Implementing voluntary assisted dying in Victoria, Australia

Abstract

This paper describes the process undertaken to implement voluntary assisted dying (VAD) in Victoria, Australia. While the Bill became law in December 2017, an 18-month implementation period was allocated to anticipate the clinical complexities of how VAD would occur in various settings, requiring an exhaustive process to address the significant changes required of health services.Implementation involved detailed health planning, and the process included a large range of health practitioners and community members, keeping a close eye to the complementarity of the various pieces of work, as well as the many safeguards required.Written from the perspective of those involved in planning the implementation, it is hoped that articulating this Victorian experience will assist others. Implementation is a complex process and takes time; it must be broadly collaborative and reflective, to ensure both health professionals and community members understand the legislative changes, as well as the responses required.

The End of Life Choice Act: A Proposed Implementation and Research Agenda

“…9,16,17 Recommendations from this literature include: establishing working groups led by experts overseen by a dedicated implementation taskforce to ensure alignment across groups; creating models of care that illustrate varying levels of organisational participation in providing AD; step-by-step clinical guidance; mentoring and training for providers; accurate consumer information; a centralised medication service; transparent data and government-funded independent evaluation research; and regular communication and meetings between Ministry and relevant organisations/stakeholders. 1,5,9,14,16,18,19 Designated local contacts from the health services could be established as a productive conduit for information between the Ministry and health services. 9 This could help ensure effective implementation at the coalface and also provide feedback about feasibility of different aspects of the process in practice.…”

“…1,5,9,14,16,18,19 Designated local contacts from the health services could be established as a productive conduit for information between the Ministry and health services. 9 This could help ensure effective implementation at the coalface and also provide feedback about feasibility of different aspects of the process in practice. 9 It is not possible to address all implementation challenges in a single article.…”

“…9 This could help ensure effective implementation at the coalface and also provide feedback about feasibility of different aspects of the process in practice. 9 It is not possible to address all implementation challenges in a single article. However, we address the following key issues that are critical for the implementation of the EoLC Act: training, how to have conversations about AD, conscientious objection, cultural safety and delivery of AD in practice.…”

“…1 There is a need for a consumer and provider information service that provides explanations in plain English and other languages. The Australian state of Victoria funded a "navigator" service 9 (as did Western Australia) as a proactive approach to enable providers and consumers to understand and engage with the statutory process. New Zealand should draw on the experience with the challenges in Victoria 3,5,6,15,24,34 and Canada 18,19,35 to ensure access to legally available AD is not unduly hampered by process which does not materially enhance the safety of the system.…”

“…This article outlines the Act, highlights key implementation issues and identifies priorities for research. Although several Australian jurisdictions designated an 18-month period for implementation, 9 the EoLC Act comes into force just 12 months after announcement of the referendum's result. Thus, the implementation issues and formation of an implementation research agenda are matters of some urgency.…”