Voluntary Assisted Dying in the context of end of life care (Voluntary Assisted Dying Board Annual Report 2022-23)

Voluntary assisted dying is a deeply personal choice offered within the broader landscape of end of life care which includes palliative care and grief and bereavement care.

Palliative care is dedicated to alleviating suffering, improving quality of life, and supporting patients and their families through the natural course of a terminal illness.

Palliative care focuses on holistic care, preventing and relieving suffering through the early identification and assessment of physical, emotional, and spiritual symptoms. For many, palliative care is a source of comfort and solace, and supports a dignified death. It neither seeks to shorten or extend life but focuses on optimising the quality of remaining life for the dying person and supporting their families/carers.

Approximately 70 percent of those who applied for voluntary assisted dying during the first 5 months of operation were receiving support from a palliative care service at the time. The Review Board is monitoring access to palliative care for people applying for a voluntary assisted dying permit to ensure the full range of services are available to all.

In addition, the Minister for Health and Wellbeing must report annually to Parliament on the total amount spent by South Australians on palliative care during the previous financial year.

Rather than diminishing the importance of palliative care, the availability of voluntary assisted dying expands the range of options available to individuals, recognising the complexity of human experiences, beliefs, and values. For some, the integration of voluntary assisted dying into the end of life care continuum may provide a sense of security and comfort providing a legislated pathway for individuals to exercise autonomy over their own lives and permitting them to make a profoundly personal decision about when and how they will die.

A person’s request for voluntary assisted dying is an opportunity to explore their individual concerns and can stimulate broader discussions about end of life care, encouraging healthcare providers to offer more comprehensive, patient-centred support. By emphasising shared decision-making and fostering open dialogues between patients, families, and healthcare teams, it is possible to ensure that the spectrum of end of life care options is safe, well-informed, accessible, and responsive to individual needs.

Whilst palliative care is different from voluntary assisted dying, they can sit comfortably together. It is not one or the other. A person requesting voluntary assisted dying does not need to choose one or the other and palliative care can be continued until the death of the patient from voluntary assisted dying with support for family continuing.