a first assessment) to determine whether the patient is eligible for voluntary assisted dying. This is because the Act requires that two appropriately qualified and trained medical practitioners separately assess a person’s eligibility for voluntary assisted dying.

Of the 344 people who were assessed as eligible for voluntary assisted dying at a first assessment, 311 people went on to have a consulting assessment.


Figure 4 above shows the number of consulting assessments per month. In 2023-24 there was an average of 26 consulting assessments per month, up from 18 per month in 2022-23

Of these, 307 were assessed as eligible for voluntary assisted dying after the consulting assessment. Reasons for not progressing from a first assessment to a consulting assessment include:

  • dying prior to the consulting assessment
  • withdrawing from the pathway
  • being assessed as ineligible for voluntary assisted dying.

Once a person has been deemed eligible for voluntary assisted dying by both a Coordinating and Consulting Practitioner, the Coordinating Practitioner supports the person to complete the necessary next steps in the pathway in order to be able to apply for a voluntary assisted dying permit. These include steps:

  1. complete a written declaration to access voluntary assisted dying
  2. make a final request for voluntary assisted dying
  3. choose a contact person

7. Doctor completes a final review

Voluntary assisted dying permits

Once a Coordinating Practitioner has completed a final review, they can submit an application for a voluntary assisted dying permit to SA Health.

A permit application can either be for a self-administration permit or for a practitioner administration permit. Under the Act, a person can only apply for a practitioner administration permit if the Coordinating Practitioner is satisfied that the person is physically incapable of self-administration or digestion of the voluntary assisted dying substance.

Of the 277 permit applications submitted by a Coordinating Practitioner to SA Health between 1 July 2023 and 30 June 2024 a total of 250 people were issued with a voluntary assisted dying permit.

Reasons why a person may not be issued with a voluntary assisted dying permit include the person:

  • died prior to the permit being issued
  • withdrew from the pathway
  • was assessed as ineligible for voluntary assisted dying.

It is important to note that in some circumstances a patient may be issued with two permits. For example, a patient may be granted a self-administration permit and later lose the capability to self-administer, requiring them to request a change to a practitioner administration permit. In these instances, the first permit is revoked, and a new permit is issued.

Of the 250 people who were issued with a permit, 229 (92%) people were issued with a self-administration permit and 21 (8%) were issued with a practitioner administration permit.

The number of permit applications per month is shown in Figure 5 below. Over the past 12 months there was an average of 21 permit applications per month, an increase from an average of 15 per month in 2022-23.


Demographics of voluntary assisted dying applicants summary

Of the 380 people who underwent a first assessment for voluntary assisted dying between 1 July 2023 and 30 June 2024:

  • 85% were aged 60 years or older
  • 53% were male and 47% were female
  • 67% lived in metropolitan Adelaide and 33% lived in regional South Australia
  • 69% were born in Australia
  • 80% were currently accessing palliative care
  • 1% identified as Aboriginal or Torres Strait Islander
  • 1% were supported by an interpreter

Patients accessing voluntary assisted dying are geographically spread

Voluntary assisted dying operates across geographical boundaries with medical practitioners supporting patients across SA Health Local Health Network (LHN) catchments.

251 (66 percent) of the 380 patients who had a First Assessment to access voluntary assisted dying between 1 July 2023 and 30 June 2024 lived in metropolitan areas and 129 (34 percent) of all patients who had a First Assessment lived in a regional LHN catchment.

Approximately 20 percent of first assessments provided to patients in regional areas were provided by practitioners located in a metropolitan LHN with some use of telehealth strictly for assessments of eligibility and not in relation to administration of the voluntary assisted dying substance.

Whilst these numbers are beginning to tell a story, the voluntary assisted dying system in South Australia is still emerging and patterns of access will continue to evolve over the coming years as more potential voluntary assisted dying applicants become aware of the scheme.

