The Voluntary Assisted Dying Act 2021 (the Act) requires that registered health practitioners do not initiate discussion about voluntary assisted dying or suggest voluntary assisted dying to a patient they provide health or professional care services to. Doing so may constitute unprofessional conduct under the Health Practitioner Regulation National Law (South Australia) Act 2010 which may attract disciplinary action.
There are also restrictions on communications about self-administration over a carriage service such as telephone, fax, email, video conference, internet and the like, which are explained in detail on this page.
Discussion initiated by the patient
Registered health practitioners can only provide information about voluntary assisted dying to a patient at the patient’s request.
Once a patient has requested information about voluntary assisted dying, registered health practitioners can provide relevant information.
An initial discussion about voluntary assisted dying does not begin the voluntary assisted dying pathway or constitute a first request for access to voluntary assisted dying.
A patient may initiate a discussion about voluntary assisted dying with any registered health practitioner involved in their care. They may ask about voluntary assisted dying using a range of words and phrases including:
- “Can you help me die?”
- “How do I get euthanasia in South Australia?”
- “I don't see the point of another couple of months slowly dying. Can you give me a drug to speed things up?”
- “How do I get that medicine to end it all when it gets too much?”
If it is unclear whether the patient is explicitly asking about voluntary assisted dying, clarify what they are asking about before providing information, for example, ask open-ended questions.
In some situations, the patient may have had an initial discussion about voluntary assisted dying with another registered health practitioner. If the patient gave consent for that health practitioner to tell their treating medical practitioner about their discussion and the health practitioner recorded the conversation in the patient’s medical record, then the registered medical practitioner should:
- confirm the conversation was recorded in the patient’s medical record
- tell the patient that the registered health practitioner has informed them about the discussion regarding their end of life choices
- give the patient the opportunity to respond.
Requests for information from someone other than the patient
A person can only access voluntary assisted dying by requesting it personally. They may make the request verbally or by gestures or other means of communication available to them.
Another person, for example a family member, friend or carer can support someone to access voluntary assisted dying, however, they cannot request access to voluntary assisted dying on that person’s behalf.
If someone asks a registered health practitioner for information about voluntary assisted dying on another person’s behalf, health practitioners should tell them:
- where to find more information, for example, how to contact the SA Voluntary Assisted Dying Care Navigator Service (SAVAD-CNS)
- that they cannot request to access voluntary assisted dying on another person’s behalf
- that health and medical practitioners need to talk to the person directly before having any conversation with another person about voluntary assisted dying.
Health practitioners’ choice to participate in a discussion
The Act permits registered health practitioners to choose the extent of their involvement in voluntary assisted dying, taking into consideration if they have a conscientious objection to voluntary assisted dying.
Registered health practitioners who choose not to participate in a discussion about voluntary assisted dying are encouraged to be aware of their professional obligation not to impede or obstruct access to a health service.
If a registered health practitioner chooses not to participate in a discussion about voluntary assisted dying, it is recommended that they:
- tell the patient where to find more information, for example, how to contact the SA Voluntary Assisted Dying Care Navigator Service (SAVAD-CNS)
- record the conversation and details of the discussion in the patient’s medical record
Restrictions on communicating about self-administration
The Commonwealth Criminal Code Act 1995 contains offences which limit the use of a carriage service to access and transmit suicide-related material. This directly impacts how certain parts of the Voluntary Assisted Dying Pathway can be communicated, specifically, communications about self-administration.
As a general rule, all discussions that provide information relating specifically to the act of administering a voluntary assisted dying medication or provides details or instructions about the act of administering a voluntary assisted dying medication must not be discussed or shared by telephone, fax, email, video conference, internet, and the like.
General information about voluntary assisted dying and associated processes may be communicated via a carriage service ensuring that the information does not advocate, encourage, incite, promote or teach about how to undertake the act of self-administration of a voluntary assisted dying medication.
Good clinical practice should always guide decision making where voluntary assisted dying is concerned, including when deciding if a consultation with a person is best to take place in person or if it can occur via the use of a telehealth option (for example, telephone, video conference etc.).