Our focus for the coming year (Voluntary Assisted Dying Board Annual Report 2022-23)
Grief and bereavement support
The Review Board has received feedback regarding the limited bereavement services available for families after someone has died on the voluntary assisted dying pathway. This is particularly an issue for the small number of patients accessing voluntary assisted dying who are not receiving palliative care services prior to their death. SA Health has two statewide bereavement projects currently underway. This work will look at bereavement needs across the whole system, and any resources developed will be inclusive of and available to people whose family member has accessed voluntary assisted dying.
Development of a culturally appropriate Aboriginal voluntary assisted dying model of care
Work has commenced on engaging Aboriginal stakeholders to have open conversations regarding death and dying with a particular focus on how to support conversations regarding voluntary assisted dying. SA Health will continue to work with the Aboriginal Health Council of SA (AHCSA) and South Australian Aboriginal Community Controlled Health Organisations (ACCHO) to co-design a voluntary assisted dying model of care. SA Health will work with the Aboriginal Controlled Health sector on access to culturally safe and appropriate voluntary assisted dying, recognising that this is a complex area to work through. This will include building knowledge of voluntary assisted dying and training for Aboriginal Liaison Officers, Aboriginal Health Workers, and ACCHO staff.
Medical practitioner recruitment and sustainment
Medical practitioners play an essential role in ensuring access to voluntary assisted dying in South Australia as the only healthcare professionals able to facilitate access for eligible South Australians to voluntary assisted dying.
To ensure a safe, sustainable, equitable, and accessible voluntary assisted dying pathway in South Australia, a Medical Practitioner Education and Training Strategy is being developed. The Strategy will promote increased medical practitioner registration, training and participation in voluntary assisted dying and outline actions to ensure the sustainment of the existing, invaluable workforce.
Medical practitioners involved in voluntary assisted dying understand their role in supporting people through this significant end of life choice. They respect this by being as flexible and available as possible for those on the voluntary assisted pathway. This can incur significant time and travel to provide care to patients and families.
Participating medical practitioners in the primary care sector have expressed concerns about the limitations of seeking remuneration under the Medicare Benefits Schedule as there are currently no Medicare rebates specifically related to voluntary assisted dying. To further support practitioners, SA Health can provide funding to facilitate regional access for patients through travel and time reimbursement for practitioners where no suitable mechanism exists, for example when a practitioner travels to a rural community to see a patient for a first assessment.
SA Health will continue to advocate with the Federal Government for remuneration for voluntary assisted dying to promote the sustainable provision of voluntary assisted dying in Australia and will consider a local remuneration framework for medical practitioners in the next year.
Improvements to voluntary assisted dying resources
A range of written resources were released prior to the commencement of voluntary assisted dying to support patients, families, medical practitioners, and staff to understand and engage with voluntary assisted dying.
In response to practice and learnings gained from the operation of voluntary assisted dying since it commenced, the following resources are now being updated:
- Knowing your choices: information for people considering voluntary assisted dying patient information booklet (PDF 675 KB) a resource designed to inform consumers of the requirements and law that governs access to the voluntary assisted dying pathway.
- The SA Health Voluntary Assisted Dying Policy which outlines requirements for SA Heath services and staff to comply with the Act appropriately, safely, and effectively.
- Voluntary Assisted Dying Clinical Guidelines: an extensive written resource to support health professionals to understand the voluntary assisted dying pathway and their obligations when providing care and support to people accessing voluntary assisted dying. A number of process improvements are being embedded into the Clinical Guidelines to provide additional guidance.