Metropolitan demographics

Metropolitan demographics
Local Health Network (LHN) Popultation 18+ years (2024) Percentage of popultation 18+ Voluntary assisted dying applicants Percentage of voluntary assisted dying applicants
Central Adelaide LHN 407,735 27 110 29
Northern Adelaide LHN 340,037 23 65 17
Southern Adelaide LHN 308,436 21 76 20

Regional demographics

Regional demographics
LHN Popultation 18+ years (2024) Percentage of popultation 18+ Voluntary assisted dying applicants Percentage of voluntary assisted dying applicants
Barossa Hills Fleurieu LHN 180,084 12 69 18
Yorke and Northern LHN 64,737 4.5 18 5
Riverland Mallee Coorong LHN 60,388 4 13 3
Limestone Coast LHN 55,447 4 11 3
Flinders and Upper North LHN 35,224 2.5 4 1
Eyre and Far North LHN 32,787 2 14 4

Statewide demographics

Metro and regional demographics
Popultation 18+ years (2024) Percentage of popultation 18+ Voluntary assisted dying applicants Percentage of voluntary assisted dying applicants
1,484,875 100 380 100

8. Doctor prescribes substance once permit approved

Once a voluntary assisted dying permit has been issued, the Coordinating Practitioner must submit a prescription for the voluntary assisted dying substance to the SA Voluntary Assisted Dying Pharmacy Service (SAVAD-PS).

9. Arrange supply of substance with pharmacist

In order to take delivery of the substance after the prescription has been sent to the SAVAD-PS, a person who is the subject of a self-administration permit must contact the SAVAD-PS to arrange for a supply visit from the pharmacy team. During the supply visit, the pharmacist provides comprehensive education regarding the storage and administration of the substance, as well as the role of the contact person in returning the locked box and any remaining contents after the person has self-administered. Whilst this education can be confronting, feedback from patients and families affirms the skilled, sensitive and compassionate approach of pharmacists.

In the case of a practitioner administration permit, once the prescription has been sent to the pharmacy the Coordinating Practitioner can contact the pharmacy to arrange for delivery of the practitioner administration kit


Between 1 July 2023 and 30 June 2024, the SAVAD-PS completed 234 visits across South Australia to supply the voluntary assisted dying substance. 95% of these visits were completed within two days of the substance being requested by the patient. Of the 234 kits dispensed, 214 were for self-administration and 20 were for practitioner administration.

Of the 20 practitioner administration kits, 7 were for enteral administration and 13 were for intravenous administration. The number of substance kits supplied per month is shown in figure 6. There was an average of 20 kits supplied per month on 2023-24, this is an increase from an average of 11 per month in 2022-23.

10. Decide to administer substance

Between 1 July 2023 and 30 June 2024, 214 of the 250 people who were issued with a voluntary assisted dying permit died for one of the following reasons:

  • 141 died from self-administration of the voluntary assisted dying substance
  • 15 died from practitioner administration of the voluntary assisted dying substance
  • 58 died without administration of the voluntary assisted dying substance.

Of the 214 people who died who were the subject of a permit, 174 (81%) had advanced progressive cancer as the disease for which they were eligible for voluntary assisted dying and 22 (10%) had a neurodegenerative disease. The others had end stage organ failure of various kinds.

Demographics of people who died on the voluntary assisted dying pathway

Of the 214 people who died who were the subject of a voluntary assisted dying permit between 1 July 2023 and 30 June 2024:

  • 117 (55%) were male and 97 (45%) were female
  • 147 (69%) lived in metropolitan Adelaide and 67 (31%) lived in regional South Australia
  • 189 (88%) were aged over 60 years at the time of their death
  • 141 (66%) were born in Australia
  • 109 (51%) died in a private residence, 76 (36%) died in a public hospital and 22 (10%) died in a residential aged care facility
  • 178 (83%) were receiving a palliative care service while accessing voluntary assisted dying.

11. Death certification

The Registrar of Births Deaths and Marriages notifies the Voluntary Assisted Dying Review Board of all voluntary assisted dying deaths on receipt of a Doctors Certificate of Cause of Death (Certificate).

The Doctors Certificate of Cause of Death allows for the certifying doctor to indicate whether the person who has died was the subject of a voluntary assisted dying permit and, if so record both the manner and cause of death.

In the case of a person who has administered the voluntary assisted dying substance, the manner of death recorded is voluntary assisted dying and the cause of death recorded is the underlying disease, illness, or condition for which the person was eligible for voluntary assisted dying. To uphold the privacy of patients and families, only the cause of death is listed on the official death certificate issued by Births Deaths and Marriages.

For those people who die on the pathway prior to receiving a permit, deaths are recorded on the monthly Births, Deaths and Marriages SA Death list that is provided to the Voluntary Assisted Dying Review Board. This ensures data is kept up to date and supports accurate record keeping.

People who did not complete the voluntary assisted dying pathway

For a range of reasons some people commence but do not continue on the voluntary assisted dying pathway prior to the issue of a permit. Of the 404 people who made a first request for voluntary assisted dying between 1 July 2023 and 30 June 2024, 154 people were not issued with a voluntary assisted dying permit. Reasons for this were:

  • 6 people did not have their first request accepted by the medical practitioner
  • 43 people were assessed as ineligible for voluntary assisted dying at the first or consulting assessment.
  • Of the remaining 87 people who were found eligible:
    • 72 people died from their illness prior to the issue of a permit
    • 11 people became ineligible due to loss of decision making capacity prior to being issued with a permit
    • 4 people withdrew from the pathway prior to the issue of a permit.

How long does the voluntary assisted dying application process take?

Between 1 July 2023 and 30 June 2024, for the 250 people who were issued with a permit, the median number of days between a person making a first request for voluntary assisted dying and being issued with a permit was 18 days with a range from 1.7 to 141 days.

Calendar days between first request and permit outcome 2023-24

  • Minimum: 2 days
  • Median: 18 days
  • Maximum: 142 days

A small number of people are issued with a permit in under 9 days due to their very short prognosis in accordance with the requirements of section 56 of the Act.

The median timeframe is reflective of how long it takes along the pathway to be issued with a voluntary assisted dying permit. Longer timeframes reflect patient preference or in some cases extra time required to undertake assessments to determine eligibility.

Once a person has been issued with a voluntary assisted dying permit, that person has full autonomy and control over the timing of the next steps on the pathway. This means that there can be a significant variability in the time it takes between being issued with a permit and a person making the decision to administer the substance.

For the 156 people who died from administration of the voluntary assisted dying substance, the median number of days between a person being issued with a permit and choosing to administer the voluntary assisted dying substance was 8 days with a range of 0 to 313 days.

Calendar days between permit issued and date of death 2023-24:

  • Minimum: 0 days
  • Median: 8 days
  • Maximum: 313 days.

Medical practitioner involvement in voluntary assisted dying

As of 30 June 2024, a total of 131 medical practitioners were registered to undertake the mandatory practitioner training to support access to voluntary assisted dying. Of those, 73 percent resided in metropolitan Adelaide with the remaining 27 percent in regional South Australia.

Of the 131 practitioners who registered to undertake the mandatory training, 75 (57%) had completed the training by 30 June 2024 becoming eligible to support access to voluntary assisted dying in South Australia. Of those, 73 percent reside in metropolitan Adelaide and 27 percent reside in regional South Australia closely reflecting the distribution of the South Australian population with approximately 30 percent living in regional areas and 70 percent residing in metropolitan Adelaide.

A small number of individual medical practitioners provide the majority of voluntary assisted dying services across South Australia. Of the 75 trained medical practitioners, 57 (74 percent) have provided a voluntary assisted dying service and in the period 1 July 2023 – 30 June 2024, 20 medical practitioners provided 75 percent of all Coordinating Medical Practitioner services.


Medical practitioner roles in voluntary assisted dying

In order to access voluntary assisted dying in South Australia, a person must have their eligibility for voluntary assisted dying assessed by two medical practitioners who have both undertaken the mandatory training. A medical practitioner who has undertaken the mandatory training is eligible to undertake either role. Not all medical practitioners who have completed the mandatory training are actively engaged in providing access to voluntary assisted dying.

For the period 1 July 2023 to 30 June 2024:

  • 43 of the 75 trained medical practitioners accepted a first request from a person seeking access to voluntary assisted dying becoming the Coordinating Practitioner for that person.
  • 51 of the 75 trained medical practitioners accepted a referral from a Coordinating Practitioner to be a Consulting Practitioner.
  • Many practitioners have undertaken both roles for different patients.

Registered practitioners by specialty

Of the 131 medical practitioners who registered to complete the mandatory training to support access to voluntary assisted dying in South Australia by 30 June 2024, 78 are General Practitioners, 12 are Medical Oncologists, 8 are Palliative Medicine specialists and the remaining 41 are from a range of medical specialties including General Medicine, Neurology, Emergency Medicine, Anaesthesia, Psychiatry and Surgery.


Care and support provided to patients on the voluntary assisted dying pathway

Care Navigators and Voluntary Assisted Dying Liaison Nurses are nursing and allied health professionals with experience in complex end of life care. Care Navigators provide support to patients in the community and voluntary assisted dying Liaisons provide support to patients who are in hospital.

Care Navigators and Voluntary Assisted Dying Liaison Nurses are available to provide individualised support to each person on the voluntary assisted dying pathway including:

  • responding to requests for information about voluntary assisted dying
  • linking patients with voluntary assisted dying medical practitioners
  • support to organise interpreters
  • support to book appointments
  • referring patients to palliative care and other service
  • supporting patients at appointments for voluntary assisted dying
  • support related to administration of the voluntary assisted dying substance
  • declaring life extinct
  • bereavement support and support after death
  • providing assistance and support for family and loved ones.

Feedback received from patients and families highlights the essential role and the importance of the support provided by Care Navigators and voluntary assisted dying Liaison Nurse Consultants.

The voluntary assisted dying application process

Each application for voluntary assisted dying requires the submission of a range of prescribed forms to the Voluntary Assisted Dying Clinical Portal by medical practitioners and pharmacists. Some of these forms must be submitted within a specified timeframe after being completed as prescribed by the Act. Forms include:

  • First Request form
  • First assessment report form (within 7 days)
  • consulting assessment report form (within 7 days)
  • written declaration
  • contact person appointment form
  • final review form (within 7 days)
  • substance dispensing form (within 7 days)
  • practitioner administration form (within 7 days)
  • substance disposal form (within 7 days).

Forms submitted to the Voluntary Assisted Dying Clinical Portal 1 July 2023 to 30 June 2024

Of the 1,417 forms submitted to the Voluntary Assisted Dying Clinical Portal that are required to be submitted with 7 days, 99.2 percent were submitted within the legislated timeframes.


Applications for review of a reviewable decision by the South Australian Civil and Administrative Tribunal (SACAT)

If a person seeking access to voluntary assisted dying is deemed ineligible by the Coordinating or Consulting Practitioner, they can make an application for review of a reviewable decision to SACAT. Reviewable decisions include whether the person:

  • is or is not ordinarily resident in South Australia
  • was or was not ordinarily resident in South Australia for at least 12 months prior to making the first request
  • does or does not have decision-making capacity in relation to voluntary assisted dying.

During 2023-24 there was one application made to SACAT for review of a reviewable decision.

The application was for eligibility on the basis of residency as the person was not ordinarily resident in SA for 12 months at the time of the first request. This application was withdrawn prior to a decision by SACAT, and the patient recommenced the voluntary assisted dying application process a few weeks later once they had been resident in South Australia for 12 months.

In addition, SA Health clinicians and SACAT worked closely regarding decision making capacity for a person who had already received a voluntary assisted dying permit and who had an application with SACAT for another matter. This person was found to have decision making capacity in relation to voluntary assisted dying.

Compliance with the VAD Act 2021

Between 1 July 2023 and 30 June 2024, the Review Board undertook a detailed review of 307 voluntary assisted dying episodes for compliance with the Act. There were 23 episodes of non-compliance, all related to administrative and technical issues that did not affect the clinical care of the patient or the voluntary assisted dying pathway for the patient.

Late submission of forms

The late submission of forms to the Voluntary Assisted Dying Clinical Portal did not result in any issues regarding a person’s eligibility or any risks to the applicant or any other person.

Resupply of expired voluntary assisted dying substance

Dispensed voluntary assisted dying substance was initially marked with an expiry date of 12 months or less, depending on the date of dispensing, resulting in some patients receiving a substance with a shorter expiry date. There have been 7 instances whereby the voluntary assisted dying substance supplied to the patient had reached its expiry date and was resupplied by the South Australian Voluntary Assisted Dying Pharmacy Service (SAVAD-PS). In each of these instances the expired substance was returned to the SAVAD-PS and disposed of in a safe and timely manner.

To ensure compliance with the Act, the replacement of an expired substance now results in the cancellation of the permit and an application for a new permit prior to resupply. All dispensed voluntary assisted dying substance is now marked with the manufacturer’s expiry date with 12 months or longer until expiry.

When a technical or administrative non-compliance is identified such as those identified above, the Review Board provides information to the relevant persons to support future compliance.

Referral to other agencies

During this reporting period, the Voluntary Assisted Dying Review Board referred one matter to Australian Health Practitioner Regulation Agency (Ahpra). This matter did not require further investigation, and no further action was taken. There were no matters referred to the Commissioner of Police or the State Coroner.